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The Diverse Forms of Lupus

Updated on June 12, 2015

Abstract

This paper is going to delve into the world of Lupus through research of online articles and periodicals. Lupus is a disease with many several different forms. Each form of Lupus varies differently in it effects on the body. While there is no cure for Lupus there are treatment options available for those affected.

Keywords: Lupus, Systemic lupus erythematosus or SLE, Cutaneous lupus erythematosus, Drug-induced lupus and Neonatal lupus.


Lupus in the broad aspect is a chronic autoimmune disease. Depending on the form of the disease it can damage many parts of the body such as skin, joint or some organs. Lupus is categorized by the body’s immune system beginning to attack its own tissues and organs. Unfortunately Lupus can be hard to diagnose due to its signs and symptoms mirroring those of other illnesses. (Mayoclinic) One telltale sign is a butterfly rash on the cheeks that appears to be butterfly wings unfolded. However not all those with Lupus get this distinctive rash.

The prevalence of lupus is abundant. Lupus affects 1 out of every 200 Americans. That adds up to 1.5 million Americans being affected by the disease. It is estimated that each year 16,000 Americans develop Lupus. (cure4lupus) The statistics of Lupus also show that 90 percent of those affected by the disease are women. In America thousands of people die from Lupus each year. The survival rate has increased since the 1950s when only 50 percent of patients diagnosed lived 4 years. Now 80-90 percent of patients are surviving 10 or more years after being diagnoses. Almost 37% of SLE deaths are people aged between 15 and 44. Women are five times as likely to die from Lupus than men. Lupus deaths are three times higher for blacks than whites.

With a disease like Lupus it really differs so much from patient to patient. Lupus is not so much of a constant disease but instead one that the symptoms tend to come and go. When dealing with Lupus the disease flares and the symptoms will get worse and then there will be a period of remission where the symptoms improve. Some of the most commons signs are joint pain and stiffness that can be accompanied with or without swelling, muscle aches, pains or weakness, unexplained fever, fatigue, butterfly-shaped rash across the nose and cheeks or other skin rashes, unexplained weight loss or gain, anemia, trouble with concentration, memory or confusion, chest pain when breathing deep, photosensitivity, hair loss and purple or pale fingers or toes. Some of the less common symptoms can be blood clots, seizures, sores in the mouth and nose, severe headache, dizzy spells, not able to judge reality, sadness, strokes, and dry or irritated eyes. (womenshealth.gov)

Even with all the technology we have Lupus can still be very hard to diagnose and is very often misdiagnosed as other diseases. People with Lupus often have it for a while before they are diagnosed with it. There is no single test that can diagnose Lupus but instead it is a serious of things the doctor. The doctor will start by looking into the patient’s medical history to get a better understanding of the situation. Family history of Lupus or any other autoimmune disease is important to the doctor. The doctor will do a complete physical exam to look for any signs or symptoms, such as rash. The antinuclear antibody (ANA) test can show if the immune system is more likely to make autoantibodies of Lupus. Most people with Lupus do test positive for ANA but a positive test does not mean you have Lupus. The doctor may also get a skin or kidney biopsy to look for any signs of autoimmune disease. All of this information together can help provide the doctor the tools he needs to make the correct diagnosis.

There are several different types of lupus. Systemic lupus erythematosus or SLE is the most common and accounts for about 70 percent of all cases. Cutaneous lupus erythematosus can be broken down into two sub categories, Discoid lupus erythematosus and Subacute Cutaneous lupus erythematosus, which accounts for about 10 percent of Lupus cases. Drug-induced lupus usually resolves after the patients stops taking the medicine. Neonatal lupus is the most rare of all the Lupus cases.

Systemic lupus erythematosus or SLE can vary greatly in its symptoms and affects on the body. SLE ranges from mild to severe. The symptoms can include fatigue, hair loss, photosensitivity, swollen and painful joints, skin rashes, kidney problems and unexplained fevers. Doctors usually use a combination of physical symptoms and laboratory results to verify SLE.

Cutaneous lupus erythematosus is can be just skin or part of SLE. The “symptoms include rashes or lesions, hair loss, swelling of the blood vessels, ulcers and photosensitivity.” The doctor will remove a piece of the rash and view it under a microscope to tell if it is skin lupus. Cutaneous lupus erythematosus is broken down into two major kinds Discoid lupus erythematosus and Subacute cutaneous lupus erythematosus.

