What you need to know about Lupus

What is lupus?

Who gets lupus?

What causes lupus?

Lupus symptoms

Diagnosing lupus

Treatment

Medications

Pregnancy with lupus

Coping with lupus

Lupus Association (Singapore)

What you need to know about lupus
Copyright © 1997 Lupus Association (Singapore).

What is lupus?
.....Lupus is a disease which can affect joints, muscles and other parts of the body. It is often described as an auto-immune disease. This means that for some unknown reason people with lupus seem to develop antibodies (which usually fight bacteria and viruses) that attack healthy tissues instead. This produces inflammation in different parts of the body resulting in pain and swelling. Lupus can also affect the skin, heart, lungs, nervous system, kidneys and blood and in particular the immune system. Lupus is a chronic, systemic disease. This means that it lasts a long time, probably for the rest of your life. However, nearly all people with lupus have periods of improvement (remissions). Some people have complete and long-lasting remissions.

Who gets lupus?
..... Lupus tends to affect women in their childbearing years. However, lupus can occur in young children or in older people. The number of women affected outnumber men by nine to one. The disease is commoner in Orientals and Blacks.

What causes lupus?
.....We don't know the cause of lupus. Some people seem to inherit the tendency to get a disease like lupus. Research suggests that an unidentified virus may trigger the tendency and bring on the disease. A few drugs taken for conditions like high blood pressure or tuberculosis can cause symptoms just like lupus but these symptoms always disappear when the drug is stopped. Exposure to sunlight seems to trigger lupus in some people. the prospects of pulling this deal off.

Lupus Symptoms
.....Lupus can present in many different ways. The onset is usually gradual, with the development of vague feelings of disease until some specific lupus symptoms develop. Common symptoms include

Fever	Headache
Fatigue	Depression
Loss of appetite; weight loss	Easy bruising
Aches & pains	Edema/swelling
Hair loss	Swollen glands

The following symptoms and signs are much more suggestive of lupus:

A rash over the cheeks and bridge of the nose
Rashes after exposure to the sun or ultraviolet light
Ulcers inside the mouth
Arthritis of two or more joints i.e, the joints hurt and are swollen
Pleurisy – pain in the chest on deep breathing
Seizure
Anemia
Raynaud's – fingers turning white and/or blue in the cold

Diagnosing Lupus
.....Lupus is usually easy to diagnose when an individual has many of the more characteristic symptoms and signs, but is made more difficult if only a few are present. Laboratory tests are then usually conducted to help confirm or reject the diagnosis, These tests may include a blood count and urine analysis. More specific laboratory tests look for antibodies, in particular antibodies to the nuclei of cells (the ANA or Anti-Nuclear Antibody test) and antibody to DNA. Over 99 per cent of people with lupus have a positive ANA test. However, only about 30 per cent of people with a positive ANA test have lupus.

Treatment
.....Lupus is an unpredictable disease but in most cases it can be successfully treated. Once an effective treatment program has been started, it is important for the patient to keep to it faithfully and to inform the doctor of any change in symptoms so that the medications can be modified.

Medications
.....

Corticosteroids

Prednisolone is the most commonly used drug. Steroids are powerful drugs that suppress inflammation and are commonly used in controlling lupus. It is important for the patient to keep to the prescribed dose. Flare-ups of disease can occur if the dose is reduced too rapidly. NEVER ALTER YOUR DOSE OF CORTICOSTEROIDS WITHOUT FIRST DISCUSSING IT WITH YOUR DOCTOR, SINCE STOPPING THEM OR CHANGING THE DOSE QUICKLY CAN MAKE YOU VERY ILL.

Antimalarial Drugs

Antimalarial drugs seem to be effective in reducing inflammation and controlling skin problems. These drugs increase resistance to sun exposure.

Aspirin and Other Anti-Inflammatory Drugs

Aspirin and other anti-inflammatory drugs such as Indocid, Clinoril, Brufen and Naproxen may be the only medications the doctor will prescribe. These drugs control pain and reduce inflammation.

Immunosuppressiye Drugs

Immunosuppressive drugs are usually used in conjunction with corticosteroids to control more severe disease. If you're taking an immunosuppressive, regular blood tests will be done because the drug can interfere with the formation of blood cells.

Ointments/Skin creams

Your doctor may prescribe a cream containing a sunscreen to protect against sun exposure. Corticosteroid containing creams are used to control skin rashes.

Pregnancy and Lupus
.....Pregnancy may mean special problems for the woman with lupus since the disease affects people in their child-bearing years. The majority of women have normal pregnancies, although there is an increased risk of early miscarriage. There may be worsening of symptoms after delivery. It is important for the patient and doctor to discuss and plan the best time for the patient to have a child.

Coping with lupus
.....In a chronic disease like lupus, social and emotional problems are common. You may experience feelings of anger, fear and depression. It is extremely helpful to be able to talk about how you feel with someone close to you or someone who has had similar problems.

Lupus Association (Singapore)
.....The Lupus Association (Singapore) is a self-help group dedicated to provide support for patients and their families. The group aims to assist lupus patients by providing practical support and by giving people the opportunity to share experiences with others who have lupus. The Lupus Association (Singapore) is committed to research on the disease and in improving understanding of the disease especially among people with lupus and their families.