Lupus

Lupus is a chronic autoimmune disease that is caused by the immune system attacking healthy cells and tissues. The immune system produces excessive amounts of antibodies compared to a normal person, and these antibodies can attach themselves to various bodily structures, causing inflammation and pain as a result.

 

This disease is quite rare and affects women more than men. Women of childbearing age are also more commonly affected.

Statistically Lupus affects over 20, 000 Australians, and 90% of those affected are women aged 15 – 45. (http://www.lupuswa.com.au/content/page/about-lupus.html)

 

There are 5 types of Lupus:

  • Systemic Lupus Erythematosus: This is the most common form of Lupus. It can affect any organ or system of the body and can range from mild to life-threatening. This type of Lupus commonly has flare ups and periods of remission. About 20% of people with SLE will also go on to develop DLE.
  • Discoid Lupus Erythematosus: This form of Lupus mainly appears as a skin condition. The skin of the sun-exposed areas such as the face and hands appear reddened, and round, scaly patches tend to develop. In some cases extensive lesions can appear on other areas of the body, for example: the back, legs, arms, and neck. This form of Lupus is generally milder than SLE. Approximately 5% of DLE sufferers will go on to develop SLE.
  • Drug-induced Lupus: This occurs when people are exposed certain medications. The symptoms then disappear when the medication is stopped. Medications that can cause this form of Lupus are hypertensive medications (used for high blood pressure), and medications for heart abnormalities. Men are more likely to suffer from this than women, and the susceptibility of an individual is usually determined by genetics.
  • Neonatal Lupus: This is a rare form of Lupus and affects a foetus or a newborn baby. It is a temporary form of Lupus and occurs when the autoantibodies of the mother with SLE are passed to her child in utero. The disease usually becomes obvious in the first few months of the child’s life, where it affects the baby’s skin, heart, and blood. The tell-tale rash usually goes away after a few months but 50% of babies with this disease end up having heart problems.
  • Subacute Cutaneous Lupus Erythematosus: This form is characterized by sores or lesions present on the skin as a result of sun exposure. The affected persons are often extremely photosensitive, and have blisters, ulcers, cheilitis (inflamed lips), and malar rashes.

 

SYMPTOMS:

  • Rashes of face, scalp, and other areas of the skin such as the neck, back, body, arms, legs, hands, and feet
  • Fatigue
  • Joint and muscle pain
  • Hair loss
  • Ulcers
  • Fever
  • Weakness
  • Photosensitivity
  • Chest pain due to Serositis (inflammation of the lining of the lung or heart)
  • Anaemia
  • Kidney problems
  • Seizures or visual disturbances
  • Permanent bald patches (Scarring Alopecia) in DLE sufferers
  • Scars and discoloured patches (DLE)
  • Pale extremities due to reduced blood flow
  • Inflamed lips (DLE)
  • Headaches
  • Depression and anxiety
  • Dizziness
  • Miscarriage
  • Abdominal pain and nausea if the digestive tract is affected
  • Arrhythmias (abnormal heart rhythms) if the heart is affected
  • Swelling in the legs and weight gain if the kidneys are affected

 

TRIGGERS AND CAUSES:

  • Hormones
  • Medications
  • Viruses
  • Bacterial infections
  • Stress
  • Genetics
  • Pregnancy
  • Exposure to UV light
  • Dietary factors
  • Physical stress (such as injury)

 

LONG TERM RESULTS OF LUPUS:

  • Blood clots
  • Inflammation of the blood vessels
  • Inflammation of the heart (pericarditis)
  • Heart attacks
  • Strokes
  • Memory issues/changes
  • Behavioural changes
  • Seizures
  • Inflammation of the lungs
  • Kidney problems
  • Decreased kidney function
  • Kidney failure

 

DIAGNOSIS:

Diagnosing Lupus is extremely difficult because it is an illness that develops slowly over time and the symptoms often change and come and go. The disease often does not show up on blood tests, and positive results can occur, followed by negative ones. It can also take months or years for enough symptoms to develop so a doctor can make an accurate diagnosis.

Lupus has also been known to ‘mimic’ the symptoms of other diseases such as blood disorders, diabetes, Lyme disease, thyroid problems, fibromyalgia, rheumatoid arthritis, Multiple Sclerosis, depression, and disorders of the heart, lung, muscle, and bone. No single test can be used to diagnose Lupus, but rather several laboratory tests, along with physical examinations, and medical history.

 

Tests used to diagnose Lupus are:

  • Physical exam to check for malar/butterfly rashes, photosensitivity, mouth and nose ulcers, swelling of the joints and muscles, hair loss, and signs of cardiac or lung involvement such as murmurs, or irregular heartbeats
  • Examination of the medical history of the individual and the medical history of their family
  • Anti-Nuclear Antibody Test: which tests the levels of antibodies in relation to tissues
  • Complete Blood Count Test: this test measures the amount of red blood cells, white blood cells, haemoglobin, and the fraction of red blood cells present in relation to the rest of the blood. It also provides information on the average size of the red blood cells, the haemoglobin amount per red blood cell, the amount of haemoglobin relative to the size of the cell, and platelet count
  • Erythocyte Sedimentation Rate: tests the rate at which red blood cells settle at the bottom of a tube in an hour. Faster than usual settling rates are indicative of a Systemic Disease such as Lupus
  • Chest X-rays: used to reveal abnormal shadows indicating fluids or inflammation in the lungs
  • Urinalysis: checks for increased protein levels and red blood cells present in the urine which often occurs if the kidneys are affected by Lupus
  • Kidney and liver assessment: as the disease can affect these organs
  • Echocardiogram: uses sound waves to produce real-time images of a beating heart, allowing for examination to determine problems with the valves, and other sections of the heart
  • Tissue biopsy of lesions

