What Is Lupus?

Systemic lupus erythematosus (lupus) is a disease of the immune system. Normally, the immune system protects the body from infection. 

The cause of lupus is unknown.

However, in lupus, the immune system inappropriately attacks tissues in various parts of the body. 

In addition to affecting the skin and joints, it can affect other organs in the body such as the kidneys, the tissue lining the lungs (pleura) and heart (pericardium), and the brain. 

Most patients feel fatigue and have rashes, arthritis (painful and swollen joints) and fever This abnormal activity of the immune system leads to tissue damage and illness.

Lupus can affect men and women of any race or age. People of African, Asian and Native American descent are more likely to develop lupus than are Caucasians.

If only women of childbearing age (14 to 45 years old) are considered, as many as 1 in 250 may develop lupus.

Lupus is a rare disease and should be treated by best rheumatologist.

What Problems May Lupus Patients Develop?

Many patients with active lupus feel poorly in general and complain of

• 1. Systemic symptoms such as fever, weight loss and tiredness.
• 2. Hematological involvement-The blood may also be affected during the course of lupus, resulting in low red blood cell count (anemia, low white blood cell count and low platelet count).
• 3. Skin problems are a common feature of lupus. Some patients with lupus have a red rash over their cheeks and the bridge of their nose. Hair loss and sores in the mouth or nose lasting from a few days to more than a month are also common. 
• 4. Joint- Arthritis is very common in people who have lupus.
• 5. Kidney involvement in people with lupus is potentially life threatening and may occur in up to half of lupus patients. Kidney problems may become apparent when lupus patients feel ill with arthritis, have a rash, fever and weight loss. Less often, kidney disease may occur when there are no other symptoms of lupus. Kidney disease itself usually does not produce symptoms until it is in the advanced stages. It is important that kidney disease be diagnosed early and treated appropriately. The earliest signs of kidney disease are apparent from a urine analysis.
• 6. Blood clots are seen with increased frequency in lupus. Clots often occur in the legs (a vein clot, called deep venous thrombosis). Blood clots that develop in lupus patients may be associated with the production of anti phospholipid antibodies. These antibodies are abnormal proteins that may increase the tendency of the blood to clot. 
• 7. Heart and lung involvement is often caused by inflammation of the covering of the heart (pericardium) and lungs (pleura). When these structures become inflamed, patients may develop chest pain when breathing deeply, irregular heartbeat and accumulation of fluid around the lungs (pleuritis or pleurisy and heart (pericarditis) 

How Is Lupus Diagnosed?

The diagnosis of lupus is best made by an experienced and best rheumatologist who fully understands the disease and other diseases with similar features that can mimic lupus. 

If your doctor suspects you have lupus from your symptoms, you will need a series of blood tests to confirm that you do have the disease. 

The most important blood screening test measures ANA, but you can have ANA and not have lupus. 

Therefore, if you have positive ANA, you may need more specific tests to prove the diagnosis. These blood tests include antibodies to anti-dsDNA and anti-Sm. The presence of antiphospholipid antibodies can help expert rheumatologist detect lupus. 

Doctors also may measure levels of certain complement proteins (a part of the immune system) in the blood, to help detect the disease and follow its progress.

Does A Positive Antinuclear Antibody (ANA) Test Mean That I Have Lupus?

Not necessarily. The antinuclear antibody (ANA) test is positive in most patients with lupus, but it may also be positive in many people who do not have lupus. Therefore, a positive ANA test alone is not adequate for the diagnosis of lupus there must be at least three additional clinical features for the diagnosis to be made.

How Is Lupus Treated?

There is no cure for lupus, and treating lupus can be a challenge. However, treatment for lupus has improved a great deal.

Because lupus is a condition that can change over time and is not always predictable, a critical part of good care includes periodic visits with a knowledgeable, available rheumatologist (search for rheumatologist near me in google search). Some patients with mild features of the disease do not require treatment, while patients with serious involvement (such as kidney complications) may require the use of powerful medications.

• 1. Lupus treatment includes following medications:  Steroids or prednisone and related derivative of cortisone. Steroid creams can be directly applied to rashes. The use of creams is usually safe and effective, especially for mild rashes.  The use of steroid creams or pills in low doses can be effective for mild or moderate features of lupus. Steroids can also be used in higher doses when internal organs are threatened. Unfortunately, high doses are also most likely to produce side effects. 
• 2. Hydroxychloroquine is commonly used to help keep mild lupus related problems, such as skin and joint disease, under control.
• 3. Cyclophosphamide is a drug that has very powerful effects on reducing the activity of the immune system. It is used to treat severe forms of lupus. 
• 4. Azathioprine : It is commonly used to treat the more serious features of lupus. 
• 5. Methotrexate is another chemotherapy medication used to suppress the immune system. Its use is becoming increasingly popular for skin disease, arthritis, and other non life threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.
• 6. Belimumab is a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies. Belimumab is used to treat lupus that does not involve the kidneys and has not responded to other types of treatments. 
• 7. Rituximab is also a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies. It is sometimes used to treat lupus that has not responded to other types of treatments and administered under guidance of expert/best rheumatologist.
• 8. Rheumatologists may lower the dose of a drug or stop a medicine because of side effects or when the disease goes into remission. As a result, it is important to receive careful and frequent health exams and lab tests to track your symptoms and change your treatment as needed.