Lupus

Around 20% of people with scleroderma, also have lupus as a cross over condition.

Systemic Lupus Erythematosus (SLE), is an autoimmune condition, which causes inflammation and damage to the joints, muscles and other organs.

There are two other forms of the condition: Discoid lupus (DLE), is usually a condition of the skin alone although some patients may develop systemic lupus.

Drug- induced lupus (DILE), which can occur during the administration of certain drugs in susceptible individuals such as Hydralazine, Phenytoin and anti-TNF drugs. (In most cases, after treatment is stopped the symptoms of drug-induced lupus will be alleviated.

Symptoms of Systemic Lupus

While there are lots of different possible symptoms of lupus, the two most common symptoms are joint/ muscle aches and pains and extreme fatigue and weakness, although it is worth stressing, no two patients present with the same symptoms and they can vary in severity.

Other common signs include:

  • Joint/ muscle aches and pains
  • Extreme fatigue and weakness
  • Butterfly rash over cheeks
  • Kidney problems
  • Oral/ nasal ulcers
  • Hair loss
  • Rashes from sunlight/ UV light
  • Flue-like symptoms and/ or night sweats
  • Raynaud's
  • Seizures, mental illness or other cerebral problems
  • Headaches, migraines

Who gets lupus?

Lupus is most prevalent in women (nine times as often as men), and often occurs during the childbearing years. It can also occur in children or any age.

Afro-Caribbean, Asian and Eastern races, are statistically, more likely to develop lupus.

What causes lupus?

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

Lupus has also been found to be hereditary. Where there is a family history of the condition or other autoimmune illnesses such as rheumatoid arthritis or scleroderma.

How is it diagnosed?

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

Can it be treated?

Anti-inflammatory drugs can be used for patients who have mainly joint/ muscle pain as well as steroids such as prednisolone, and immunosuppressants (such as methotrexate and azathioprine) for those for whom the disease is more severe.

Antimalarials are the most commonly prescribed treatment for lupus. In addition to helping with skin and joints, they can help with fatigue, decrease cardiovascular risk, improve pregnancy outcomes and decrease frequency of lupus flares. Hydroxychloroquine and mepacrine are most commonly used.

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

Is there anything that can done to help day-to-day?

Although it may be difficult, try to plan rest periods throughout the day and minimise stress by taking regular gentle exercise

Keep good communication with your specialist team, advise them of any changes so they can monitor drug usage and assist with self help techniques.

Avoid sun exposure, wear a hat, moisturiser with factor 30 sunscreen as a minimum and cover up where you can. Many people with Lupus can have factor 50+ sunscreen prescribed.

If you smoke try to stop as soon as possible. We know 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 where symptoms may be triggered more severely due to environment or personal factors such as sunlight or stress). By speaking with your health professional during the earlier stages it may allow earlier treatment.

Raynaud's Phenomenon can often be a sign of Lupus, when it is in it's secondary form and occurs in 1 fifth of people with the condition.

Overlap syndromes: some patients with 'lupus' do not have pure SLE as described, but have overlapping features 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's important if your symptoms change, you go back to your consulting team and get checked out.

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.

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