What is lupus? (Overview)
Systemic Lupus Erythematosis (SLE), also known by its shortened name, Lupus, is a chronic autoimmune disease which causes inflammation throughout the body. An autoimmune disease is characterised by the body’s own immune system as the primary source of inflammation, as well as the breakdown of its own cells. Basically, the body’s immune system mistakes its own tissues for foreign ‘invaders’ and ‘attacks’ them.
Inflammation can affect various tissues and organs in the body including joints, skin, lungs, brain, heart, bloodstream and kidneys. In some cases, this can lead to permanent damage in one or more areas of the body.
Lupus is often difficult to diagnose as the most common symptoms generally mimic those of other ailments and conditions. One symptom, however, which is a distinctive sign of lupus is a facial rash resembling the wings of a butterfly across the bridge of the nose and both cheeks. This rash does not, however appear in all cases of lupus.
Some individuals appear to be naturally more prone (born with a tendency) to developing lupus that is triggered by infections, medications, and even sunlight.
SLE affects the skin and vital internal organs. SLE incorporates systemic rash, SCLE and other skin manifestations. The raised, scaly, butterfly rash (or malar rash) across the bridge of the nose and cheeks is typically seen with this condition, as with other parts of the skin too. Rashes can leave scars if left untreated.
Inflamed or damaged connective tissue in the joints, muscles and skin, as well as the membranes surrounding or within the lungs, kidneys, heart and brain is also commonly seen with SLE. Extensive damage can lead to kidney disease, depression and confusion, seizures and strokes.
SLE also affects the blood vessels in the body, which may come ‘under attack’. This can result in sores and lesions developing on the skin, particularly on the fingers. Another condition which typically develops because of this is Raynaud’s syndrome (disease) where small blood vessels contract in the skin, preventing blood from circulating properly to the hands and feet. This often occurs in response to cold. Those experiencing this should keep their hands and feet warm throughout the colder months of the year (in particular). Most of these ‘attacks’ last a few minutes, but are known to be painful at times, turning the hands and feet a white or bluish colour.
Typically, lupus affects African, Asian or Native American ethnic groups more so than white (Caucasian) people (2 to 3 times as often). Nine out of ten people diagnosed with lupus are women. A diagnosis in both males and females is also often made between the ages of 15 and 44. Lupus can, however, be diagnosed in older individuals too.
Lupus can be severe, and for some, is potentially life-threatening. Some may suffer life-long disabilities due to the disease. Many, however, experience a milder form of it. In all cases, lupus is currently an incurable disease and can only be treated and managed with the help of a medical professional.
Symptoms of lupus
The nature of lupus symptoms varies between mild and severe, and may develop over a short period of time or slowly. The body’s natural defence system (the immune system) is compromised and ‘attacks’ viruses and bacteria (as in a normally functioning and healthy individual) as much as it does its own healthy cells and tissues.
Every case of lupus is different, and no two diagnoses are exact mirror images of one another. Symptoms typically depend on the specific areas of the body the condition is affecting, and show flare-ups (every so often). Sometimes symptoms worsen and then appear to resolve (clear up), and in other instances go away completely, while others seem never to improve at all.
General symptoms in most cases are:
- Extreme fatigue
- Muscle aches, severe joint pain and swelling
- Skin rashes (on the face and body – known as a ‘butterfly rash,’ medically termed a malar rash)
- Extreme sun sensitivity (photosensitivity)
- Weight loss (unexplained)
- Chest pain (especially when taking a breath)
- Shortness of breath
- Sores in the nose, mouth or throat (lesions and skin growths)
- Poor blood circulation (in the fingers and toes)
- Hair loss and bald patches
- Chronic dry eyes
Less common, but notable symptoms can include:
- Confusion or memory loss
- Raynaud’s disease / syndrome
- Enlarged lymph nodes (15% of Lupus patients have enlarged lymph nodes)
How does lupus affect the body?
