What is lupus?
Lupus is an autoimmune disease. This means that your immune system attacks healthy cells and tissues by mistake. This can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
There are several kinds of lupus
- Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
- Discoid lupus causes a red rash that doesn’t go away
- Subacute cutaneous lupus causes sores after being out in the sun
- Drug-induced lupus is caused by certain medicines. It usually goes away when you stop taking the medicine.
- Neonatal lupus, which is rare, affects newborns. It is probably caused by certain antibodies from the mother.
Other Types of Lupus
- Discoid lupus erythematosus, which mainly affects the skin. The symptoms of this form of lupus include a rash on the face, scalp, or elsewhere. The rash may last for days or years, and can recur.
- Drug-induced lupus, which is triggered by certain medications, usually goes away when the medicine is stopped. The symptoms in this form of lupus may be milder.
What causes lupus?
The cause of lupus is unknown.
Who is at risk for lupus?
Anyone can get lupus, but women are most at risk. Lupus is two to three times more common in African American women than in white women. It’s also more common in Hispanic, Asian, and Native American women. African American and Hispanic women are more likely to have severe forms of lupus.
What are the Lupus symptoms ?
Lupus can affect almost any organ in your body. The symptoms of lupus also differ from person to person. For example, one woman with lupus may have swollen knees and fever. Another woman may be tired all the time or have kidney trouble. Someone else may have rashes. Over time, new symptoms can develop or some symptoms may happen less often.
Lupus symptoms also usually come and go, meaning that you don’t have them all of the time. Lupus is a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better).
Lupus symptoms include:
- Muscle and joint pain. You may experience pain and stiffness, with or without swelling. This affects most people with lupus. Common areas for muscle pain and swelling include the neck, thighs, shoulders, and upper arms.
- Fever. A fever higher than 100 degrees Fahrenheit affects many people with lupus. The fever is often caused by inflammation or infection. Lupus medicine can help manage and prevent fever.
- Rashes. You may get rashes on any part of your body that is exposed to the sun, such as your face, arms, and hands. One common sign of lupus is a red, butterfly-shaped rash across the nose and cheeks.
- Chest pain. Lupus can trigger inflammation in the lining of the lungs. This causes chest pain when breathing deeply.
- Hair loss. Patchy or bald spots are common. Hair loss could also be caused by some medicines or infection.
- Sun or light sensitivity. Most people with lupus are sensitive to light, a condition called photosensitivity. Exposure to light can cause rashes, fever, fatigue, or joint pain in some people with lupus.
- Kidney problems. Half of people with lupus also have kidney problems, called lupus nephritis.3 Symptoms include weight gain, swollen ankles, high blood pressure, and decreased kidney function.
- Mouth sores. Also called ulcers, these sores usually appear on the roof of the mouth, but can also appear in the gums, inside the cheeks, and on the lips. They may be painless, or you may have soreness or dry mouth.
- Prolonged or extreme fatigue. You may feel tired or exhausted even when you get enough sleep. Fatigue can also be a warning sign of a lupus flare.
- Anemia. Fatigue could be a sign of anemia, a condition that happens when your body does not have red blood cells to carry oxygen throughout your body.
- Memory problems. Some people with lupus report problems with forgetfulness or confusion.
- Blood clotting. You may have a higher risk of blood clotting. This can cause blood clots in the legs or lungs, stroke, heart attack, or repeated miscarriages.
- Eye disease. You may get dry eyes, eye inflammation, and eyelid rashes.
How is lupus diagnosed?
