Lupus is a disease in which the immune system mistakenly attacks healthy tissues and cells. Accurate diagnoses have only been available in recent decades, so estimates of the number of people with the disease vary greatly. But with estimates ranging between 270,000 and 1.5 million people who have lupus in the United States, the disease is more prevalent than cystic fibrosis, leukemia or cerebral palsy.
There are many kinds of lupus. The most common type is systemic lupus erythematosus (SLE), which affects many parts of the body. While it can occur in anyone at any age, it is more prevalent in women of childbearing age and women of African, Hispanic, Asian, and Native American origin although this may be due to socioeconomic factors. Relatives of those who suffer from SLE, thrombotic thrombocytopenic purpura, or rheumatoid arthritis are also at a slightly higher risk of developing SLE.
Other more common types of lupus include discoid lupus, which causes a persistent rash, subacute cutaneous lupus, which causes sores after exposure to the sun, and drug-induced lupus (DIL), which unlike systemic forms of the disease is usually reversible by discontinuing the use of the medication that caused it. A rarer form of the disease called neonatal lupus affects newborns.
A very popular drug that has potential links to DIL is Accutane, which is used to correct Follicular Keratinization, a severe form of acne. The link has not been conclusively determined in part because Accutane, on its own, has side effects that are similar to the symptoms caused by lupus. More noticeable instances of lupus cases in which the patient used Accutane, however, has led many to believe that Accutane can trigger the onset of lupus.
The medications that have conclusively been associated to lupus include:
- Procainamide (Procan, Pronestyl)
- Hydralazine (Apresoline, Apresazide)
- Isoniazid (INH)
There is no cure for lupus and its exact cause has not been established. It is hypothesized that someone’s genetic makeup combined with exposure to an unknown environmental trigger, such as exposure to sunlight, infections, hormones or stress, may provide the right circumstances for lupus to develop. The genetic link is currently not thought to pre-destine someone to develop lupus, but rather to make someone more susceptible to developing it.
The symptoms of SLE vary so widely and come and go so unexpectedly that it is often mistaken for other illnesses. Initial chronic complaints include fatigue, fever, joint pains and myalgias. But because these symptoms commonly appear with other conditions, they are not included in the diagnostic criteria for SLE. They are considered suggestive when they occur in combination with some of the following symptoms or indications:
- Rash on cheeks
- Red, scaly patches on the skin which cause scarring
- Sensitivity or rashes when exposed to sunlight
- Oral or nasopharyngeal ulcers
- Nonerosive arthritis of multiple peripheral joints, with swelling, tenderness, or effusion
- Certain kinds of renal disorder
- Seizures or psychosis
- Inflammation of the membrane around the heart or lungs
- Low red or white blood cell count
- Positive, very sensitive, but unspecific anti-nuclear antibody test
- Certain immunologic disorders
Since there is no known cure for SLE, drugs, alternative medicine and lifestyle changes are used to preventing flare-ups of the symptoms, and reducing their severity and duration.
In mild or remittent cases, anti-malarials and non-steroidal anti-inflammatory drugs are sometimes used. In more severe cases, immunosuppressants, corticosteroids, and similar medications that modulate the immune system are used to manage the disease and prevent the re-occurrence of symptoms. Corticosteroids may also be used to treat flares when they occur and disease-modifying antirheumatic drugs (DMARDs) are used to prevent them. The use of steroids is prevented, if possible, since they tend to have severe side effects of their own.
Acupuncture has shown to provide relief for some of the symptoms of lupus although more research in this area needs to be done. Avoiding sunlight and wearing sun protective clothing can prevent problems associated with photosensitivity. Weight loss of obese and overweight patients can alleviate joint pains and other symptoms.
The mapping of the human genome and other genetic discoveries has recently greatly accelerated research into new treatments. Autologous stem cell transplants and additional immunosuppressants are also under investigation as potential cures.