What is Lupus?
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Systemic lupus erythematosus (S.L.E.), commonly called lupus, is a chronic autoimmune disorder that can affect virtually any organ of the body. In lupus, the body's immune system, which normally functions to protect against foreign invaders, becomes hyperactive, forming antibodies that attack normal tissues and organs, including the skin, joints, kidneys, brain, heart, lungs, and blood. Lupus is characterized by periods of illness, called flares, and periods of wellness, or remission.
Because its symptoms come and go and mimic those of other diseases, lupus is difficult to diagnose. There is no single laboratory test that can definitively prove that a person has this complex illness.
Other Types of Lupus
Although the broad term "lupus" usually refers to S.L.E., this is only one type of the illness. There are two 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.
Symptoms of Lupus
Most people with lupus have symptoms in only a few organs. If you have not already been diagnosed, the following table may alert you to the possibility of lupus. If you have already been diagnosed, these symptoms may indicate increased activity of the disease, known as a "flare." You may also have periods of remission when few or no symptoms are present. For most people, lupus can be managed and will affect only a few organs. Others may face serious, sometimes life-threatening problems.
Common Lupus Symptoms
- Achy joints (arthralgia)
- Fever over 100 degrees F
- Swollen and painful joints (arthritis)
- Prolonged fatigue
- Skin rashes
- Swollen ankles (kidney involvement)
- Chest pain upon deep breathing (pleurisy)
- Butterfly-shaped rash across cheeks and nose
- Sensitivity to sun (photosensitivity)
- Unusual hair loss
- Abnormal blood clotting problems
- Pale or purple fingers from cold or stress (Raynaud's Phenomenon)
- Mouth ulcers (often painless, at roof of mouth)
These symptoms are particularly important when several occur together. No two lupus patients have identical symptoms and complaints.
Many people have lupus for a long time before it's detected. If you think you may have lupus, contact a doctor for an initial diagnosis. If you do have lupus, it needs to be treated and managed as early as possible.
Lupus is chronic, complex, and difficult to diagnose. No single lab test can tell if you have lupus. Many lupus symptoms imitate symptoms of other diseases and often come and go. Your primary care doctor or rheumatologist will use your medical history, a physical exam, and many routine as well as special tests to rule out other diseases. Many physicians also use the American College of Rheumatology's "Eleven Criteria of Lupus" to aid in the diagnosis of lupus. The criteria include symptoms as well as specific laboratory findings that provide information about the functioning of a person's immune system. In most cases, the diagnosis of lupus is made when four or more of the criteria have occurred at some time.
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
For more information about Lupus: