Lupus (systemic lupus erythematosus, or SLE) is a serious and potentially fatal autoimmune disorder that primarily affects young women. Although the underlying causes of autoimmune disease is not fully understood, the body’s immune system mistakenly attacks its own healthy tissue, leading to long-term (chronic) inflammation. Tissues affected by patients with lupus include joints, skin, kidneys, heart, lungs, blood vessels and brain. It is typically diagnosed between the ages of 15 and 45.
An estimated 240,000 Americans are diagnosed with lupus. Although people of all races and ethnicity are diagnosed with lupus, it is more common in women of Hispanic, Asian and Native American descent, and is three times more likely to be diagnosed in African American women than Caucasian women. African-American women also tend to develop lupus at a younger age and to develop more serious complications. Nine times more women than men have lupus. SLE may also be caused by certain drugs.
Symptoms may come and go and may vary from person to person. Almost everyone with SLE experiences joint pain and swelling. Frequently affected joints are the fingers, hands, wrists and knees.
Other common symptoms include:
- Chest pain when taking a deep breath
- Fever with no other cause
- General discomfort, uneasiness or ill feeling (malaise)
- Hair loss
- Mouth sores
- Sensitivity to sunlight
- Skin rash — a “butterfly” rash over the cheeks and bridge of the nose affects about half of people with SLE and worsens when exposed to sunlight. The rash may also be widespread.
- Swollen lymph nodes
Other symptoms depend on what part of the body is affected:
- Brain and nervous system Headaches, numbness, tingling, seizures, vision problems and personality changes
- Digestive tract Abdominal pain, nausea and vomiting
- Heart Abnormal heart rhythms (arrhythmias)
- Lung Coughing up blood and difficulty breathing
- Skin Patchy skin color, fingers that change color when cold (Raynaud’s phenomenon)
- To be diagnosed with lupus, you must have 4 out of 11 typical signs of the disease. Patients who only have skin symptoms are diagnosed with discoid lupus.
Regarding treatment, there is currently no cure for SLE. The goal of treatment is to control symptoms. Mild disease may be treated with:
- Nonsteroidal anti-inflammatory medications (NSAIDs) treat arthritis and pleurisy
- Corticosteroid creams to treat skin rashes
- An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms
- Protective clothing, sunglasses and sunscreen when in the sun
Severe or life-threatening symptoms (such as hemolytic anemia, extensive heart or lung involvement, kidney disease, or central nervous system involvement) often require more aggressive treatment, including:
- High-dose corticosteroids or medications to decrease the immune system response
- Cytotoxic drugs (drugs that block cell growth) if there is no improvement or symptoms worsen after discontinuing corticosteroid therapy
Regarding complications, people with SLE have abnormal deposits in the kidney cells leading to a condition called lupus nephritis. Patients with this condition may eventually develop kidney failure and need dialysis or a kidney transplant.
How well a person does depends on the severity of the disease, but outcomes have improved in recent years. Many people with SLE have mild symptoms.