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Lupus: You may be at risk.

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Friday, November 12, 2010

Lupus: You may be at risk.

 Lupus is an chronic inflammatory autoimmune disease (where your bodies cells attack itself) that primarily affects women ages 15 to 35.  There are four types of Lupus: Systemic Lupus Erythematosus (SLE), discoid lupus erythematosus, neonatal lupus, and drug-induced lupus erythematosus, of which SLE is the most common and serious form.  Because it is an autoimmune disease, your immune system attacks not only viruses and bacteria that are trying to invade your cody, but the healthy cells of your body too, which causes inflammation and can damage your joints, heart, skin, kidneys, lungs, blood vessels, and brain.  It is presumed that you are predisposed to having lupus, not lupus itself, but them something from the environment can trigger the lupus and then it will become a chronic disease with flare ups and remission.  It is being studied a great deal because there is so much unknown about this disease and why it occurs.

What are the four types?
SLE: Can effect nearly every part of your body (as noted above: heart, skin, joints, kidneys, lungs, blood vessels, brain) and is the most common form of lupus; usually what people are talking about when they are referring to lupus.
Discoid Lupus Erythematous (AKA cutaneous lupus): affects the skin and usually is in the form of a rash on the face, neck, and scalp.  Some cases can lead to SLE but it is rare.
Drug-induced Lupus Erythematous: Can happen with a lot of different prescription meds, and mimics SLE, but the symptoms stop when you stop taking the meds (read the drug inserts from the pharmacy and if you get the side effects, call your HCP).
Neonatal Lupus: A rare form of lupus in which the mother (who may not display signs of lupus) can pass the antibodies associated with autoimmunity to the baby and the baby will get a skin rash that usually subsides within several weeks. It will go away but it some serious cases can cause long term cardiac disturbances.

Are there any risk factors?
Female, age 15-40, usually affects blacks/latinos/asians, exposure to sun may trigger a response, prescription medications, infection with Epstein-Barr virus, and exposure to chemicals (mercury, silica, and cigarettes).

What are the complications?
Kidneys: almost 3/4 of the people with SLE will have renal problems from the disease which can usually be treated with medications and in severe cases dialysis.
Brain: headaches, dizziness, confusion, behavior changes, seizures, and memory problems.
Blood vessels: can cause inflammation of the blood vessels (vasculitis), along with blood clots, and anemia.
Lungs: risk of pleurisy (an inflammation of the chest wall lining), and it puts you at a higher risk of pnemonia
Heart: a risk of endocarditis and myocarditis (inflammation of the heart) and pericarditis (inflammation of the heart membrane), and this chronic inflammation increase your risk of heart attacks and long term cardiac disease. You can also develop hypertension and high cholesterol levels, leading to atherosclerosis.
Infection: are at a higher risk of infection due to the medications (usually corticosteroids) to treat the other symptoms of the disease.  Some of these infections can become quite serious and cause death, as the infection can lead to further inflammation requiring more steroids to squelch the flare up.
Cancer: having lupus apparently increases your risk of cancer, possibly due to the drugs used to treat the disease and cause immunosupression, the good news is that you are less likely to die from the cancers (it's unknown why.)
Bone tissue death: blood supply to the bones can diminish because of micro clots and the bones become brittle and break, and the bone dies.  Most often the hip bone is affected.
Pregnancy: Women with lupus are at a higher risk for miscarriage, as well they are at risk for severe high blood pressure (preeclampsia), and pre term birth.

Treatments:
Non-Steroidal Anti Inflammatory Drugs (NSAIDS): such as Aleve, Ibuprofen are used to treat the symptoms initially, but can cause renal damage in high doses and stomach ulcers, so your HCP will need to regulate this dosage despite it being and over the counter (OTC) medication.
Anti Malarials: For some reason antimalarial drugs work very well at helping with the symptoms of lupus and may prevent flare ups.  Hydroxychloroquine (plaquenil) is one example, and most commonly prescribed.
Corticosteroids: They decrease the swelling but have major long term complications such as: weight gain, osteoporosis, high blood pressure, diabetes, and increased risk of infection.  The risks are higher with higher doses, so your HCP will work with you to find the lowest possible dose, and increased doses that may be needed for flare ups.
Immunosuppressants: medications that are given to patients after transplants are used to decrease your immune response, and also have serious long term complications, but can be used in severe lupus cases, or for flare ups.  some of the side effects can be infertility, infection, increased risk of cancer, and liver damage.
There are also numerous drugs being studied at the moment, that hopefully have less side effects.

How to treat yourself:
-Get enough rest, and don't let your body get too overtired
-Wear adequate SPF in the sun, and try not to spend extended amounts of time in the sun
-Exercise 30 minutes a day 4-5 days a week, but don't over tax your body.
-Don't smoke because it can increase your risk of heart and lung disease associated with lupus.
-Eat a healthy diet full of fresh fruit and veg with whole grains, and if you have renal issues watch your sodium intake or other dietary restrictions you HCP may give you.

All forms of Lupus can be difficult to diagnose at first, and your HCP will have to run a bunch of tests to rule out other diseases or causative factors for your symptoms.  So, it can be a very difficult and frustrating road at first, but there are people that will support you and help you through every step of the diagnosis and treatment.

I hope this gives some insight to those of you who might know someone with any for of lupus and might give you an idea of their daily struggles and how you can help them.  As well, if you have any of these symptoms, please go see your HCP to get checked out.

Yours in Good Health
B

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