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Nov-22-2008

Lupus

Posted by Summer under Welcome

Lupus: An Introduction

immune system

Lupus is a chronic inflammatory disease that can target your joints, skin, kidney and lungs. The great majority of people affected are women. For reasons that aren’t clear, lupus develops when the immune system attacks your body’s own tissues and organs.

Three main types of lupus exist; systemic lupus erythematosus (SLE), discoid lupus erythematosus and drug-induced lupus. Of these, SLE is the most common and serious form of the disease, frequently causing swollen, painful joints, skin rash, extreme fatigue and kidney damage. In rare cases, mothers can pass antibodies to their babies during childbirth (neonatal lupus erythematosus), though the mothers themselves usually show no signs of lupus.

The outlook for people with lupus was once grim, but diagnosis and treatment of lupus has improved considerably. With proper care, most people with lupus can lead normal, active lives.

SIGNS AND SYMPTOMS

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Even the distinctive rash that gives the disease its name; “lupus” is the Latin word for “wolf” because doctors once thought the rash resembled a wolf bite doesn’t occur in every case.

Most people with lupus have one thing in common, however, and that’s the tendency of the disease to get decidedly worse in episodes called flares and then to improve or even disappear completely for a time.

COMMON SIGNS AND SYMPTOMS

The most common signs and symptoms of lupus, which usually develop at intervals, rather than all at once, include the following:

  • RASH: Although it only affects about one in three people with lupus, the skin problem most often associated with the disease is a butterfly-shaped rash (malar rash) that develops across the cheeks and bridge of the nose. A malar rash may be flat or raised and may be blotchy or completely red in the affected areas. Some people with lupus develop skin lesions (subacute cutaneous lesions) that initially resemble small pimples but that eventually turn scaly and itchy, whereas others have large, flat, itchy lesions with clear centers. Both types of lesions usually appear after exposure to sunlight. Still other people develop a crusty, red, raised rash (discoid rash) on the face, neck, chest or scalp. A discoid rash is usually thick and scaly, may last for days or years, and often leaves hypopigmented or hyperpigmented scars. This rash is the only symptom in people with the discoid form of lupus. In a small percentage of cases, people with discoid lupus may go on to develop a mild version of SLE.
  • ARTHRITIS: Most people with lupus eventually develop joint pain, stiffness and swelling, mainly in their fingers, hands, wrists and knees. The pain may shift from one joint to another or affect the same joint on both sides of the body. Lupus-associated arthritis can come and go quickly and usually isn’t deforming, although the pain can be severe during a flare.
  • KIDNEY PROBLEMS: People with lupus are especially vulnerable to kidney damage, lupus can cause numerous types of glomerulonephritis, a condition that affects the kidneys’ ability to filter toxins, leading to kidney failure. Although some people with kidney problems may develop frothy or tea-colored urine, swelling in their ankles or lower legs, or high blood pressure, kidney damage often occurs without any warning signs or symptoms.
  • SENSITIVITY TO LIGHT: People with lupus are often highly sensitive to sunlight, frequently developing severe rashes on sun-exposed skin. Sometimes even indoor lighting, especially fluorescent lighting, can cause the same response.
  • BRAIN OR CNS PROBLEMS: Lupus can cause a range of serious problems related to the brain or central nervous system, including headaches, seizures, dizziness, vision problems, behavior changes or stroke.
  • HEART PROBLEMS: Lupus can affect all parts of the heart, including the sac surrounding the heart (pericardium), the heart muscle (myocardium) and the lining of the inside of the heart (endocardium). Pericarditis, which occurs when the pericardium becomes inflamed, is particularly common in people with lupus, causing shortness of breath and sharp chest pain that may feel like a heart attack.
  • LUNG PROBLEMS: Lupus can cause a number of lung problems, the most common of which is pleurisy, an inflammation of the chest cavity lining that can produce sharp, stabbing chest pain. Less common lung conditions include pleural effusion, which is the accumulation of excess fluid in the pleural space between the lung and the chest wall, and lupus pneumonitis, a lung inflammation. Occasionally, people with lupus develop high blood pressure in the blood vessels in the lungs (pulmonary hypertension).
  • MUCOSAL ULCERS: These generally painless sores develop in the mouth, especially the roof of the mouth or, less often, in the nose. You’re not likely to notice mucosal ulcers unless you eat spicy food or experience recurring nosebleeds.
  • BLOOD VESSEL DISORDERS: Inflamed blood vessels can affect blood circulation. The inflammation may be mild and not require treatment or it can be quite severe.

    • OTHER SIGNS AND SYMPTOMS

    Other signs and symptoms also may occur that aren’t specific to lupus. These include:

  • FATIGUE: The fatigue that accompanies lupus is not the same tiredness you experience after a sleepless night or hard physical work. Instead, it’s an ongoing, extreme exhaustion that’s usually not relieved by rest.
  • FEVER: An unexplained fever, especially a chronic fever higher than 100 F may be an early sign of lupus.
  • RAYNAUD’S PHENOMENON: In this condition your fingers, toes, nose and ears turn pale and numb when exposed to cold temperatures.
  • SWELLING: You may have swollen glands or swelling in your legs or around your eyes.
  • DIGESTIVE PROBLEMS: These problems may include abdominal pain, weight loss, nausea and vomiting.
  • HAIR LOSS: Because lupus can affect the skin of your scalp, you may experience some patchy hair loss.
  • DEPRESSION: People with lupus may also experience depression or difficulty concentrating, either because of the disease itself or because of the challenges of living with a chronic condition.


Original Article

By Mayo Clinic Staff Dec 27, 2006

1998-2007 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

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