Discoid lupus erythematosus, or DLE, mainly affects the skin. Discoid usually begins with a rash that is red and raised that will eventually become scaly and brown. Usually this rash appears on the face and scalp. Many people experience scarring with DLE. To test a doctor will remove a piece of the rash and look at it under a microscope. While DLE starts with the skin there is a small chance that the patient will later get SLE. (womenshealth.gov)

Subacute cutaneous lupus erythematosus is considered a skin Lupus. It causes skin lesions on the body after exposure to the sun. These lesions do not usually cause scars. Almost 50 percent of people with this form of Lupus will also have SLE.

Drug-induced lupus is a form of lupus that is trigged by certain medicines. The symptoms can be joint pain, muscle pain, and fever but are usually mild. While the symptoms are similar to those of Systemic lupus the difference is usually the disease goes away once the medicine is stopped and rarely affect any major organs.

Neonatal lupus is an extremely rare condition in infants. Certain antibodies in mothers who have lupus cause it. It is still possible for an infant to have Neonatal lupus even if the mother is healthy. In these cases the mother usually develops lupus later in life. Infants with this form of Lupus may have a skin rash, liver problems, or low blood cell counts. Usually the symptoms completely disappear within a few months and have no long-term effects. There rarely are serious effects such as heart defects but most infants born to mothers with lupus are healthy.

While a lot of information is known about Lupus what causes it is still unknown. Sometimes it seems to be hereditary and run in family. Other times environmental factors seems to be the trigger such as sunlight and certain drugs. Researchers are working hard to find out why people get Lupus. While there is no cure most cases can be managed. (niams.nig.gov)

Unfortunately there is no cure yet for Lupus. While there are treatments available there has been no new treatments approved by the FDA for Lupus in over 50 years. However thankfully they do have treatment options available for those suffering from Lupus. The treatment options will depend on each individual case as it depends on the symptoms and needs of the patient. All treatment plans are working to prevent flare-ups and to treat symptoms that may occur. Most importantly treatment plans need to reduce damage done to organs. Most treatment plans include several steps that involve medicine and lifestyle changes to help the patient deal with their Lupus. Drugs play a very important part in the treatment of Lupus. Often the drugs change during treatment. There are a few commonly used medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain and swelling in joint and muscles. Corticosteroids are used to reduce swelling, tenderness, and pain in certain parts of the body. Antimalarial drugs are used in Lupus patients to treat joint pain, skin rashes, fatigue, and inflammation of the lungs. BLyS-specific inhibitors are used to block the action of a certain protein that is important in the body’s immune response. Immunosuppressive agents/ chemotherapy is also used in more severe cases of Lupus. The downside is most of these medicines are side effect and some can only be used for short periods of time intermittently. (womenshealth.gov) In order to get the right treatment plan the doctor and patient will have to review all the symptoms and decided on a plan of treatment. Doctor, Patient communication is a big part of the success of any treatment plan.

Most forms of Lupus are a lifelong disease and so patients have to learn to ways to cope with it. Along with working with their doctor on a treatment plan it is important for Lupus patients to make many lifestyle changes to help keep Lupus flare-ups down. Those with Lupus have to learn how to read their body and take very good care of themselves. Having a good support network can help out tremendously. Living with Lupus can be hard but it can be done with the right tools to cope. Patients need to learn about Lupus, have open communication with their doctor, get support, reduce stress and pace their selves.


References

Mayo Clinic Staff. (2011). Lupus. MayoClinic. Retrieved October 5, 2013. http://www.mayoclinic.com/health/lupus/DS00115.

Diamond, Betty. (2011). Lupus Fact Sheet. WomensHealth. Retrieved October 5, 2013. http://www.womenshealth.gov/publications/our-publications/fact-sheet/lupus.cfm#i.

Lupus Statistics. Cure 4 Lupus. Retrieved date October 5, 2013. http://cure4lupus.org/store/index.php?main_page=page&id=152&chapter=2.

Eustice, Carol. (2012). Lupus – 10 Things You Should Know. About. Retrieved October 5, 2013. http://arthritis.about.com/od/lupus/a/lupus_facts.htm.

Shiel, William C. (2012). Do I Have Lupus? National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved October 5, 2013. http://www.niams.nih.gov/Health_Info/Lupus/do_i_have_lupus.asp.

Camacho, Ivan. (2012). Drug-Induced Lupus Erythematosus. MedScape. Retrieved October 5, 2013. http://emedicine.medscape.com/article/1065086-overview.

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