Lupus

Systemic lupus erythematosus (SLE), is an autoimmune condition, which causes inflammation and damage to the joints, muscles, kidneys and other organs.Around 20% of people with scleroderma also have lupus as a cross-over condition or 'overlap syndrome'.

One third of people who have lupus also have Raynaud's. There are two other forms of this condition. Discoid lupus (DLE) usually affects the skin alone, although some patients may develop systemic lupus. Drug-induced lupus (DILE) can occur during the administration of certain drugs in susceptible individuals such as Hydralazine, Phenytoin and anti-TNF drugs. In most cases, the symptoms of drug-induced lupus will be alleviated once the treatment is stopped.

Signs and symptoms

Whilst there are many possible symptoms of lupus, the most common signs are aches and pains within the joints and muscles and extreme fatigue and weakness. It is important to note that no two people will have exactly the same symptoms, and lupus varies widely in its severity. Typical symptoms may include all of the following:

  • Joint/muscle aches and pains
  • Extreme fatigue and weakness
  • Butterfly rash over the cheeks
  • Kidney problems
  • Oral/nasal ulcers
  • Hair loss
  • Rashes from sunlight/UV light
  • Flu-like symptoms and/or night sweats
  • Raynaud's phenomenon
  • Mental health problems
  • Headaches or migraines
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Who gets lupus?

Lupus is most prevalent in women (the incidence is around nine-times higher than in men), and often occurs during the childbearing years, although it can affect anyone at any age.

What causes lupus?

There are various factors that may cause someone to develop lupus such as puberty, the menopause, following childbirth or after trauma. It can also be triggered by a virus or following exposure to UV rays.

Lupus has also been found to be hereditary so family history is important, as well as any history of other autoimmune conditions such as scleroderma or rheumatoid arthritis.

How is it diagnosed?

With such a wide range of symptoms, lupus can be difficult to diagnose. A health professional may carry out an ANA (anti-nuclear antibody) blood test as well as a urine test to check for blood and protein.

Can lupus be treated?

Unfortunately, there is no cure for lupus yet but if the condition is monitored and a good treatment programme is put in place, it can usually be managed fairly well.

Antimalarials, such as hydroxychloroquine and mepacrineare, are the most commonly prescribed treatment for lupus. In addition to helping with skin and joint problems, they can reduce fatigue, decrease the cardiovascular risk, improve pregnancy outcomes and reduce the frequency of lupus flares.

Anti-inflammatory drugs can be used if someone has mainly joint and muscle-related symptoms, as well as steroids such as prednisolone. Immunosuppressants, including methotrexate and azathioprine, can be prescribed if the symptoms are more severe.

Living well with lupus

  • Although it may be difficult, try to plan rest periods throughout the day and minimise stress by taking regular, gentle exercise
  • Keep in contact with your specialist team and advise them of any changes so that they can monitor drug usage and assist with self-help techniques
  • Avoid sun exposure, wear a hat, use a minimum of factor 30 sunscreen and cover up where you can. Sunscreen is available on prescription to many people who have lupus
  • If you smoke, try to stop as soon as possible. We know that smoking causes circulatory problems and fibrosis of the lungs
  • Be aware of your own body and symptoms as these may signal a 'flare' (a time when symptoms may be triggered more severely due to environmental or other factors such as sunlight or stress). Talking to a healthcare professional during the earlier stages can help you to access help quickly
  • Raynaud's phenomenon can often be a sign of lupus. Secondary Raynaud's occurs in one-fifth of people diagnosed with lupus
  • 'Overlap syndromes' occur in some lupus patients who also have symptoms that overlap with other connective tissue diseases, such as scleroderma, polymyositis, rheumatoid arthritis and Sjögren's syndrome. Symptoms such as chronic fatigue, joint aches and pains are common to several conditions so it is important to talk to your doctor if your symptoms change

Lupus specialist centres

  • Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL
  • Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ
  • Manchester Royal Infirmary, Grafton Str, Manchester M13 9WL
  • Louise Coote Lupus Clinic, Guys Hospital, Great Maze Pond London SE1 9RT
  • UCLH, 235 Euston Rd, Fitzrovia, London NW1 2BU
  • Queen Elizabeth Hospital, Mindelsohn Way, Birmingham B15 2TH
  • Alder Hey Children's Hospital, E Prescot Rd, Liverpool L14 5AB

Private practice

London Bridge Lupus Centre, London Bridge Hospital, 27 Tooley Street, London SE1 2PR (not NHS)

Tel: 020 7234 2155

Email: londonlupuscentre@hcahealthcare.co.uk

For further information people can contact LUPUS UK).

With thanks to Lupus UK for assisting with the content and imagery supplied for the article.