Lupus can affect any area or multiple areas of the body. To diagnose or treat lupus, it is important to understand how it affects various areas differently. We’ve broken down some of the main areas where lupus has the greatest effects:
- The heart and lungs: A person with lupus is at greater risk of heart disease and stroke because of long-term inflammation in the body. Inflammation can occur in the heart, or the sac that surrounds it, causing sharp pains in the chest area. Inflammation is also commonly experienced in the outside lining of the lungs (pleura), causing pain particularly when inhaling (taking in a deep breath). This inflammation is often referred to as pleurisy. Inflammation can cause scarring (damage) and lead to problems with shortness of breath.
- The skin: UV rays in sunlight affect the sensitive skin of a lupus sufferer and causes many changes. Common problems include red, scaly bumps or patches, coin-like patches (discoid lesions), subacute cutaneous lesions (which are commonly experienced on the arms, shoulders, neck, or upper torso), red, ring-shaped rashes and a butterfly-shaped rash (this can be appear as a faint blush or a severely scaly rash). Mouth or nose sores (ulcers), alopecia (hair loss where hair follicles become damaged, fragile or brittle) and white or blue fingers and toes that may tingle, hurt or go numb (Raynaud’s syndrome) are also common skin-related problems. Skin changes can also occur in the lower legs in the form of red / purplish spots. Inflammation and damaged blood vessels show up as small red / purplish spots or larger knots, as well as lines or spots (bumps) in the folds of your fingernails or finger tips (cutaneous vasculitis lesions). Skin tissue can become severely damaged and result in gangrene. If ever you notice small black spots on your fingers or toes, immediately consult your medical doctor. Livedo reticularis (a bluish, lacy pattern under the skin, resembling a ‘fishnet’ type of look) can also appear on the legs. As with Raynaud’s syndrome, this skin problem typically worsens in colder weather.
- The kidneys: Damage through inflammation to the kidneys can be permanent. This often results in swelling in the legs or high blood pressure. Blood cells or the presence of protein in your urine are often signs of kidney damage. In extreme cases, permanent damage can lead to kidney failure requiring dialysis.
- The brain and central nervous system: Memory loss, confusion or clouded thinking, headaches, anxiety, depression, stroke and seizures are often signals that there is some degree of damage in the brain or nervous system. All these symptoms can be caused by lupus.
- The eyes: Dryness or a ‘gritty’ sensation are common eye problems. Blood vessel changes in the retina can also weaken or impair a person’s vision. Nerves and muscles that help control eye movements can also be damaged as a result of lupus.
- The joints and muscles: Joint pain, stiffness and swelling is most commonly experienced in the hands, wrists and feet. Swelling may not damage the joint directly, but it can be painful. Muscles merely weaken in the body.
Causes of lupus
There is no single known factor that specifically causes lupus, but rather a combination of factors that trigger symptoms of the condition. Lupus is still, for the most part, a condition undergoing extensive research, especially when it comes to direct causes, and by extension most effective treatments.
The general consensus among researchers and medical professionals is that the following factors in common (or a combination of) have a strong influence on the development of this condition’s symptoms:
- Genetics: Research indicates that heredity may play a role, but is not necessarily a direct cause of the condition. However, a person can be predisposed if there is a family history. At the same time, it also doesn’t necessarily mean a person is at higher risk (than other people) of developing lupus.
- The environment: As with genetics, no definite conclusions through research have been made, but there are commonly noted environmental triggers most cases have in common. These triggers include smoking, stress, toxins, and silica dust. Sunlight (an exposure to ultraviolet / UV light) does trigger a direct internal response in those people more susceptible to the condition. Exposure to sunlight is the only environmental trigger than has been found to be directly associated with skin inflammation and especially, the malar butterfly rash, which are distinct lupus symptoms. Inflammation of internal organs in people more susceptible to developing lupus has also been found to be directly linked to UV light exposure.
