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What Is Lupus? Understanding Where Lupus Comes From and What It Can Do
Most people have only heard of lupus because of Selena Gomez's openness on her chemo for lupus. And yet, lupus is one of the most prevalent, yet underdiagnosed, autoimmune diseases in the world. More than 1.5 million Americans suffer from it, and many more live with it for a long time without the right diagnosis. It’s also unpredictable, difficult to spot, and often misunderstood.
In fact, the mysteries surrounding lupus make it a particularly dangerous health threat, one that could permanently damage the body and set the stage for other diseases.
Lupus affects the immune system, which in turn influences how other systems in your body operate. Therefore, a lupus diagnosis can have far-reaching effects on your short and long-term health.
A better understanding is the first step to gaining control of this difficult disease. Once you know a bit about how and where lupus develops, you can learn which signs to watch for and when to take action.
When Your Immune System Attacks
Your immune system is a vital line of defense: it’s what keeps you disease-free, helps you kick colds and flus, and generally protects your delicate tissues and organs from outside invaders. For most people, the immune system is neither seen nor felt, but entirely appreciated when you’re fighting a nasty virus.
Lupus confuses this immune response: instead of picking and choosing appropriate battles, the immune system turns against healthy tissue, attacking it as it would a foreign threat like bacteria, causing pain, inflammation, and damage.
In some conditions (like psoriatic arthritis) the overactive immune response might target one specific joint, but lupus is generally a systemic disease, which means the attack is launched on many different regions and systems in the body. It’s difficult to predict, when, where and how lupus will manifest, but it commonly targets the joints, skin, blood cells, as well as major organs like the heart and brain.
Types of Lupus
A range of specific conditions fall under the lupus category, but there are three predominant types of lupus:
Systemic Lupus Erythematosus (SLE)
This is by far the most common type of lupus, and can range in severity. Some people will notice only one or two symptoms in certain regions of their bodies, while others may experience body-wide inflammation that threatens the health of several major organs, the blood vessels, and the nervous system.
This form of the disease affects only the skin. Discoid lupus produces a rash that appears as raised red disks — appropriately called a lupus discoid rash — and although it’s not itchy, it can be very unsightly and can cause scarring. Other types of cutaneous lupus bring different rashes (most often, the “butterfly” pattern over the bridge of the nose and cheeks), sores around mucus membranes, and changes in the pigment of the skin.
Adult acne is a term used to describe skin problems that persist or emerge into someone’s 30s, 40s, and 50s and can target anyone.
Certain medications can trigger lupus, including some anti-seizure drugs, blood pressure medications, and antibiotics. Hydralazine, procainamide, and isoniazid are the drugs most often connected to this type of lupus. In most cases of drug-induced lupus, the symptoms disappear when you stop taking the drug.
Neonatal lupus is another known, but rare, lupus-like disease. It develops when a mother with lupus transfers antibodies to the fetus in the womb, and although the baby can be born with some distressing symptoms, they typically clear up completely within several months.
The Trouble With Diagnosis
Lupus can manifest in pretty obvious, and very painful, ways. However, many of the symptoms can also be mistaken for other diseases, which can complicate diagnosis for months, or even years.
Lupus is an unpredictable disease: symptoms may come and go, be mild or severe, and they could be temporary or permanent. Some of the most common lupus symptoms that could masquerade as other ailments include:
- Unexplained fever
- Painful or swollen joints
- Sores in the mouth or nose
- Fingers and toes that turn purple or blue when you’re cold or stressed
- Extreme fatigue
- Depression and trouble thinking
- Chest pain that comes with breathing
- Low blood count
- Unusual hair loss
However, there are other symptoms that are more specific to lupus. For instance, the classic red rash that spreads across the middle of the face and cheeks isn’t always present, but a high percentage of lupus patients will experience it. In fact, around 80 percent of lupus sufferers will notice some symptoms on their skin.
Unfortunately, there is no single, definitive lupus test that can lead to a firm diagnosis. Blood and urine tests, biopsies of tissue, and an assessment of symptoms are the main diagnostic tools.
Who Gets Lupus?
Anyone can get lupus, although the disease is far more common in women than in men. Nearly 90 percent of lupus patients are female, and between the ages of 15 and 44.
Of course, not every woman is at risk for developing lupus; sometimes your family history can indicate your risk level, and your ethnicity can provide a helpful clue. If your ancestry is Asian, African-American, Hispanic, or Native American, you are up to three times as likely to suffer from lupus.
While the scientific community is fairly certain that genes play an important role in lupus, genes alone can’t indicate whether anyone will develop the disease. Lifestyle and environment also factor in, so watch out for events in your life that coincide with the beginning of your symptoms. Several things can trigger the onset of lupus, like:
- Environmental changes
Outlook and Prognosis
Like many diseases, lupus responds best to early and aggressive treatment. If you manage to get a diagnosis and treatment plan shortly after your symptoms appear, you stand a good chance of taking control over your symptoms.
Unfortunately there is no cure for lupus, but there are ways to manage the symptoms and protect your organs from damage.
Since there are so many possible lupus symptoms, and many of them are vague or mildly uncomfortable, you might put off seeing a doctor for longer than you should. Don’t make that mistake. Instead, book an appointment if you experience unexplained fever, a facial rash, or persistent flu-like symptoms.