SYSTEMIC LUPUS EYTHEMATOSUS
Now that you have read my personal story on lupus. let’s talk about LUPUS symptoms, complications and possible treatments.
Did you know that certain ethnic groups are affected more than other groups? African Americans, Afro-Caribbean, Hispanics, Native Americans, Native Hawaiians, Pacific Islanders and Asian females are more likely to develop this disease and can have worse disease activity.
You may have lupus if your doctor finds that you have at least four of these problems:
a) malar rash- butterfly shaped rash over the cheeks (spares nasal creases)
b) discoid rash- round or disk-shaped lesions that can be scaly and thick. Lesions may be red or can become discolored and scarring over time.
c) photosensitive rash (rash with sun exposure in sun exposed areas like face, neck, arms, legs)
2) Mouth or nasal ulcers/sores- lasting at least a few days or more
3) Heart or lung inflammation
Other Symptoms Of Lupus
Pleurisy/pleuritis– swelling of the tissue lining the heart (pericarditis) or lungs that can result in chest pain with deep breaths
4) Kidney problem (Nephritis)- blood or protein in urine can be detected, facial or leg swelling, kidney function can be abnormal
5) Arthritis-Pain and swelling lasting several weeks to months in more than two joints
6) Neurologic problem- Stroke, seizure, confusion, memory difficulties or other mental health problems like psychosis, depression
7) Abnormal blood tests
a) anemia, low white blood cells or platelets counts
b) positive proteins or antibodies called antinuclear antibodies (ANA) that may cause the body to attack different organ systems. Present in many lupus patients but are also found in healthy individuals
c) complement proteins (part of the immune system, complement 3 and complement 4)
d) other specific antibodies that show an abnormality in the immune system
anti-double stranded DNA
false positive blood test for syphilis (no actual syphilis infection)
Individuals may also note fever for more than a few days, extreme fatigue for days to weeks despite sleep, sudden unexplained hair loss.
Complications of lupus
1. Early and or accelerated heart disease/atherosclerosis, heart attack
This is a MAJOR COMPLICATION and leading cause of death among people with lupus
3. Miscarriages, pregnancy complications like preeclampsia (high blood pressure in pregnancy), premature birth
4. Areas of gastrointestinal system may be affected (liver, pancreas, bile ducts)
5. High blood pressure and loss of kidney function
6. Higher risk for miscarriages or premature birth
7. Blood clotting (thrombosis)
8. Blood vessel inflammation called vasculitis
10. Diminished blood supply to bone causing bone tissue death (avascular necrosis)
Healthy Lifestyle modifications
1. There is no specific diet but maintain a well-balanced diet with fresh fruits, vegetables (spinach, broccoli), and whole grains. Possibly consider incorporating omega 3 fatty acids (flaxseed oil and fish oil) and adequate calcium and vitamin D (which play a role in bone health and immune function). Steroids can worsen bone quality.
2. Reducing stress (meditation, walking, yoga, pilates)
3. Stop smoking
4. Wearing sunscreen and sun protective clothing against UVA and UVB light
5. Stay active with exercise.
6. Rest during the day and establish good sleep regimen
7. Discuss any herbal and dietary medications, vitamins with your physician first
There is no current cure for lupus but there are some treatment options that canhelp individuals live a productive life despite the challenges. Sometimes other specialists like a nephrologist, cardiologist, gastroenterologist, hematologist or OBGYN may get involved and be part of the medical team since lupus may affect multiple organ systems.
There must be a discussion about benefits and risks of a specific medication and review of an individual’s medical history with the rheumatologist first!!
Common treatment options that a rheumatologist may consider are:
1. Nonsteroidal anti-inflammatory drugs (NSAIDS)
2. Antimalarial drugs (hydroxychloroquine)
3. Steroids (prednisone, methylprednisolone, prednisolone)
4. Immune suppressants
a. Azathioprine (Imuran)
b. Methotrexate (for predominant joint symptoms)
c. Cyclophosphamide (Cytoxan)- a form of chemotherapy in lower doses to control inflammation
d. Cyclosporine (Neoral)
e. Mycophenolate mofetil (Cellcept)
f. Biologics (newer drugs that block certain chemicals)
i. Belimumab (benlysta)- FDA approved medication for active but not severe lupus adult patien
ii. Rituximab (Rituxan)- a form of chemotherapy
iii. Abatacept (Orencia)
Some of these treatments are already approved for other rheumatic diseases like rheumatoid arthritis and may be an option for some individuals.
I am hoping for a cure for this disease in the near future! Remember, May is Lupus Awareness Month!
You can read some of my personal experiences with lupus patients in the ebook LUPUS-REAL LIFE, PATIENTS TALK by Marisa Zeppieri-Caruana
For more information of lupus, please check out these websites:
American College of Rheumatology www.rheumatology.
Lupus Foundation of America www.lupus.org
Lupus Research Alliance www.lupusresearch.org
Lupus Chick lupuschick.com– I am involved with this wonderful nonprofit organization which helps individuals who are living with lupus and other autoimmune diseases connect to each other and feel that there is an online support community.