Lupus

Systemic Lupus Erythematosus is an auto-immune disease which can affect most systems of the body. The immune system in our body becomes hyperactive and attacks normal healthy tissues. This is why different body systems can be involved including joints, skin, kidneys, blood cells, heart and lungs. Therefore the symptoms are numerous and they may vary from person to person depending on which part of the body is affected. Traditionally diagnosis and follow up is performed by a Rheumatologist and co-operation with other Physicians such as a skin, kidney and chest specialists is very frequent in this illness.

What are the common symptoms of Lupus?

Joint pain, skin rashes, tiredness are very common. Some patients have a particular rash on their face, occasionally there is fever, weight loss, and loss of hair, Raynaud ’s phenomenon (cold hands and feet), photosensitivity, mouth ulcers and swelling of the lymph glands. Lupus is more common in younger women and tends to become rare after the age of 50.

 

Classification and Variations

The common type is the systemic lupus which describes involvement of internal body organs but there are other types:

  1. Discoid – affects mainly the skin
  2. Drug induced - caused by taking some medications – anti-epileptics, anti-TNF and minocycline.
  3. Neonatal – affects babies whose mothers have lupus
  4. Associated with antiphospholipid antibody syndrome, the latter is also an autoimmune disease which has manifestations similar to lupus, but more frequent clotting and miscarriages.

 

Diagnosis and Treatment

This requires a high level of alertness by the clinician, in addition to clinical symptoms/signs. There are specific blood tests that support the diagnosis. It is more important to observe patients and follow their complaints over a period of time. Appropriate treatments and the side effects should be discussed with the rheumatologist. Steroid and antimalarials are frequently helpful but duration and dosages depend on severity of lupus symptoms.

We are lucky in the UK that there are several organisations that will help patients with arthritis and lupus. Furthermore research is very active on these topics.

 

Useful Links

LUPUS UK – St James House, Eastern Road, Romford, Essex, RM1 3NH
www.lupusuk.org.uk

St Thomas’ Lupus Trust – The Louise Coote Lupus Unit, Gassiot House, St Thomas’ Hospital, London, SE1 7EH
www.lupus.org.uk