Lupus

It is a disease that can negatively affect any part of your body including internal organs. The disease is autoimmune, which means that your immune system works by itself abnormally. In normal cases, your immune system only responds when there is a foreign element in the body and will send antibodies to fight off the foreign element.

In the case of lupus, your immune system is not able to identify if the targeted element is your healthy tissue or the foreign element and it automatically sends out antibodies that will then destroy the healthy tissue. This incident can become painful and it may cause damage and inflammation in any part of the body.

Types of Lupus

These are the 5 types of lupus:

Systemic lupus erythematosus (SLE)

This chronic disease is considered the most common type of lupus. The disease inflames parts of the body that help connect, strengthen and make our body more flexible like the connective tissues. SLE can affect various systems and organs in our body and the effect varies on every individual. Examples of areas that will possibly be affected are the joints, lungs, skin, central nervous system, etc.  

Drug-induced lupus

This form of lupus is temporary because the symptoms of lupus disappear when medication intake is stopped, and it is less serious than SLE. This disease is acquired as a side effect of using particular prescription drugs for a long time. The disease hardly hits any major organs of your body, but it may affect your lungs, kidneys and other parts. Most common drugs that cause drug-induced lupus are Isoniazid, Hydralazine, Quinidine, Minocycline, and Procainamide.

Discoid lupus erythematosus (DLE)

This form of lupus grows inflammatory sores and scarring normally on the face, scalp, and ears. There may be cases when lesions may appear in other areas, but it is less serious than SLE as it only affects the skin of the body and it is more benign. It appears as somewhat like an area with red patches that is scaly. Hair loss is also possible once the sores grow on an area where there is hair like the scalp and beard, and it may be permanent. Skin biopsy is needed to diagnose this form of illness.  

Neonatal lupus

Considered as a rare disease, it is acquired at childbirth and infants acquire some form of red rashes or eruptions on the skin. There are various symptoms to neonatal lupus. Infants may show signs in the heart and/or skin. There is also a potential occurrence of congenital heart block which would a require an infant to be assisted with a pacemaker. Symptoms of low blood platelets, macrocephaly, liver disease, neutropenia, and anemia are uncommon.

Diagnosis

This disease, in any of its forms, is difficult to diagnose as its symptoms vary a lot from every individual who acquired lupus. It would always take a combination of various tests, like physical examination, urine, and blood test, to be able to get a lead on diagnosing lupus. Listed below are the following ways on how to diagnose lupus:

Laboratory tests

Two of the most basic laboratory tests are urine test and blood test. With these two tests, you may already acquire information on blood count, urinalysis, sed rate, ANA test, kidney, and liver assessment.

Complete blood count (CBC)

CBC measures not only the number of platelets, white and red blood cells, but it also indicates the amount of hematocrit and hemoglobin. With these results, you may know if you are anemic, low on platelets or white blood cells, which happens when you acquired lupus.

Urinalysis

This is when your urine is analyzed to see if red blood cells and protein levels have increased in the sample urine. If so, this would show problems in your kidneys, which is also another possible occurrence when you have lupus.

Erythrocyte sedimentation rate or sed rate

Sed rate checks if there are any signs of inflammation which may lead to identifying various diseases such as cancer or arthritis. The test is done by using a test tube and measuring the rate of red blood cells settling at the bottom within an hour. The faster it settles, the more chances of having a disease like lupus. However, it doesn’t specify the certain disease the person has.

Antinuclear antibody (ANA) test

ANA test is used to identify if there are positive traces of antibodies. If positive, this could mean that your immune system is stimulated. If you have lupus, your ANA test is definitely positive. But, not all who have positive results have lupus.

Kidney and liver assessment

As lupus can affect internal organs like the kidney and liver, a blood test can help show the condition of your kidney and liver.  

Imaging tests

These are tests that shows an image of the affected area. If a person is suspected to have lupus and affects your heart or lungs, you may be asked by the doctor to have either of the two tests:

Chest X-ray

A radiologist will take a special image of your chest using light. The abnormal shadows seen on the x-ray result may imply that there is either inflammation or fluid in the lungs.

Echocardiogram

This test can show the image of your heart through the use of soundwaves. It can see any irregularities in your heart.

Biopsy

As mentioned previously, lupus can attack any part of your body. For example, if you potentially have lupus and your kidneys have been affected, the doctor may require you to undergo biopsy. This is done by collecting a small kidney tissue sample to get a much better understanding of what treatment to use.

Treatments for Lupus

There is no definite way to be cured of lupus. However, the treatments described here can help in controlling the symptoms of your disease. The treatment to use varies a lot on what type of lupus and the symptoms are. But the general goal of these treatments is to lessen inflammation, prevent damage in any organ and relieve the symptoms.

Non-steroidal anti-inflammatory drugs (NSAIDs)

The use of NSAIDs like Ibuprofen can help a lot in relieving symptoms of swelling and pain in the joints and in some cases fever. These are over-the-counter medications or medications that don’t need a prescription. Possible side effects of stomach irritation when taken without food and increasing the risk of heart attack after taking high doses of NSAIDs.

Anti-Malarial drugs

Anti-malarial drugs are used to treat mild to moderate symptoms of lupus. The medication can help in alleviate symptoms of swelling of joints and rashes. There are three possible anti-malarial drugs that will be prescribed by the doctor; Hydroxychloroquine, Chloroquine, and Quinacrine. The Hydroxychloroquine (Plaquenil) is most likely to be prescribed by the doctor as it has lesser side effects compared with other anti-malarial drugs. The other two brands Chloroquine (Aralen), side effects are a bit serious, and Quinacrine (Atabrine), which can cause the skin to turn yellow, are only options if in case the Planequil cannot be used.

Anti-coagulants

Anti-coagulant drugs are also considered as blood thinners because the drug reduces the blood’s capability to clot. There are a lot of cases of lupus where antiphospholipid antibodies are found in the body which leads to the creation of blood clot, also known as a thrombus, and result in stroke, heart attack or deep vein thrombosis (DVT).  

Immunomodulators

Since lupus is an autoimmune disease, medications that suppress the hyperactive immune system or immunomodulators may help treat the disease.  This is especially helpful if the patient has already been treated with steroids and wasn’t able to ease the symptoms. Examples of immunomodulators are Azathioprine, Cyclophosphamide, and Methotrexate. However, immunomodulators may bring some serious side effects like rashes, nausea, diarrhea, or pancreatitis.  

Corticosteroids

Corticosteroid is a type of steroid hormones that help regulate moderate to serious cases of lupus. It helps in treating symptoms of pain and inflammation, and also help reduce tissue damage. There are two doses of corticosteroids; the low-dose and high dose.

The low-dose is used when anti-malarial drugs and NSAIDs are not able to alleviate specific symptoms of lupus. It is also meant for treating specific symptoms such as fever, muscle and joint pain, fatigue, and rashes. The high dose is used to treat the more serious cases of lupus, like vasculitis, kidney problem, myocarditis, pleurisy, pericarditis, peritonitis, thrombocytopenia, and hemolytic anemia. The use of high dose can also help alleviate some problems in the central nervous system. Examples of these are nerve damage and headache.

 

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