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Lupus: A Mysterious Autoimmune Disease that Needs Careful Management

Over 1 million Indians are possibly diagnosed with Lupus every year with the women-to-men ratio being 9:1.

Imagine a day when your closest pals who have had your back all your life, start betraying you. At that moment, the world seems to fall apart, right? Well, Lupus is that chronic condition that can make you go through a similar situation. It manipulates your staunch protector aka your immune system to turn rogue. Following this, the latter launches an attack on its tissues. And damages several organs in the process. What’s more concerning is that Lupus often takes the help of disguise. The symptoms do not even follow a pattern making it hard to diagnose.


Believed to be a disease of modernization, the cases have been less in India. But recent numbers have shown to leap. About 1 in every 1000, with Hyderabad alone estimated to have 20,000 Lupus patients.

So, it’s best we refine our understanding of Lupus and stay prepared to fight the condition better.


What is Lupus Disease?

Lupus is defined as a long-term inflammatory condition. In this, the body’s defences start attacking the healthy cells. In other words, the mechanism that protects you by fighting harmful foreign matters becomes the very cause of your troubles. The autoimmune disorder causes inflammation and pain in various parts of the body. This, in turn, opens doors to several new bodily complications. The list includes:

  1. Lupus Nephritis (kidney failure)

  2. Central Nervous System damage and its related issues (headaches, dizziness, strokes, seizures, etc.)

  3. Blood problems like Anemia or Lupus Anticoagulant Syndrome (blood clots)

  4. Chest inflammation (difficulty in breathing, pneumonia, etc.)

  5. Cardiovascular diseases (vulnerability to heart attacks)

  6. Frequent infections

  7. Risk of cancer

  8. Bone collapse

  9. Pregnancy difficulties (miscarriages/high blood pressure)


Types of Lupus

Lupus medical term is often described as Systemic Lupus Erythematosus (SLE). That’s because SLE is the most common kind of Lupus. In this, you get inflammation throughout your body. But there are 3 more types that also need consideration.

  • Cutaneous Lupus- Also known as skin Lupus, it primarily affects your skin.

  • Drug-induced Lupus - It results from an overreaction to a drug and can be temporary.

  • Neonatal Lupus - It is a rare kind that happens in an infant. The child who is born with the condition most probably has a mother with SLE.

Now, if you have any doubts regarding which Lupus is the worst? Well, Systemic Lupus Erythematosus it is.


Lupus Symptoms

Lupus works in mysterious ways as no two patients experience identical symptoms. At times, the signs occur out of nowhere while in other situations, the process is more gradual. Also, whether they are mild, acute, temporary, or long-lasting varies from one Lupus patient to another. In most cases, the experience you have depends on the body systems that the disease has affected.



Here are some familiar signs that you should watch out for:

  • Red, itchy butterfly-shaped rashes on the face (cheek, nose, and body)

  • Fatigue

  • Fever

  • Pain, rigidity, and inflammation in the joints

  • Skin lesions

  • Breathlessness

  • Chest pain

  • Dry eyes

  • Headaches

  • Confused state of mind

  • Memory loss

  • Mouth sores

  • Hair loss


When Lupus Flares Up? - Lupus Causes

Researchers are yet to confirm the exact causes of Lupus. But it is understood to be a complex situation that can be triggered by a lot of factors.

  • Genes

  • Environmental factors like:

  • Viral infections

  • Sunlight

  • Certain drugs

  • Smoking

  • Immune/Inflammatory factors (In this, the body fails to get rid of dead or damaged cells naturally. This may leave the immune system confused and thereby self-destructive)


Who is At More Risk of Getting Affected by Lupus?

While Lupus can happen to anyone, few people are more prone to having the disorder.

  • Gender - About 90% of individuals with Lupus are females.

  • Age - Women between 15 to 44 years are more vulnerable to Lupus.

  • Family history- Those who have a biological parent with Lupus can develop the disease.


How is Lupus Diagnosed?

Lupus diagnosis is quite a tricky process. This is due to the varied mix of body parts it affects which in turn leads to diverse symptoms. The method typically involves a thorough physical examination and blood/urine tests.

The common laboratory tests include:

  1. Complete blood count (CBC)- It measures Red/ White Blood Cells, Platelets, and Hemoglobin.

  2. Erythrocyte sedimentation rate - It is the rate at which red blood cells move to the bottom of the tube. If they settle faster than the usual pace, that may indicate Lupus.

  3. Assessing kidney and liver functioning

  4. Urinalysis - Increased amount of red blood cells and protein in the urine is a sign of Lupus.

  5. Antinuclear antibody (ANA) test - A positive ANA may signal Lupus. However additional tests are required for verification.

If there is a chance that the disease has harmed your lungs/heart, the doctor may go for the following tests.

  1. Chest X-ray (Helps find the presence of inflammation/fluid in lungs)

  2. Echocardiogram (It uses sound waves to locate the several heart complications)

Given kidney damage is common in Lupus, doctors often test kidney tissue to determine the cure. For that, they may suggest a Biopsy. In this, a needle or a minor incision is used to obtain the sample. Sometimes, a skin Biopsy is also done to confirm Skin Lupus.


Lupus Treatment

The treatment apt for you depends on your Lupus symptoms. You may also need to change medicines or adjust the doses when Lupus flares or subsides. But in general, the following medicines work best to keep the disease under check.

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs) - They relieve you of aches, swelling, and fever. Examples include Ibuprofen and Naproxen Sodium.

  2. Antimalarial drugs - Hydroxychloroquine, effective on Malaria can help avoid Lupus flares.

  3. Corticosteroids - Prednisone is great for controlling inflammation. While Methylprednisolone can counter a serious case involving kidneys and the brain.

  4. Immunosuppressants - They are helpful in severe scenarios. Examples include Azathioprine, Mycophenolate, and Cyclosporine.

  5. Biologics - In some cases, Belimumab helps ease the signs of Lupus.

There are some alternative Lupus treatments too. But you need to consult your doctor first before initiating them.

  1. Dehydroepiandrosterone (DHEA) - Supplements containing DHEA can reduce Lupus episodes.

  2. Fish oil supplements - These contain omega-3 fatty acids, quite effective on Lupus.

  3. Acupuncture - Tiny needles are inserted under the skin to relieve you of muscle pain.


Final Thoughts - Can Lupus be Cured?

Unfortunately, there is no permanent cure for Systemic Lupus Erythematosus as of now. But living with the condition isn’t always miserable either. Apart from regular checkups and effective treatments, self-care works like magic. So:

  • Avoid excessive exposure to sunlight

  • Quit smoking

  • Exercise daily

  • Eat healthy

  • Boost your mental health by exchanging emphatic support with fellow Lupus patients

Lupus victims also need people around to understand them. So, if you're aware of someone experiencing Lupus, be their pillar of strength.

 

The Author : Dr. Sunil Khattri

sunilkhattri@gmail.com

+91 9811618704


Dr. Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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