Lupus

Lupus is an autoimmune disease that attacks women between the ages of 15 and 40. It occurs less often in men than in women. The people affected by lupus vary depending on the country or region. In the US alone, the prevalence rate is highest among Asians of Hawaii, blacks of Caribbean origin, and Native Americans of the Sioux, Arapahoe, and Crow tribes. Lupus is a disease that affects the immune system. We can think of the immune system as an army within the body with hundreds of defenders (known as antibodies). They defend the body from attack by germs and viruses. In lupus, however, the immune system becomes overactive and creates antibodies that attack healthy tissues in the body, such as: the skin, kidneys, lungs, heart and brain. This attack induces inflammation, causing redness, pain, and swelling. It is not contagious. Symptoms come and go and vary from person to person. The symptoms can develop so slowly that the person may not notice for a long time. When the lupus symptoms are evident, they are called flares or relapses. When the symptoms are better, it is said that they are in remission.

There are three major types of lupus:

1. Systemic Lupus Erythematosus - lupus that affects certain parts of the body

2. Discoid or Cutaneous Lupus - lupus mainly of the skin

3. Drug-Induced Lupus - lupus caused by medicine

Systemic lupus erythematosus, sometimes called SLE, is the most serious form of the disease. Systemic means that it may affect many parts of the body, such as the joints, skin, kidneys, lungs, heart, or the brain. This type of lupus can be mild or serious. If it is not treated, systemic lupus can cause damage to the organs inside your body. Discoid and cutaneous lupus mainly affects the skin. The person may have a red rash or a color change of the skin on the face, scalp, or other parts of the body. Drug-induced lupus is caused by a small number of prescription medications. The person with drug-induced lupus may have the same symptoms as the person with systemic lupus, but it is usually less serious. Usually when the medicine is stopped, the disease goes away. The most common drugs that can cause lupus are procainamide, used for heart problems, hydralazine used for high blood pressure, and dilantin used for seizures. Drug-induced lupus is usually found in older men and women of all races.

The cause is not known, but certain factors combined are thought to be significant contributors to the development of lupus. These include genetic defects, hormonal factors, medications, some infections, exposure to ultraviolet B light, and chemical exposure. Some of the infections that are suspected triggers are the Epstein-Barr virus, cytomegalovirus, parvovirus, and hepatitis C. Some known chemical exposures include trichloroethylene found in well water and silica dust.

The most common symptoms are fatigue, rashes, or joint pain. Other symptoms that might develop are skin problems, sensitivity to light, neuropsychiatric problems, fever, changes in weight, hair loss, and/or swollen glands. Some specific skin problems are skin rashes, i.e., the facial butterfly rash. Raynaud's phenomenon is often common, affecting the fingers, toes, ears, or tip of the nose. About 90% of lupus patients have fatigue in various degrees. Symptoms depend on what body organs are affected and how seriously they are affected. This disease can cause problems in nearly any system of the body, including the:

Ð'* Heart

Ð'* Kidney

Ð'* Lung

Ð'* Digestive system

Ð'* Blood cells and related organs

Ð'* Blood's clotting factors (antiphospholipid antibody syndrome)

In a few cases these problems are severe and may be life-threatening.

In order to diagnose a person with lupus, a doctor must look at the medical history and a physical examination must be done. During the examination the doctor will check for the presence of certain criteria and then must separate these from other diseases with similar symptoms. If the individual has 4 of the 11 criteria; they will likely be diagnosed with lupus. With 3 there is a probability that it is present, and 2 raise the possibility of the disease. Afterwards an antinuclear antibody (ANA) test will be conducted. This test alone cannot diagnose a person with lupus, but along with the medical history, physical, and other tests, the ANA test can help confirm the diagnosis. If physical signs and a positive ANA test result occur, further testing may not be necessary. If the doctor deems further testing necessary, these are some that he might request:

Ð'* Other antibody