Lupus

What is lupus?

Lupus is a chronic autoimmune disease in which the immune system attacks healthy tissues, causing inflammation and damage. It can affect joints, kidneys, skin, blood vessels, heart, lungs, and brain. The most common form, systemic lupus erythematosus (SLE), involves multiple organs. Other forms include cutaneous lupus (skin‐only), drug‐induced lupus (triggered by medications), and neonatal lupus (affecting infants born to mothers with lupus).

What are the types of lupus?

  • Systemic lupus erythematosus (SLE)
  • Cutaneous lupus (discoid lupus)
  • Drug‐induced lupus
  • Neonatal lupus

What causes lupus?

The exact cause is unknown, but risk factors include:

  • Genetic factors: Family history and specific genes that affect immune function
  • Environmental triggers:
    • Ultraviolet light exposure
    • Viral or bacterial infections
    • Certain medications (e.g., some blood pressure drugs, anti-seizure medications, antibiotics)
    • Smoking
    • Physical or emotional stress
  • Hormonal factors: Higher prevalence in women of childbearing age suggests a role for estrogen

What are the symptoms of lupus?

Symptoms vary by person and may flare and remit. Common features include:

  • Fatigue and unexplained fever
  • Joint pain, stiffness, and swelling
  • Skin rash, including the butterfly rash on cheeks and nose
  • Photosensitivity (sun‐triggered rashes)
  • Hair loss
  • Mouth or nose ulcers
  • Lupus nephritis (kidney inflammation)
  • Neurological issues (headaches, seizures, cognitive changes)
  • Blood abnormalities (anemia, low white cells or platelets)
  • Cardiopulmonary involvement (pericarditis, pleuritis)
  • Raynaud’s phenomenon

How is lupus diagnosed?

Diagnosis is based on:

  • Medical history and physical examination
  • Laboratory tests:
    • Antinuclear antibody (ANA) test
    • Anti‐dsDNA and anti‐Smith antibody tests
    • Complete blood count (CBC)
    • Urinalysis for kidney involvement
  • Imaging (chest X-ray, echocardiogram) to assess organ involvement
  • Biopsy (kidney or skin) when organ damage needs confirmation

Because symptoms overlap with other diseases, diagnosis may require ongoing evaluation and multiple tests.

How is lupus treated?

Treatment aims to control symptoms and minimize organ damage:

  • Nonsteroidal anti‐inflammatory drugs (NSAIDs) for pain and inflammation
  • Antimalarials (e.g., hydroxychloroquine) for skin and joint symptoms
  • Corticosteroids (e.g., prednisone) for rapid control of flares
  • Immunosuppressants (azathioprine, mycophenolate, methotrexate) for organ involvement
  • Biologics (belimumab) targeting specific immune pathways
  • Lifestyle measures:
    • Sun protection
    • Balanced diet and regular exercise
    • Smoking cessation
  • Supportive care: calcium and vitamin D for bone health, cardiovascular risk management

Regular monitoring by a rheumatologist and other specialists is essential to adjust therapy and detect complications early.

Sources

  • Lupus. American College of Rheumatology. Accessed Apr. 18, 2024.
  • Overview of Systemic Lupus Erythematosus (Lupus). National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Apr. 18, 2024.
  • What is Lupus? Lupus Foundation of America. Accessed Apr. 18, 2024.
  • Systemic Lupus Erythematosus (SLE). Centers for Disease Control and Prevention. Accessed Apr. 18, 2024.
  • What is Lupus? Autoimmune Association. Accessed Apr. 18, 2024.