- Hormones: Abnormal oestrogen levels are being researched as a potential risk factor or trigger for lupus. Nothing conclusive has, as yet, been determined as a direct link but numerous studies do suggest that hormonal abnormalities could play a role in disease development.
- Infections: Many types of viral (and bacterial) infections have been researched and it is strongly believed that these may be linked to triggering lupus symptoms or causing a relapse. Most associations, however, are still being researched to establish direct links. Viruses or infections believed to play a role include cytomegalovirus, hepatitis C, and the Epstein-Barr virus.
- Medications: Direct links between lupus and the long-term use of medications for other chronic conditions are undergoing extensive research. Drug-induced lupus erythematosus (DILE) is classified as a subset of the condition, but has been found to be rare. Common medications that have been found to play a role include those used to treat high blood pressure and irregular heartbeats, as well as anti-seizure medications and antibiotics. Symptoms influenced by DILE can subside or clear completely once the specific medication is discontinued.
Cutaneous types of lupus
Lupus dermatitis is classified into 4 cutaneous manifestation types (skin manifestation types). These are:
- Discoid lupus erythematosus (DLE): This type mainly affects skin that is exposed to UV light (sunlight), resulting in skin lesions which often leave scars once healed. Typically, sunlight exposure does not affect vital internal organs. This is a separate diagnostic entity when there is no vital organ involvement.
- Systemic rash: Photosensitive and slightly raised erythema occurs on the face, ears, neck, chin, back and arms.
- Subacute cutaneous lupus erythematosis (SCLE): Scaly red patches, similar to psoriasis, appear and are severely photosensitive.
- Other: Other skin manifestations such as urticaria, or lichen planus occurs.
Risk factors and complications
Some basic factors which may increase your risk if you are more susceptible to falling ill with lupus include:
- Your sex: Lupus can be diagnosed in both men and women, but is more common among the fairer sex.
- Your age: The most common age range (although not exclusively) in which lupus is diagnosed is between 15 and 44.
- Your race: Ethnicity does play a role in how high a person’s risk for lupus is. It has been commonly diagnosed among African-American, Hispanics and Asians.
Lupus can lead to an increased risk of infections such as urinary tract infections, respiratory infections, yeast infections, salmonella, herpes and shingles, as well as cancer, avascular necrosis (bone tissues which diminish or ‘die’ due to collapse) and pregnancy complications (higher risk of miscarriage, high blood pressure (preeclampsia) and preterm birth.
Typical complications of lupus often result from inflammation in the body in varying degrees of severity. Serious kidney damage (or failure) is one of the leading causes of death among people with lupus.
Other complications include damage to the brain and central nervous system where sufferers experience physical and behavioural changes (headaches, dizziness, hallucinations, seizures and even stroke). Blood problems (anaemia, bleeding, blood clotting or vasculitis) are also common complications.
Breathing problems and inflammation of the chest cavity lining (pleurisy) can also lead to the development of pneumonia. Inflammation of the heart muscle, arteries or pericardium (heart membrane) known as pericarditis can also occur resulting in cardiovascular disease and heart attacks.
Lupus and pregnancy
Pregnancy and lupus does carry their own set of risks and complications for both mother and child. Not all women with lupus will be completely discouraged from falling pregnant, but it is essential to work with your doctor to ensure the best outcome, keeping all risk factors and complications top of mind, for you and your unborn baby.
Many women have been able to safely fall pregnant and have healthy babies while managing symptoms of lupus.
For a woman with lupus, the first steps for a healthy pregnancy begin before the time of conception. It’s vitally important to ensure that your lupus is under control for at least 6 months before falling pregnant. Pregnancy naturally places additional stresses on the body and its functions. The healthier you are when you conceive, the greater your chances of a healthy pregnancy and baby.
Once pregnant though, your pregnancy will be classified as ‘high-risk’ and your doctor will take extra precautions. Selecting an obstetrician (gynaecologist) who specialises in or has experience with high-risk pregnancies is recommended. Selecting a hospital that is well-known for successful high-risk deliveries is also worth considering. It is also a good idea to ensure that you check your health insurance plan thoroughly so that any necessary treatments you or your baby may need are covered.
