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Questions & Answers on Lupus

Q. What is lupus?

A. Lupus is a chronic autoimmune disease in which the immune system turns against the body and harms healthy cells and tissues. Lupus, which is also considered a rheumatic (arthritic) disease, can affect many parts of the body including the joints, skin, kidneys, lungs, heart or brain. Some of the most common symptoms of lupus include extreme fatigue, painful or swollen joints, unexplained fever, skin rashes, and kidney problems. For many symptoms, lupus treatment is possible.

Q. What is an autoimmune disease?

A. An autoimmune disease is a disease that occurs when antibodies (immune system proteins that counteract or eliminate foreign substances) react against the body’s own tissues. Examples of other autoimmune diseases include rheumatoid arthritis, Sjögren’s syndrome, scleroderma, Graves’ disease, inflammatory bowel disease, Type I diabetes, and multiple sclerosis. Autoimmunity has a genetic component and may appear in families as different autoimmune diseases.

Q: What is a rheumatic disease?

A: The rheumatic diseases are a group of disorders that cause aches, pain and stiffness in the joints, ligaments, tendons, muscles, and bones. Some examples of rheumatic diseases include osteoarthritis, rheumatoid arthritis, scleroderma, vasculitis, and myositis.

Q: What causes lupus?

A: We don't know yet what causes the immune system to become overactive. Scientific evidence indicates that lupus is caused by a combination of genetic and environmental factors. Studies show that lupus runs in families, meaning that certain genes predispose you to the disease. Environmental triggers may include ultraviolet light, bacterial and viral infections, medications, diet and stress.

Q: Are there different kinds of lupus?

A. Yes, there are three major types of lupus:

  • Systemic Lupus Erythematosus is the most serious form of the disease. It is a chronic, inflammatory, multisystem disorder of the immune system that may affect parts of the body such as the joints, skin, kidneys, heart, lungs, blood vessels or brain.
  • Discoid Lupus primarily affects the skin, causing lupus face rash. A red, raised rash may appear and become thick and scaly. Lesions usually occur on the face or other sun-exposed areas and may scar.
  • Drug-induced Lupus is caused by a small number of prescription medications. Usually when the medicine is stopped, the disease goes away. The most common drugs that can cause lupus are procainamide (for heart problems), hydralazine (for high blood pressure) and dilantin (for seizures).

Q: What are flares?

A: Lupus is characterized by periods of increased or intensified disease activity, called flares. Some patients may have persistent disease activity without distinct flares. Understanding how to prevent flares and how to treat them when they do occur helps people with lupus maintain better health.

Q: Who gets lupus?

A: According to the National Institutes of Health, nine out of ten people who have lupus are women. It often first appears during the childbearing years—ages 15 to 45. Lupus is three times more common in African American women than in Caucasian women, and is also more common in women of Hispanic, Asian, and Native American descent.

Q: What are the criteria for diagnosing lupus?

A: The following eleven criteria for formal classification were established by the American College of Rheumatology. If at least four of the eleven criteria develop at one time, or individually over any period of observation, you may have lupus.

  • Malar rash ­ a redness or rash that may appear in a butterfly configuration across the nose and cheeks. It can appear on one or both sides of the face and is usually flat
  • Discoid rash ­ thick raised patches that can occur on any part of the body and may result in scarring
  • Sun-sensitivity ­ a reaction to sunlight that is more severe than just sunburn
  • Oral ulcers ­ frequent development of mouth or nose ulcers
  • Inflammation of joints ­ pain, tenderness or swelling in two or more joints
  • Inflammation of the lining of the lungs (pleurisy) or heart (pericarditis)
  • Kidney disorder ­ existence of excessive protein in the urine (proteinuria), or the existence of cellular casts in the urine. Casts are aggregates of cells, or cell remnants, stuck together which are normally found in the blood, or fragments of the tubules of the kidney itself
  • Nervous system disorder ­ seizures or psychotic behavior that cannot be attributed to drugs or metabolic dysfunction
  • Blood system disorder ­ changes in the blood which may include hemolytic anemia (red blood cells are coated with antibodies that cause them to break down and break apart); leukopenia (low white blood cell count); lymphopenia (decrease in the number of lymphocytes, the main cells of the immune system, in the blood); or thrombocytopenia (low number of platelets in the blood)
  • immunologic disorder ­ the presence of the LE (lupus erythematosus) cell, a false positive reaction to the tests for syphilis, or the presence of antibodies (proteins that make up the cell's membrane or covering)
  • A positive ANA ­ antibodies made against the nucleus of cells

Q: How is lupus treated?

A: Treatments may differ, depending upon the person with lupus and the physician. There is, however, a general consensus on several forms of treatment:

  • physical and emotional rest
  • avoidance of, or protection from direct sunlight
  • healthy diet
  • prompt treatment of infections
  • avoidance of known allergens and aggravating factors
  • female patients must plan pregnancy for times when the disease is in remission
  • Medications most frequently used to control symptoms are nonsteroidal anti-inflammatory drugs (NSAIDs)
  • antimalarials
  • corticosteroids
  • immunosuppressants (or cytotoxic drugs)
  • other medications may be necessary to control specific manifestations

Q: Can you catch lupus from someone else?

A: No, lupus is not contagious. You cannot give it to someone else.

Q: Is there a cure for lupus?

A: There currently is not a cure for lupus and treatments may have serious side effects. The Alliance for Lupus Research hopes that more intensive research will lead to better lupus prevention, treatment, and a cure. In the meantime, people with lupus should seek the care of a physician familiar with the disease.

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