What is Lupus?

Contrary to common knowledge there are multiple types of lupus. When people use the word they are most often referring to Systemic Lupus Erythematosus. This, (along with the other forms) is an autoimmune disease. Simply put an autoimmune disease is one in which the person’s immune system starts to produce antibodies that attack their own body, rather than invading pathogens. In those with lupus the immune system attacks many different types of cells and tissues, and as such it can affect many different parts of the body.

What causes lupus? 

As with many autoimmune diseases we don’t know what the trigger is that causes the immune system to start attacking it’s own body. Furthermore, you cannot prevent lupus from developing; it is not a result of bad diet or smoking for example. As with other autoimmune diseases, it seems to be a combination of both genetic factors and environmental factors that increase one’s risk of developing the disease. On the genetic side, those who have a family history of lupus or other autoimmune diseases such as rheumatoid arthritis, hypothyroidism, or Type 1 diabetes are considered at higher risk. On top of this research has shown that Lupus is more common in those of African, Caribbean, Hispanic and Asian descent, and that up to 90% of those with lupus are women.

There are many possible environmental triggers for what might cause someone who is of higher risk to develop lupus. For most women it occurs during childbearing years, ie between the ages of 15 and 50, and as such it’s not surprising that many of the triggers seem to be hormonal. Puberty, menopause and childbirth have all been recorded as triggers. Others include a viral infection, physical trauma, prolonged use of certain medications and sunlight. Worldwide lupus is more common than leukaemia, muscular dystrophy and MS.

What does lupus look like? 

The symptoms of lupus vary greatly from person to person, especially considering that there are various different types of lupus. As such it can present in very different ways, meaning that no two cases are ever the same.

There are four main types of lupus.

Systemic Lupus Erythematosus:

This is the most common type of lupus, and is what most people think of when someone says the word. Because of the way in which the body’s antibodies attack various tissues, it can affect many areas of the body.

One of the hallmarks of lupus is the way in which it manifests on a person’s skin. The classic ‘butterfly’ rash that spreads across the nose and cheeks is one of the more visible symptoms of lupus. Many people also get discoid lesions on their face, neck and scalp. These are disc shaped sores that appear on the person’s skin and whilst they usually do not cause discomfort, they often cause scarring and discolouration that can be permanent. If this scarring occurs on the scalp then it can lead to permanent hair-loss. Lesions and rashes can be caused by exposure to the sun, fluorescent lights or sometimes without an obvious cause.

Inflammation is also the cause of much of the pain that those with lupus experience. Many people experience swelling around their joints, causing joint and muscle pain but inflammation can also occur around internal organs.  This can cause chest or abdominal pain, heart problems, pancreatitis, kidney problems, and if the issue persists even kidney failure depending on where the inflammation occurs.

Fatigue is a part of almost all chronic illnesses including lupus. Those with lupus often experience fatigue and weakness that, unlike normal tiredness, doesn’t go away with rest. They are also much more easily drained than those without chronic illness. Many people also experience frequent headaches and migraines, which are often made worse by high levels of fatigue.

Cutaneous Lupus Erythematosus

This is a form of lupus that only affects a person’s skin, rather than their joints and internal organs. With this form of lupus patients will experience the rashes and lesions that those with SLE experience, but not necessarily other symptoms such as the inflammation etc. Whilst this typically affects the face, neck and scalp, these rashes and lesions can materialise all over the body in some cases. This type of lupus has been found to be more common in smokers, and those of African descent.

Drug Induced Lupus 

Sometimes lupus can be caused by taking certain prescription drugs over a long period of time. This type of lupus manifests in the same way as SLE, including the skin rashes, inflammation and fatigue. The drugs most associated with the development of drug induced lupus are some of those used to treat hypertension, an irregular heart beat (though these two are less frequently the cause) those used to treat TB, and those used to treat rheumatoid arthritis. That is not to say that these drugs will always cause one to have lupus, but for those who are already at a higher risk, using some of those drugs for long periods of time increases their risk.

What’s the outlook? 

In the past those with lupus would have frequently been given only 5 years to live. Now however this could not be less true. There are many treatments for lupus and often those with the condition go into ‘remission’. Living with lupus is about learning how to manage it and your expectations of your self so that you can lead a fulfilled life whilst still taking care of your body.