Definition

Lupus is an autoimmune disease. It inflames:

• Joints
• Tendons
• Skin
• Other connective tissue and organs

It causes the immune system to make antibodies that attack the body's healthy cells and tissue.

Causes

The cause of lupus is unknown. Researchers believe it may be a combination of:

• Genetic factors
• Environmental factors, which may include:
  • Sunlight (UV rays)
  • Stress
• Viral or other type of infection
• Drug-induced (methyldopa, procainamide, hydralazine, isoniazid, chlorpromazine, TNF-blocking drugs)

Risk Factors    TOP

These risk factors increase your chance of developing lupus. Tell your doctor if you have any of these risk factors:

• Sex: female to male ratio: 10:1
• Age: childbearing age (20-45 years)
• Race: African American, Native American, Asian, and Hispanic

Symptoms    TOP

Symptoms can be mild or very severe. For some people, only part of the body (such as skin) is affected. For others, many parts are affected. Though symptoms can be chronic, they can flare up and get better on and off.

Common symptoms:

• Swollen and/or painful joints
• Fever
• Skin rashes over areas exposed to sunlight (especially on the nose and cheeks)
• Extreme fatigue

Common Lupus Rash Sites Facial butterfly rash is hallmark of Lupus. Copyright © Nucleus Medical Media, Inc.

Other symptoms may include:

• Hair loss
• Chest pain, coughing up blood, shortness of breath, difficulty breathing
• Kidney inflammation
• High blood pressure
• Anemia or other blood disorders
• Sensitivity to sunlight
• Raynaud phenomenon
• Ulcers in nose or mouth
• Swollen glands
• Headaches
• Dizziness
• Seizures
• Stroke
• Inflamed heart, heart vessels, or membrane surrounding the heart
• Blood clots

A pregnant woman who has lupus may experience complications, like a flair-up of symptoms, high blood pressure, and kidney inflammation. There may also be problems with the pregnancy (such as premature birth, miscarriage, restricted growth in the fetus).

Diagnosis    TOP

Diagnosing lupus can be difficult. It can take time to identify the condition because you may develop more symptoms over time.

To aid in making the diagnosis, the American College of Rheumatology (ACR) has created the following criteria. You must have 4 out of the 11 items to be diagnosed with lupus:

• Butterfly facial rash
• Rash (or red patches) on sun-exposed areas
• Skin photosensitivity (easily burned by the sun)
• Ulcers in the mouth or near the throat
• Arthritis in at least two joints
• Inflammation of the lining of the heart or lungs (called serositis)
• Kidney problems (identified by kidney function tests)
• Seizures or psychosis that are not caused by another condition
• Abnormally low number of blood cells
• Antinuclear antibodies—these are immune chemicals produced by your body that attack the nuclei in your cells. These antinuclear antibodies may contribute to the cause of lupus.
• Immune dysfunction—in people with lupus, several other antibodies have been found. These antibodies can be detected with lab tests.

To find out if you do meet the criteria, your doctor will order tests, such as:

• Blood tests, such as complete blood count, antinuclear antibody (ANA) test
• Urine test to check kidney functioning
• Imaging tests (such as MRI scan) if you have neurological symptoms

Depending on your symptoms, your doctor may diagnosis you with lupus even if you have less than four of the ACR’s criteria.

Your doctor will also rule out other conditions that may have similar symptoms, such as:

• Sjogren syndrome (an inflammatory disease)
• Fibromyalgia
• Idiopathic thrombocytopenic purpura (a blood disorder)
• Rheumatoid arthritis

Treatment    TOP

Treatment options depend on your symptoms.

Prevention    TOP

You cannot prevent lupus because the cause is unknown.

To prevent flare-ups of symptoms:

• Schedule regular check-ups.
• Treat all infections quickly and vigorously.
• Avoid sun exposure and wear sunscreen and protective clothing when outdoors.
• Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
• Limit emotional stress.
• Get adequate rest.
• Exercise moderately (as much as your condition allows) with your doctor's permission.
• Call your doctor if you think you will have a flare-up.
• Avoid oral contraceptives, especially if you have had a blood clot.