Lupus

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What is lupus?

Lupus is a chronic disease that can have a serious and widespread effect on the body including the skin, joints, muscles, and other organs. However, in many cases, lupus is a mild disease that can be successfully controlled with regular medical care. About 1.5 million Americans have lupus, and about 90 percent of people with lupus are women, according to the Lupus Foundation of America (Source: LFA).

Lupus is an autoimmune disease. Normally, your immune system can tell the difference between your own tissues and foreign invaders, such as bacteria or viruses. The immune system produces antibodies that target bacteria, viruses, and other abnormal substances for destruction. But in an autoimmune disease, the body’s immune system mistakes healthy tissues and organs as dangerous invaders in the body and attacks them. This results in chronic inflammation that can eventually damage and destroy the affected tissues and organs.

There are four types of lupus. They include:

  • Discoid lupus erythematosus affects the skin. Discoid lupus is also known as cutaneous lupus.

  • Drug-induced lupus erythematosus occurs as a side effect of some drugs, such as beta blockers, which are commonly used to treat heart disease and hypertension.

  • Neonatal lupus erythematosus is a rare form of lupus in newborn babies whose mothers have lupus, which can cause problems at birth or a serious heart defect in rare cases.

  • Systemic lupus erythematosus causes inflammation in multiple organs and body systems.

The onset of lupus often occurs in young adulthood through middle age. Common lupus symptoms include joint pain; extreme fatigue; headaches; swelling of the legs, feet, hands and face; hair loss; and a butterfly-shaped rash across the bridge of the nose. However, in many cases, lupus is a mild disease characterized by periodic episodes of some of these symptoms. Seeking regular medical care and following your treatment plan may help reduce the risk of serious complications of lupus.

In some cases, lupus can progress further and result in serious, even fatal complications, such as heart disease, infections, and kidney failure. Seek immediate medical care (call 911) if you have symptoms of complications of lupus, such as trouble breathing, swelling of the legs, decreased urine output, chest pain, high fever, or a change in alertness or consciousness.

What are the symptoms of lupus?

Symptoms of lupus are the result of tissue inflammation throughout various parts of the body. The type and severity of symptoms vary between individuals and the type of lupus. However, lupus generally occurs as periodic attacks of symptoms. These symptom flare-ups are followed by periods of time in which symptoms improve.

At the onset of the disease, the symptoms of lupus can be mild and vague. The classic butterfly-shaped rash on the face may not occur in all people with lupus.

Symptoms of lupus include:

  • Butterfly-shaped skin rash over the cheeks and nose and other skin rashes from sun exposure
  • Fever
  • Hair loss
  • Headaches
  • Inflammation of the lungs and chest pain when breathing deeply
  • Lesions or sores in the mouth or nose
  • Photosensitivity

Symptoms that might indicate a serious or life-threatening condition

Complications of lupus can be serious and life threatening in some cases. Complications include damage to the brain and nervous system, digestive tract, kidneys, heart, and lungs. Seek immediate medical care (call 911) if you have any of the following symptoms:

What causes lupus?

Lupus is an autoimmune disease. In an autoimmune disease, the body’s immune system mistakes healthy tissues and organs as dangerous invaders in the body and attacks them. This results in inflammation that can eventually damage and destroy the affected tissues and organs. What causes this autoimmune response in the body is not known, but it is thought that lupus is triggered by various environmental factors and possibly a genetic predisposition for developing an autoimmune disorder. In some cases, an individual who develops lupus has a relative with lupus or another autoimmune disease.

What are the risk factors for lupus?

A number of factors are linked to an increased risk of developing lupus. Not all people with risk factors will develop lupus. Risk factors for lupus include:

  • Family history of lupus

  • Female gender between ages 15 and 44

  • Hispanic, American Indian, Pacific Islander, or African American descent

  • Use of beta blockers, which are commonly used to treat heart disease and hypertension

How is lupus treated?

There is no cure for lupus. However, it is a myth that lupus is commonly a fatal disease. With early recognition, regular medical care, and good patient compliance with a treatment plan, it is possible for most people with lupus to live a normal life.

Lupus treatment plans use a multifaceted approach that is individualized to the type and severity of lupus, and your age, medical history, and coexisting diseases and conditions. Treatment includes medications, lifestyle changes, diet, and avoiding exposure to the sun. People with lupus can be very sensitive to the sun, and sun exposure can trigger flare-ups of symptoms including skin rashes.

Medications for lupus

The goal of medication therapy is to relieve pain, reduce inflammation, and suppress the abnormal response of the immune system. Medications include:

  • Acetaminophen (Tylenol), which reduces pain but has no anti-inflammatory effects

  • Anticoagulants, which thin the blood and reduce the risk of developing serious blood clots

  • Antimalarial drugs, which can treat joint pain and inflammation as well as rashes and mouth sores

  • Aspirin, which is very effective in treating the pain and inflammation caused by lupus. Aspirin also thins the blood and reduces the risk of developing serious blood clots. However, aspirin use should be closely monitored because it can cause serious side effects, such as bleeding gastrointestinal ulcers.

  • Corticosteroids, such as prednisone, which reduce the inflammation caused by lupus. Long-term corticosteroid use has the potential for serious side effects. People taking corticosteroids should not stop taking them suddenly and should immediately report any side effects to their health care provider.

  • Immunosuppressive medications, which suppress an overactive immune system but can increase the risk of developing infections

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil and Motrin), naproxen (Naprosyn and Aleve), and indomethacin (Indocin), which are very effective in treating the pain and inflammation caused by lupus. However, long-term use of NSAIDs can cause serious side effects, such as bleeding gastrointestinal ulcers and possible heart problems and cardiovascular events.

Other treatments and therapies for lupus

A variety of additional treatments and therapies may be recommended for lupus including complementary therapies. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for full medical care.

Other treatments and therapies for lupus may include:

  • Acupuncture to help relieve joint pain

  • Avoiding exposure to the sun

  • Meditation and biofeedback to help relieve stress and pain

  • Using sunscreen, wearing a hat, and covering bare skin while in the sun

What are the possible complications of lupus?

You can best minimize life-threatening complications of lupus by following your treatment plan and seeing your health care provider as recommended. Complications of lupus can be serious and affect almost any organ in the body. Complications include:

  • Arthritis

  • Bleeding

  • Blood clots

  • Central nervous system damage and stroke

  • Frequent infections

  • Kidney damage and kidney failure

  • Liver damage

  • Pleurisy (inflammation of the lungs)

  • Seizures

  • Vasculitis (inflammation of the blood vessels that can lead to decreased blood flow to major organs, and such conditions as atherosclerosis and heart attack)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 27
  1. Lupus. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/lupus.html
  2. Lupus. National Institute of Arthritis and Musculoskeletal Diseases. http://www.niams.nih.gov/Health_Info/Lupus/default.asp
  3. Understanding Lupus. Lupus Foundation of America. http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding.aspx?articleid=2231&...
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