Many potential risks or complications in expectant moms with lupus can be prevented or sufficiently treated if addressed early. Some problems which could develop are:
- ‘Flares’: An improvement of normal lupus symptoms during pregnancy, while in others symptoms appear to worsen (especially during the first 3 months after birth).
- Hypertensive complications: High blood pressure (preeclampsia) often requires immediate treatment.
- Miscarriage: The loss of a baby can be as a result of high blood pressure, active lupus (a flare-up of symptoms), kidney disease or antiphospholipid antibodies (a type of antibody that increases the risk of blood clots in the veins and arteries, as well as those in the placenta). An expectant mom should be screened for antibodies, especially if a woman has miscarried before.
- Preterm delivery: This occurs more frequently where preeclampsia, antiphospholid antibodies and active lupus symptoms develop during pregnancy. Symptoms that can indicate premature labour include backache, pelvic pressure, leakage of fluid (clear or blood) from the vagina, abdominal cramps and contractions occurring every 10 minutes (or more).
When should you see a doctor?
Severe complications from lupus can happen quickly in many instances, and will require immediate medical assistance (escalating to an emergency).
Life-threatening signs can include those of a heart attack (chest pain or pressure, profuse sweating, shortness of breath, nausea and vomiting, a fast or irregular heartbeat, pain or pressure in the back, neck, jaw, upper abdomen and one or both shoulders or arms, as well as light headedness and sudden weakness), or stroke (sudden numbness, tingling or weakness, paralysis, vision changes, seizure, difficulty with speaking or understanding speech, or sudden nausea, vomiting, headache or dizziness).
Consult your doctor as soon as possible if you:
- Experience shortness of breath
- Have blood in your urine, begin urinating less often or notice smaller amounts than usual
- Have a high fever (with or without a headache or body aches typical of flu, but you haven’t likely been exposed to a virus)
- Experience unexplained changes in behaviour or thinking, and depression
- Have tingling sensations or numbness in your hands and feet
- Experience dizziness and muscle weakness
- Notice any swelling in your lower legs and or / feet
- Develop any new symptoms of lupus
Who should you see?
- A general practitioner (GP), rheumatologist or immunologist can help assess initial symptoms or treat mild cases of lupus.
- A rheumatologist or immunologist can also assist with the long-term management of more severe or complex lupus cases.
- Other specialists that are consulted as needed include psychiatrists (for mental health problems), cardiologists, dermatologists, haematologists, nephrologists, neurologists, and pulmonologists who can all treat vital organ problems caused by lupus.
Diagnosis and tests
Before making a diagnosis, your doctor or specialist will likely ask some very specific questions. Diagnosing lupus is particularly difficult as signs and symptoms can vary considerably from person to person, may vary over a period of time or even overlap with those of other disorders.
Questions you may be asked will be:
- Have you ever experienced skin rashes after being out in the sun?
- Have you noticed that your fingers become pale, numb, uncomfortable or tingle, especially during cold weather?
- Do you experience any symptoms that include problems with concentration or memory?
- Do any of your symptoms limit your ability to function normally at work, school or in your personal relationships?
- Are you aware of or have you been diagnosed with any other medical conditions?
- Are you pregnant? Do you plan to become pregnant?
If lupus is suspected, a combination of tests may be discussed with you. No single test can currently diagnose lupus. Following a physical exam, your doctor may suggest a combination of blood and urine tests.
Blood and urine tests will assess the following:
- A complete blood count: Anaemia is a strong indication of lupus. Your doctor will measure the number of red blood cells, white blood cells, platelets and the amount of haemoglobin (a protein in the red blood cells) with this blood test.