There is no specific test for lupus, and it’s often mistaken for other diseases. So it may take months or years for a doctor to diagnose it. Your doctor may use many tools to make a diagnosis:
- Medical history
- Complete exam
- Blood tests
- Skin biopsy (looking at skin samples under a microscope)
- Kidney biopsy (looking at tissue from your kidney under a microscope)
The “Eleven Criteria of Lupus”
- Malar rash: butterfly-shaped rash across cheeks and nose
- Discoid (skin) rash: raised red patches
- Photosensitivity: skin rash as a result of unusual reaction to sunlight
- Mouth or nose ulcers: usually painless
- Nonerosive Arthritis (bones around joints do not get destroyed): in 2 or more joints with tenderness, swelling, or effusion
- Cardio-pulmonary involvement: inflammation of the lining around the heart (pericarditis) and/or lungs (pleuritis)
- Neurologic disorder: seizures and/or psychosis/cognitive dysfunction
- Renal (kidney) disorder: excessive protein in the urine, or cellular casts in the urine
- Hematologic (blood) disorder: hemolytic anemia, low white blood cell count, or low platelet count
- Immunologic disorder: antibodies to double stranded DNA, antibodies to Sm, or antibodies to cardiolipin
- Antinuclear antibodies (ANA): positive test in absence of drugs known to induce it
What are the treatments for lupus?
People with lupus often need to see different doctors. You will have a primary care doctor and a rheumatologist (a doctor who specializes in the diseases of joints and muscles). Which other specialists you see depends on how lupus affects your body. For example, if lupus damages your heart or blood vessels, you would see a cardiologist.
Your primary care doctor should coordinate care between your different health care providers and treat other problems as they come up. Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it is working. You should report new symptoms to your doctor right away so that your treatment plan can be changed if needed.
The goals of the treatment plan are to
- Prevent flares
- Treat flares when they occur
- Reduce organ damage and other problems
Treatments may include drugs to
- Reduce swelling and pain
- Prevent or reduce flares
- Help the immune system
- Reduce or prevent damage to joints
- Balance the hormones
Alternative treatments are those that are not part of standard treatment. At this time, no research shows that alternative medicine can treat lupus. Some alternative or complementary approaches may help you cope or reduce some of the stress associated with living with a chronic illness. You should talk to your doctor before trying any alternative treatments.
What types of medicines treat lupus?
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen and naproxen, help reduce mild pain and swelling in joints and muscles.
- Corticosteroids. Corticosteroids (prednisone) may help reduce swelling, tenderness, and pain. In high doses, they can calm the immune system. Corticosteroids, sometimes just called “steroids,” come in different forms: pills, a shot, or a cream to apply to the skin. Lupus symptoms usually respond very quickly to these powerful drugs. Once this has happened, your doctor will lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. Stopping this medicine suddenly can harm your body.
- Antimalarial drugs. Medicines that prevent or treat malaria also treat joint pain, skin rashes, fatigue, and lung inflammation. Two common antimalarial medicines are hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen). Studies found that taking antimalarial medicine can stop lupus flares and may help people with lupus live longer.
- BLyS-specific inhibitors. These drugs limit the amount of abnormal B cells (cells in the immune system that create antibodies) found in people with lupus. A common type of BLyS-specific inhibitor that treats lupus symptoms, belimumab, blocks the action of a specific protein in the body that is important in immune response.
- Immunosuppressive agents/chemotherapy. These medicines may be used in severe cases of lupus, when lupus affects major organs and other treatments do not work. These medicines can cause serious side effects because they lower the body’s ability to fight off infections.
- Other medicines. You may need other medicines to treat illnesses or diseases that are linked to your lupus — such as high blood pressure or osteoporosis. Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (“blood thinners”), such as warfarin or heparin, to prevent your blood from clotting too easily. You cannot take warfarin during pregnancy.
Talk to your doctor:
- About any side effects you may have
- If your medicines no longer help your symptoms
- If you have new symptoms
- If you want to become pregnant
- About any vitamins or herbal supplements you take — they might not mix well with medicines you use to treat lupus
How can I cope with lupus?
It is important to take an active role in your treatment. It helps to learn more about lupus – being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.
It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help. Keep in mind that so far, scientific support for that claim that any form of alternative medicine can treat lupus is lacking. These are some proposed complementary therapies.
Can I die from lupus?
