Lupus: Symptoms, Causes and Treatment

Lupus is a highly variable disease that damages every organ of the body and affects both children and adults. Learn about the symptoms, causes and treatments available.

Autoimmune diseases represent a great challenge in medical practice. One of the most complex pathologies is systemic lupus erythematosus (lupus or SLE). It’s characterized by lasting over time with periods of reactivation or outbreaks.

The pathophysiological mechanism by which this disease affects the organs is through the creation of antibodies and immune complexes against the tissues themselves. In this way, the cells of the organs will be recognized as a harmful agent and their apoptosis or death will be carried out.

It has been shown that lupus is more common in women of childbearing age, however, it can also occur in men and children. In addition, the disease varies depending on the ethnic origin of the patient, being more serious in Afro-descendant and Hispanic women.

What are the causes of lupus?

The precise cause of autoimmune diseases is generally unknown. In any case, advances have been made in the investigation of this pathology, which is why a large number of environmental and genetic factors that predispose to its appearance have been identified.

In this sense, studies establish that the environmental factor most linked to lupus is ultraviolet radiation (UV). In fact, it causes exacerbation of the disease in 70% of cases. This occurs by inducing the death of keratinocytes, the cells that predominate in the superficial layer of the skin.

In addition to UV radiation, there are other environmental factors that have an influence, including virus infections (Epstein-Barr and cytomegalovirus) and drug use (antiarrhythmics).

Heredity is also a major factor in the development of systemic lupus erythematosus. In this way, a woman with a family history is much more likely to develop the disease. Various genes have also been related to it, specifically the 1q23-24 region of the long portion of chromosome 1.

On the other hand, lupus is characterized by alternating between symptomatic and asymptomatic periods. In this sense, among the factors that can cause the appearance of an outbreak, the following stand out:

• Physical and emotional stress
• Pregnancy
• Recurring infections
• Solar radiation
• Drug consumption

SLE symptoms

It’s important to remember that this is a disease that can vary greatly from person to person, as it’s capable of affecting multiple organs at the same time. Therefore, it isn’t possible to establish a characteristic medical condition that occurs in all patients. Among the most common general symptoms are fever, asthenia, and anorexia.

Fever can have variable patterns and is usually moderate in most cases, while asthenia and anorexia have a greater impact on the patient’s life. The more specific signs usually appear after a while.

An unequivocal symptom of lupus is the appearance of a butterfly-shaped malar rash, that is, a redness that will extend to both cheekbones. In addition, one of the most common complications is lupus nephropathy, which appears in between 28% and 74% of patients.

Other very frequent symptoms presented by patients with lupus are the following:

• Lesions and skin rash with photosensitivity
• Oral thrush
• Joint and muscle pain
• Thrombocytopenia
• Hair loss

Diagnosis of systemic lupus erythematosus

For the correct diagnosis of the disease, the American College of Rheumatology established 11 diagnostic criteria based on the symptoms and laboratory results, which are the following:

1. Malar rash
2. Discoid rash
3. Photosensitivity
4. Mouth ulcers
5. Arthritis
6. Pericarditis or pleurisy
7. Neurological problems: seizures or psychosis
8. Kidney problems: blood or protein in the urine
9. Low blood cell count: anemia and thrombocytopenia
10. Presence of abnormal antibodies
11. Presence of antinuclear antibodies

The specialist will be able to diagnose lupus in any patient who has at least 4 of the 11 symptoms described, the most important being the presence of antinuclear antibodies. If this result is negative, the presence of the disease must be ruled out.

However, when confirmed, more laboratory tests should be performed. This is in order to look for antiphospholipid antibodies and antibodies against dsDNA or anti-Sm, which are specific for lupus.

Treatment

Unfortunately, there’s no cure for lupus. In this sense, the main objective of the approach is to suppress the hyperactive immune system and avoid permanent organ damage. In this way, what doctors seek is to control the symptoms and make the crises subside for a period of time.

In this sense, among the drugs used to treat systemic lupus erythematosus are the following:

• Immunosuppressants: These seek to inactivate the immune system so that it stops attacking the body’s own tissues. Azathioprine, methotrexate and cyclophosphamide stand out.
• Corticosteroids: These are used in patients with severe inflammatory processes that present cardiac, pulmonary, cerebral, or renal involvement. Prednisone is one of the most frequently used.
• NSAIDs: Non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen are recommended to treat pain caused by arthritis.
• Antimalarials: Hydroxychloroquine, a drug used to treat malaria, is prescribed in lupus patients to improve arthritis, rashes, fatigue, and canker sores.

A chronic disease that can be controlled

Despite the fact that lupus can be life-threatening for those who have it, treatment has come a long way and expectations have risen. In this way, people diagnosed are able to live with a certain normality if they comply with the following recommendations:

• Have a regular medical check-up
• Learn about the disease
• Exercise frequently
• Avoid excessive exposure to the sun and UV rays

If you suspect that you have lupus or have any of the symptoms described, it’s important that you see a doctor immediately. Only the specialist will be able to give you an accurate diagnosis and recommend the therapy to follow.