- The erythrocyte sedimentation rate: This blood test will be used to measure the rate at which your red blood cells settle to the bottom of a tube within a period of an hour. A faster than normal rate indicates a systemic condition (like lupus), but isn’t specific to any one disease or another. An elevated or faster rate can indicate any other inflammatory condition, cancer or infection.
- Kidney and liver assessment: This blood test looks at how well your kidneys and liver are functioning, and whether lupus may be affecting these organs negatively.
- Urinalysis: A urine sample will be taken to assess whether there is an increased protein level or presence of red blood cells in the urine. This test usually ties in with the blood test assessing your kidney function. If lupus is affecting your kidneys, it will be evident in the results of this test.
- Antinuclear antibody test (ANA): This test will assess the presence of antibodies, produced in the immune system, which may indicate a stimulated immune system. A positive ANA result may prompt your doctor to conduct more specific antibody testing. A positive result isn’t enough to determine lupus – many with a positive result are diagnosed with lupus, while others aren’t.
Other tests include:
- Imaging tests: If your doctor suspects any lung or heart damage, a chest X-ray (assessment of any abnormal shadows suggesting possible fluid or inflammation on the lungs) or echocardiogram (use of sound waves to produce real-time images of your beating heart, and assess any problems with the valves and other portions of the heart) test will be suggested.
- Biopsy: A small sample of organ tissue (such as the kidneys) may be taken to determine the type and extent of damage that may have occurred. This will then help your doctor determine what the best course of treatment may need to be. A needle may be used to extract this sample. Alternatively, a small incision may be required.
Treatments: medications, surgery and lifestyle
Before any treatment recommendation is made, your doctor or specialist will ensure that testing is done with great care. Testing as part of the diagnosis process can reveal a lot about how lupus is affecting your body, and as such determine the best course of treatment for your specific signs and symptoms.
Treatment won’t remain the same. As symptoms flare and abate, your treatment plan will need to be adapted to effectively manage the condition.
Treatments and lifestyle changes are helping those with the condition to live longer and better quality lives. But there is no known cure for lupus, as yet.
Treatment will focus on ways and means to reduce inflammation in the body, help prevent or relieve flares, as well as prevent further damage to organs and other areas of the body.
Medications commonly recommended include:
- NSAIDs (Non-steroidal anti-inflammatory medications): Pain, fever and swelling symptoms can be treated with over-the-counter and prescribed medications. NSAIDs can lead to problematic side effects like kidney problems, stomach bleeding and a higher risk of heart concerns, so it is always a good idea to discuss with your doctor be taking any on your own.
- Antimalarial medications: Commonly used in the treatment of malaria, these medications are also effective with controlling symptoms of joint pain, mouth sores or skin rashes. Side effects are common and can include eye retina damage (although rarely) and stomach upsets.
- Corticosteroids: These medications can help counter symptoms of inflammation by weakening an overactive immune system, but should be used with caution as higher doses can produce long-term side-effects. These can include weight gain, osteoporosis (thinning bones), diabetes, easy bruising, high blood pressure, as well as a higher risk of infection. Corticosteroids work fast to ease swelling, warmth and pain in joints and can help to prevent long-term organ damage.
- Immunosuppressants: In more severe cases of lupus these medications are useful in suppressing the immune system and can also help with preventing any long-term organ damage. Side-effects include an increased risk of infection, decreased fertility, liver damage and a higher risk of cancer. Somewhat milder side-effects are symptoms of nausea, diarrhoea and fever. Immunosuppressants are some also prescribed together with corticosteroids, allowing you to take a lower dosage of each drug and thereby, reduce debilitating side-effects.
- Anticoagulants and monoclonal antibodies: Anticoagulants assist with thinning of the blood and preventing blood clots, which can be life-threatening for those suffering from lupus. Monoclonal antibodies target specific immune cells and help alleviate the need for steroid treatment. Monoclonal antibodies are often given intravenously (through a vein).