 

TREATMENT:

There is no cure for Lupus, but the condition can be managed with various treatments:

  • Nonsteroidal Anti Inflammatory Drugs (NSAIDs): such as ibuprofen, aspirin, and Cox-2 inhibitors are used to reduce inflammation, fevers, muscle pains, and arthritis
  • Anti-malaria Drugs: such as hydroxychloroquine and chloroquine are used to reduce joint pain, skin rashes, and fatigue
  • Corticosteroids: such as Prednisolone are used for treating serious complications of Lupus, for example, those affecting the heart, lungs, or nervous system. Also used to treat the skin rashes and inflammatory responses
  • Corticosteroid creams: used to treat skin rashes
  • Immune Suppressant Drugs: such as methotrexate are used to suppress the immune system and is often used for the more severe cases of Lupus
  • Blood thinners: are used in the treatment of blood clotting which is a side effect common with Lupus
  • Belimumab: (a biologic drug) has been found to be effective in some patients, but more testing is needed
  • Lifestyle changes: such as avoiding certain foods, reducing stress, wearing sun protection, avoiding smoking and alcohol, avoiding people with infections, and exercising

 

ALTERNATIVE THERAPIES:

  • Dehydroepiandrosterone (DHEA): Supplements containing this hormone reduce the amount/dose of steroids needed to stabilize Lupus symptoms
  • Fish Oil: Omega – 3 has been found to be beneficial for Lupus sufferers. More studies are required
  • Vitamin D
  • MSM: This is a natural anti-inflammatory that improves digestive systems
  • Chlorella and Spirulina: These are both powerful antioxidants and work by alkalizing the body, providing electrolytes, and boosting liver and kidney functions
  • Turmeric: This herb works in a similar fashion to steroids to decrease inflammation and swelling
  • Pine bark: reduces inflammation. More studies are required
  • Aromatherapy: Essential oils such as Frankincense (lowers inflammation), helichrysum (supports nervous system and can help reverse autoimmune reactions), lavender and geranium (treats skin inflammations), and ginger oil (used for digestion) are helpful in treating Lupus
  • Yoga: Helps to decrease stress and inflammation while providing gentle exercise
  • Acupuncture: Treats chronic pain naturally
  • Massage therapy: Helps to ease stiffness and soreness in the muscles
  • Meditation: Prevents stress, anxiety, and depression. Plus the power of positive thinking is thought to work wonders on all types of illnesses

 

FOODS TO EAT:

  • Unprocessed foods
  • Vegetables
  • Fish
  • Foods with high antioxidant properties such as sprouts, fruits, herbs and spices, beans and wholegrains
  • Avocados
  • Olive oil
  • Nuts and seeds
  • Coconut oil
  • Milk
  • Cucumbers
  • Melons
  • Green tea

 

FOODS TO AVOID:

  • Gluten
  • Trans fats, and some saturated fats: lead to inflammation and heart problems
  • Added sugars: overstimulate the immune system, resulting in increased pain
  • Food with high salt content: as Lupus can damage the kidneys, their ability to process salts is decreased, resulting in fluid retention, swelling, and electrolyte imbalances
  • Caffeine and alcohol: which has been known to increase anxiety and inflammation, cause dehydration and insomnia, and damage the liver
  • Certain legumes: such as alfalfa, green beans, peanuts, soy beans, and snow peas contain the amino acid L-canavanine which has been known to cause flare ups in Lupus sufferers.

 

LUPUS AND PREGNANCY:

It is possible for women with Lupus to have healthy babies. It is preferable that the Lupus is in remission when conceiving so there is less chance of a flare up during pregnancy. This disease does not lower fertility, however it does increase the risk of miscarriage and pregnancies are considered high risk.

 

REFERENCES:

http://www.dermnetnz.org/topics/cutaneous-lupus-erythematosus/

https://www.healthdirect.gov.au/lupus

http://www.lupus-sle.org/how-to-diagnose-lupus.html

http://www.lupusnsw.org.au/lupus/what-is-lupus/

https://www.healthgrades.com/conditions/7-conditions-confused-with-lupus

http://www.medicaldaily.com/lupus-why-every-girl-needs-learn-symptoms-autoimmune-disease-360658

http://www.rightdiagnosis.com/l/lupus/misdiag.htm

http://www.lupuswa.com.au/content/page/about-lupus.html

http://www.healthline.com/health/systemic-lupus-erythematosus#Diagnosis5

https://medlineplus.gov/ency/article/000435.htm

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/lupus

http://www.allergy.org.au/patients/autoimmunity/systemic-lupus-erythematosus-sle

http://www.niams.nih.gov/health_info/lupus/lupus_ff.asp

http://www.webmd.com/food-recipes/features/10-super-foods#3

https://draxe.com/top-5-lupus-natural-treatment-remedies/

http://www.mayoclinic.org/diseases-conditions/lupus/basics/alternative-medicine/con-20019676

http://www.mollysfund.org/2013/03/alternative-lupus-treatments-and-therapies/