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What is lupus?
Lupus is a chronic (long-lasting) autoimmune disease in which the immune system, for unknown reasons, becomes hyperactive and attacks normal tissue. This attack results in inflammation and brings about symptoms.
What does autoimmune mean?
Literally it means immune activity directed against the self. The immune system fights the body itself (Auto=self). In autoimmune diseases, the immune system makes a mistake and reacts to the body's own tissues.
What is inflammation?
Literally it means setting on fire. It is a protective process our body uses when tissues are injured. Inflammation helps to eliminate a foreign body or organism (virus, bacteria) and prevent further injury. Signs of inflammation include; swelling, redness, pain and warmth. If the signs of inflammation are long lasting, as they can be in lupus, then damage to the tissues can occur and normal function is impaired. This is why the treatment of lupus is aimed at reducing the inflammation. Reference: see Facts & Overview, What is Lupus?
What happens in autoimmune diseases like lupus?
The immune system is designed to protect and defend the body from foreign intruders (bacteria, viruses). You can think of it like a security system for your body. It contains several different types of cells, some of which function like "security guards" and are constantly on patrol looking for any foreign invaders. When they spot one, they take action, and eliminate the intruder. In lupus, for some reason and we don't know why, the immune system loses its ability to tell the difference between a foreign intruder and a person's own normal tissues and cells. So, in essence, the "Security Guards" make a mistake, and they mistakenly identify the person's own normal cells as foreign (antigens), and then take action to eliminate them. Part of their response is to bring antibodies to the site that then attach to antigens (anything that the immune system recognizes as non-self or foreign) and form immune complexes. These immune complexes help to set in motion a series of events that result in inflammation at the site. These immune complexes may travel through the circulation (blood) and lodge in distant tissues and cause inflammation there.
Where did the name come from?
Lupus is the Latin word for wolf. The term has been associated with the disease
since the 10th century, though the reasons are unclear. Erythematosus means
redness. It is speculated that the name was given to describe the skin lesions
(sores), which typically are red and perhaps at that time in history were
thought to resemble the bite of a wolf. Today we know that not everyone with
lupus has rashes or skin lesions, and those who do would not say their rashes
look anything like a wolf bite.
Which Lupus do I have?
There are three types of Lupus: discoid, drug-induced and systemic. Discoid Lupus is limited to the skin and is identified by a rash that may appear on the face, neck, and scalp. Discoid Lupus does not generally involve the body's internal organs. Drug-induced Lupus occurs after the use of certain prescribed drugs and the symptoms usually fade when the medications are discontinued. Systemic Lupus Erythematosus (SLE) can affect almost any organ or system of the body. Treatment for SLE must be customized for every patient, but typically includes physical and emotional rest, protection from direct sunlight, a healthful diet, exercise, prompt treatment of infections, avoidance of known allergens and aggravating factors, and medication.
Who gets lupus?
Lupus can occur at any age, and in either sex. Nine out of ten people with lupus
are women. During the childbearing years (ages 15-44) lupus strikes women 10-15
times more frequently than men.
People of all races can have lupus; however, African American women have a three
times higher incidence (number of new cases) and mortality than Caucasian women.
They tend to develop the disease at a younger age and to develop more serious
complications. Lupus is also more common in women of Hispanic, Asian, and Native
American descent.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
has developed a strategic plan for reducing health disparities. Lupus is
included as an area of research focus. Further information on disparities in
lupus and the strategic plan is available at:
What are the symptoms of lupus? Symptoms of lupus vary widely depending on the individual case and the form of lupus present. Most people with lupus do not experience all of these symptoms. The list only serves to alert people to clues that might indicate the presence of lupus in an undiagnosed person.
 | Achy or swollen joints |
| Persistent fever over 100 degrees |
| Prolonged, extreme fatigue |
| Skin rashes, including a butterfly shaped rash across the cheeks and nose |
| Pain in the chest on deep breathing |
| Anemia |
| Excessive protein in the urine |
| Sensitivity to sun or ultraviolet light |
| Hair loss |
| Abnormal blood clotting problems |
| Fingers turning white and/or blue in the cold |
| Seizures |
| Mouth or nose ulcers lasting longer than two weeks |
Lupus Self Test:
If you have 3 or more of these symptoms please consult your physician.
| Have you ever had achy, painful and/or swollen joints for more than three months? |
| Have you ever had an unexplained fever of over 100 degrees for more than a few days? |
| Have you ever experienced persistent, extreme fatigue/exhaustion and weakness for days or even weeks at a time, even after 6-8 hours of restful nighttime sleep? |
| Have you ever had sensitivity to the sun where your skin "breaks out" after being in the sun, but it's not sunburn? |
| Have you ever been told that you have a low blood count(s) - anemia, low white cell count or a low platelet count? |
| Have you ever been told that you have protein in your urine? |
| Have you ever had chest pain with deep breathing for more than a few days (pleurisy)? |
| Have you ever had a prominent redness or color change on your face in the shape of a butterfly across the bridge of your nose and cheeks? |
| Have you ever had a seizure or convulsion? |
| Have you had any sores in your mouth that lasted for more than two weeks? |
Clinical Criteria for Diagnosing Lupus:
4 or more of these 11 symptoms will help determine diagnosis. Recently, a new Lupus diagnosis criteria was adopted requiring 3 of 10 symptoms similar to the ones below, and appropriate screening of Anti-Nuclear Antibodies (ANA) blood test to make final diagnosis.
| Criterion |
Definition |
|
Malar Rash |
Rash over the cheeks |
|
Discoid Rash |
Red raised patches |
|
Photosensitivity |
Reaction to sunlight, resulting in the development of or increase in skin rash |
|
Oral Ulcers |
Ulcers in the nose or mouth, usually painless |
|
Arthritis |
Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed) |
|
Serositis |
Pleuritis or pericarditis (inflammation of the lining of the lung or heart) |
|
Renal Disorder |
Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells) |
|
Neurologic |
Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects |
|
Hematologic |
Hemolytic anemia or leukopenia (white blood count below 4,000 cells per cubic millimeter) or lymphopenia (less than 1,500 lymphocytes per cubic millimeter) or thrombocytopenia (less than 100,000 platelets per cubic millimeter). The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it. |
|
Antinuclear |
Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it. |
|
Immunologic |
Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL). |
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