Your doctor will not suggest any kind of surgical procedure for mild or moderate symptoms of lupus. It will only likely be considered in cases where permanent or life-threatening kidney damage is determined. Kidney transplants or kidney dialysis may be recommended instead of a long-term treatment plan involving high dosage medications due to serious side-effects which can be experienced.
Lifestyle changes and home care
Changes to your lifestyle as a lupus sufferer are just as important as a medication treatment plan. Simple changes will have a big impact on the amount of and severity of flare-ups should they occur. Lifestyle changes will help you better cope with the condition. Things you can actively do include:
- Regular check-ups with your doctor or rheumatologist (and not just when symptoms worsen). If you have kidney problems or related flare-ups, your rheumatologist will do routine blood tests to ensure that your kidneys are functioning well.
- Ensuring that you get adequate rest. Persistent fatigue as a symptom of lupus isn’t necessarily relieved by normal amounts of rest during the day. You will need to assess your own body and symptoms of fatigue and gauge when you need to slow down, take good quality breaks or naps, as well as a good night’s sleep.
- Ease levels of stress and anxiety with activities (such as yoga, meditation or tai chi) you enjoy. You can also get into the habit of using reminders if memory problems are the source of your worries. Pillboxes, cell phone voice notes, labels and other aids can help you with organisation and remembering things important to you.
- Ensuring that you are actively sun-smart. Wear protective clothing (hats, long-sleeved shirts and long trousers), and use sunscreens with an SPF (sun protection factor) of at least 55 every time you go outside. You can also take precautions when it comes to protecting your scalp and hair. Use a baby shampoo and conditioner and avoid the use of any harsh chemicals.
- Get regular exercise. This helps the body recover from a flare-up, strengthen the heart and lungs, as well as reduce the risk of heart attacks, help fight symptoms of depression and in general, promote overall well-being. Activities that are easy on the joints include walking, swimming, low-impact aerobics, yoga, pilates or using an elliptical machine.
- Ease joint and muscle pain (or stiffness) with a warm shower or bath, heating pads (or cold packs). Where joint pain and stiffness is a problem, avoid high-intensity exercises.
- Eat a balanced (healthy) diet. Diet and nutrition is fuel for your body. A healthy diet rich in fruits, vegetables and whole grains are beneficial for a person suffering from lupus, helping to keep weight, blood pressure and cholesterol under control. It can also help reduce risk of other health concerns such as high blood pressure, kidney damage or gastrointestinal problems.
- Don’t smoke. Symptoms of lupus will worsen if a sufferer smokes. Smoking directly affects the heart and blood vessels, elevating blood pressure and thus increases your risk for developing cardiovascular disease and lung infections.
- Get vaccinations. Flu and pneumonia vaccinations can help protect against infections.
Living with lupus
As with any other illness, living with and learning to cope with the condition can take its toll on a person, both mentally and emotionally. Whether having just been diagnosed, or managing the illness for years, you are likely to experience mental, physical and emotional problems (such as grief, fear, depression and anxiety).
Emotions because of your condition have multiple causes. Visible problems (physical appearance) caused by the condition or due to treatment (medications) can have negative effects on a person’s self-esteem. These include skin problems (such as rash) or excessive weight gain.
You may also feel emotionally affected by pain, fatigue and other symptoms which may make it difficult for you to participate in things you enjoy. Pain and fatigue can wear you down and cause frustration and feelings of hopelessness. You may even isolate yourself from social activities, especially if changes to your physical appearance make you more self-conscious. Things you gain pleasure from, such as your job, sense of purpose and your income can take a knock, but often may only need to be managed more effectively.
Sometimes the mental and emotional effects of lupus are related to the disease process itself. Common mental problems include cognitive dysfunction which can lead to symptoms of depression. Depression and anxiety, mood swings and personality changes can also arise as a psychological reaction to the condition, as well as a side-effect of medicinal treatment.
Living with a chronic condition, and especially one that is unpredictable can lead to feelings of uncertainty and anxiety. Will you be able to lead an independent lifestyle? What will happen if your symptoms worsen and become debilitating? Can you manage on your own physically and financially? Can you take care of your family?
