Wed | Jun 29, 2022

Understanding lupus

Published:Wednesday | May 4, 2022 | 12:10 AM

Lupus is a lifelong disorder of the immune system in which immune cells attack the body’s own healthy tissues, leading to inflammation and tissue damage. The symptoms may be limited to the skin, but more often lupus also causes internal problems, such as joint pain. In severe cases, it can damage the heart, kidneys, and other vital organs. Although there is no cure, there are treatments that can minimise the damage.

Joint and muscle pain is often the first sign of lupus. This pain tends to occur on both sides of the body at the same time, particularly in the joints of the wrists, hands, fingers, and knees. The joints may look inflamed and feel warm to the touch. But unlike rheumatoid arthritis, lupus usually does not cause permanent joint damage.

An obvious sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun, with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth sores.

Lupus can cause the nails to crack or fall off. They may be discoloured with blueish or reddish spots at the base. These spots are actually in the nail bed, the result of inflamed small blood vessels. Swelling may also make the skin around the base of the nail look red and puffy.

Most people with lupus experience some degree of fatigue. In many cases, it is severe enough to interfere with exercise and other daily activities. Most patients also run a low-grade fever from time to time. This unexplained fever may be the only warning sign in some people.


The symptoms of lupus tend to come and go, and this includes hair loss. Patients may go through periods where their hair falls out in patches or becomes thinner all across the scalp. Once the flare-up is over, new hair is likely to grow back.

As lupus progresses, it can interfere with the body’s organs. Up to three out of four people with lupus can develop kidney problems. These problems may not cause symptoms, though some people notice swelling in their legs or ankles. Most patients only learn about their kidney trouble when a urine test reveals blood or abnormal protein levels.

The most common heart problem linked to lupus is an inflammation of the sac around the heart. This may cause severe pain in the left side of the chest. People with lupus are also more likely to develop plaques that narrow or clog the arteries. This can lead to coronary artery disease. Other complications include heart valve disease and inflammation of the heart muscle.

Some people with lupus develop a condition called Raynaud’s phenomenon. Their fingers and toes become painful, numb, and tingly in response to cold temperatures or emotional stress. This happens when small blood vessels spasm and restrict blood flow to the area. During an attack, the fingers and toes may turn white or blue. People can also have Raynaud’s without having lupus or any serious health complications.

Diagnosing lupus can be tricky. The disease can mimic other conditions, and it often takes a different course in different people. Many people have it for years before developing tell-tale symptoms. Although there is no one test for lupus, certain proteins usually show up in a patient’s blood. A blood test for antinuclear antibodies can provide a critical clue. Other lab tests may check cell counts, kidney function, and clotting time. A tissue biopsy of an involved organ, such as the skin or kidneys, sometimes helps with the diagnosis.

Anyone can get lupus, but it affects women 10 times more often than men. Aside from being female, your odds of getting the disease are higher if you are African-American, Latino or Asian; between the ages of 20 and 40; and related to someone with lupus.

There are ways to control the symptoms of lupus. These include corticosteroid creams for rashes and non-steroidal anti-inflammatory drugs for joint pain and fever. Antimalarial medications can help fight joint pain, ulcers, and rashes. Corticosteroids may also be given as pills. In severe cases, they can be given intravenously. People with severe lupus may benefit from drugs that suppress the immune system.


Making some changes to your routine can also help reduce lupus flare-ups:

•Cover up when you’re in the sun.

•Don’t smoke.

•Exercise regularly.

•Improve your stress management skills.

•Also, be sure to get plenty of rest. Some people with lupus need up to 12 hours of sleep a night.

SOURCE: WebMD; Lupus Foundation of America; Centre for Disease Control and Prevention