Yes, lupus can cause death. But, thanks to new and better treatments, most people with lupus can expect to live long, healthy lives. The leading causes of death in people with lupus are health problems that are related to lupus, such as kidney disease, infections, and heart disease.
Work with your doctor to manage lupus. Take your medicine as your doctor tells you to and make healthy choices, such as not smoking, eating healthy foods, getting regular physical activity, and managing your weight. Learn more about eating healthy in our Living with lupus section.
What research is being done on lupus?
Research on lupus focuses on:
- The genes that play a role in lupus and in the immune system
- Ways to change the immune system in people with lupus
- Different symptoms and effects of lupus in different racial and ethnic groups
- Things in the environment that may cause lupus
- The role of hormones in lupus
- Birth control pills and hormone therapy use in women with lupus
- Heart disease in people with lupus
- The causes of nervous system damage in people with lupus
- Treatments for lupus
- Treatments for organ damage caused by lupus, including stem cell transplantation
- Getting a better idea of how many Americans have lupus
What is the best Natural Treatments For Lupus ?
There was a time when there wasn’t much a doctor could do for a patient with lupus. But there have been amazing advances since then, and patients will find they have many different treatment options for their lupus. Natural cures can go a long way towards helping patients alleviate, or even eliminate, their symptoms.
Here are some of the natural remedies lupus sufferers have found beneficial.
Fish Oil Omega-3 Fatty Acids
Lupus causes inflammation, which is largely responsible for the joint pain and stiffness lupus sufferers often experience. Fish oil contains omega-3 fatty acids, which can stop the body from producing the biochemicals that can cause this inflammation. Try adding more fatty fish to your diet. You can also take fish oil supplements.
Shown to curb inflammation, omega-3 fatty acids have been found to improve symptoms in lupus patients in several studies.1 You can increase your omega-3 intake by eating oily fish (such as salmon and sardines) or flaxseeds, or by taking a daily omega-3 supplement.
Vinegar and Water Soaks
One of the most bothersome symptoms lupus sufferers experience is pain in their hand joints. We all use our hands to do just about everything, including performing essential, every day tasks. But , when your hands hurt, it can be hard to do much of anything. One way to relieve pain in your hands caused by lupus is to soak them in a vinegar and water bath. Combine warm water and a two or three tablespoons of vinegar in a sink or large bowl, and soak your hands in that mixture for about 10 or 15 minutes.
- Turmeric is an Indian spice that contains a compound call curcumin. And curcumin is an antioxidant. Many patients suffering from autoimmune diseases, like lupus, find that taking 400 to 600 about three times a day helps to relieve many of their aches and pains, including joint swelling and stiffness. Also, patients who felt a lupus flare coming on often found that taken curcumin helped to decrease the severity of the flare.
Herbal Medicine and Mind-Body Therapies
- It is important to get the proper medical treatment, preferably from a specialist, if you have lupus. Natural cures, however , can help you find even more relief from lupus pain.
- Herbal Medicine –Though not specifically studied in lupus patients, anti-inflammatory herbs like ginger and turmeric may be especially helpful for lupus patients suffering from arthritic symptoms.
- Vitamin and Mineral Supplements
- Corticosteroids (inflammation-fighting drugs often used in lupus treatment) may thin your bones and increase your risk of osteoporosis. To keep your bones strong while on corticosteroids, ask your healthcare provider about daily vitamin D and calcium supplements.
- Mind-Body Therapies – Using mind-body techniques like hypnotherapy and guided imagery may help you deal with the stress of lupus.1 For more help in coping and alleviating stress, make sure to get plenty of sleep and exercise regularly. Ask your healthcare provider about the right amount and types of exercise for you.
- DHEA – Research suggests that dehydroepiandrosterone (DHEA), a steroid hormone essential to the production of estrogen and testosterone) may enhance quality-of-life for people with lupus. While DHEA shows promise as a complementary treatment for lupus, regular use of DHEA supplements could raise your risk of heart attack and some types of cancer. Therefore, it’s critical to use DHEA only under the supervision of your primary care provider.