Many questions may flood your thoughts and cause you distress. It’s important to address your anxiety through a strong support system (friends, family, support groups) or medical health professional (therapist). You may find simple solutions to many of your questions, where you yourself can adapt to enable a better day-to-day quality of life. Steps you can take include educating yourself and others about your condition and its treatment, as well as practicing healthy lifestyle habits and stress-management techniques.
It can also be as simple as changing or better managing a medication you are on. Sometimes a mental health professional can help you to better identify and understand the source of your emotions, as well as provide coping tools you will benefit from.
Understanding where these problems originate can help you to develop better coping techniques for a better quality of life.
Is lupus a hereditary disease?
There are still many questions when it comes to exact causes of lupus. A combination of factors does appear to consistently cause the condition, although none on their own are conclusive enough to diagnose it.
A genetic predisposition is one of these factors, but no single gene or group of genes has been proven as a cause. It is merely agreed among researchers that it does play a role. This is because heredity has come up as a common point of interest in multiple cases. Lupus does appear to affect certain families. In some instances, one of two identical twins can be diagnosed with the illness and the other at higher risk of developing the disease at some stage in their lives.
How serious is lupus?
As with many medical conditions, lupus can be a mild or more severe illness. The milder the symptoms and problems of the illness, the easier it is to effectively manage and treat. In all cases, lupus is a condition that should be taken seriously (thereby making it a serious condition, even if mild) as it requires constant monitoring and treatment.
The risk factors of this condition and potential complications can cause extensive harm to your internal organs, and thus put your life in great danger if not treated by a medical professional.
Can lupus go away?
The level of uncertainty around this condition means that there is still an extensive amount of research to be done. There is currently no known cure for lupus. It is a chronic illness with inconsistent symptoms, which increase and decrease in severity.
Presently medical professionals can only best manage the symptoms of the condition, as well as other complications which arise as a result. The main goal is to achieve remission (where symptoms are not present). It is, however, highly unlikely that symptoms will ever disappear completely.
Is lupus cancer?
Lupus is an autoimmune disease. Cancer is a condition of malignant, abnormal tissues in the body which grow rapidly and spread. Cancer is a serious complication of lupus, but is not the same / related illness.
Is there a link between lupus and osteoporosis and rheumatoid arthritis?
Lupus, an autoimmune disease, can have a wide range of symptoms. Some of these symptoms affect the joints of the body, which become swollen and painful due to inflammation in the body.
Osteoporosis is characterised by bones which become less dense and thus, are more likely to fracture (break). Fractures can cause a significant amount of pain and disability.
Rheumatoid arthritis (RA) is a chronic inflammatory condition and tends to affect more than just the lining of the joints. It can also damage a wide variety of other systems in the body such as those of the eyes, skin, blood vessels, heart and lungs. Rheumatoid arthritis is also classified as an autoimmune disorder and eventually causes bone erosion and joint deformity.
There is a link between lupus and an increase in bone loss and fractures in those diagnosed with SLE (Systemic lupus erythematosus). Women with lupus are nearly 5 times more at risk of fractures if also suffering from osteoporosis.
Lupus sufferers are at risk of developing osteoporosis due to:
- Medications: Some prescribed drugs for SLE treatment can trigger significant bone loss.
- Pain and fatigue symptoms: This can result in inactivity which further increases a person’s risk for osteoporosis. Bone loss can also occur as a direct result of the illness.
Another complication of lupus is arthritis. Arthritis is not usually crippling but sufferers do experience pain and stiffness, along with (or without) swelling. As a condition, arthritis can be problematic on a temporary basis (a few days or weeks) or more severe or consistent.
Symptoms of pain and stiffness in both lupus and arthritis can often be confused due to their similar nature. This makes it difficult to diagnose as there are no definitive tests. Symptoms can also overlap. It is possible, although rare, to have lupus and RA.