What Is Lupus?
Systemic Lupus is Erythematosus (SLE), commonly referred to as lupus, a chronic inflammatory disease that happens when the body’s immune system malfunctions and attacks its own tissue and organs. The inflammation that lupus causes can affect many different systems of the body, including heart, lungs, brain, blood cells, skin, joints and kidneys.
Some people are born with a genetic predisposition to lupus but may take a trigger like an infection, certain drugs, some form of trauma to the body (surgery, an accident, etc.), or too much sunlight to manifest. It usually manifests in women (although men do get it) in childbearing years – ages 14 through 45.
Many lupus warriors struggle to receive a diagnosis because symptoms can mimic those of other diseases; the most distinctive symptom of lupus is what is called a malar, or ‘butterfly’ rash – a facial rash that spreads across the cheeks and resembles the wings of a butterfly.
Lupus is a relapsing/remitting disease, where one may go through periods of feeling good and then have intermittent flare-ups of inflammation, fever, and/or rashes. There, currently, is no cure for SLE, but there are some treatments that help to manage the severity of the disease. There are also diet changes, and holistic options for managing your lupus.
Types of Lupus
There are 4 types of lupus: systemic (inflammation of the kidneys, nervous system/brain, heart and/or lungs), cutaneous/discoid (limited to the skin – rashes, lesions, etc.), drug-induced (temporary, but can mimic systemic symptoms for the duration of time a patient is on certain drugs), neonatal (affects babies of women with certain auto antibodies)
For more information on the different types of lupus you can visit John’s Hopkins Lupus Center Website
Symptoms range from mild to life threatening.
Most common symptoms:
- Extreme fatigue
- Joint pain, stiffness and swelling
- Butterfly-shaped rash on the face that covers the cheeks and nose
- Ulcers in the mouth and/or nose
- Shortness of breath
- Chest pain
- Dry eyes
- Confusion and memory loss
- Raynaud’s Phenomenon (fingers or toes that turn white or blue with exposure to cold)
- Flu like symptoms (nausea, vomiting, recurring/persistent abdominal pain)
- Bladder infections
- Blood in urine
- Persistent pain and swelling of legs, joints or feet
- Hair loss
- Abnormal blood clotting
How is Lupus Diagnosed?
There is no one blood test can be used to diagnose lupus, rather there are certain symptoms, blood test results, and examinations that a rheumatologist will use to make a diagnosis. There are two accepted diagnostic guides, the Systemic Lupus International Collaborating Clinics (SLICC) and The American College of Rheumatology (ACR). Both are listed below.
The American College of Rheumatology (ACR) states that you must present at least four (4) of the below-listed criteria
- Malar rash
- Discoid rash
- Oral or nasal ulcers
- Arthritis of multiple joints
- Serositis: inflammation of the tissue lining the lungs (pleurisy or pleuritis) or the heart (pericarditis)
- Kidney problem (blood, protein or casts in the urine or poor kidney function)
- Neurologic problem: seizures, strokes, or psychosis
- Low blood cell counts (anemia, low white blood cells, or low platelets)
- Positive antinuclear antibodies (ANA) **present in nearly all lupus patients
- Certain abnormal antibodies (anti-double-strand DNA, anti-Smith, or antiphospholipid antibodies)
The Systemic Lupus International Collaborating Clinics (SLICC) Criteria looks at clinical (symptomatic) and immunological (blood tests) categories. You must present at least four (4) of the criteria at least one (1) from each category.
1. Acute cutaneous lupus including lupus malar rash (do not count if malar discoid)
2. Chronic cutaneous lupus
3. Oral ulcers
4. Nonscarring alopecia
5. Joint inflammation involving two or more joints, characterized by swelling or effusion OR tenderness in 2 or more joints and thirty minutes or more of morning stiffness.
7. Renal (Urine protein/creatinine Red blood cell casts)
8. Neurologic (seizures/psychosis)
9. Hemolytic anemia
1. ANA above laboratory reference range
2. Anti-dsDNA above laboratory reference range
4. Antiphospholipid antibody
5. Low complement (low C3, low C4, low CH50)
6. Direct Coombs test in the absence of hemolytic anemia