Tuesday, 28 February 2017

LUPUS: CAUSES, SIGNS, SYMPTOMS, TREATMENT, LIFESTYLE MODIFICATIONS

Lupus is an immune system disorder characterized by chronic inflammation in the body. In this condition, the body’s own immune system mistakenly attacks its own organs and tissues. Many body systems are affected by the inflammation from lupus including skin, joints, blood cells, kidneys, heart, brain and lungs.
It can be quite difficult to diagnose lupus, as its signs and symptoms resemble other medical conditions. The most characteristic symptom of lupus is a facial rash resembling butterfly’s wings across both the cheeks. This is present in most of the cases of lupus. There are some individuals who are born with a tendency towards developing lupus, which is triggered by sunlight, infections, some drugs etc.
As of now, there is no cure for lupus. Treatment is done to manage the symptoms.

Causes of Lupus

The cause of Lupus is body’s immune system attacking the healthy tissue. A combination of genetics and environment are thought to be responsible for lupus. Individuals with an inherited predisposition for lupus are at a higher risk for developing this disease, especially when if there are triggering factors such as:
  • Sunlight exposure results in development of lupus skin lesions.
  • Certain medications like hypertension medications, anti-seizure medications, antibiotics etc. can trigger lupus.

Risk Factors for Lupus

  • Women are at a higher risk for developing lupus.
  • Individuals between the age of 16 and 40 are more vulnerable to develop lupus.
  • Lupus is more common in certain races, such as Hispanics, African Americans and Asians.

Signs and Symptoms of Lupus

Depending on the systems involved, signs and symptoms vary from patient to patient. They may develop gradually or have an abrupt onset. They can be mild or severe. Many patients suffer from mild lupus with flares or episodes where the signs and symptoms worsen for some time then improve or resolve for a period of time. Common signs and symptoms of lupus include:
  • Fever.
  • Fatigue.
  • Pain, stiffness and swelling in the joints.
  • Appearance of butterfly-shaped rash on the face spread across the cheeks and the bridge of nose
  • Skin lesions, which worsen upon sun exposure.
  • Fingers and toes which turn blue or white upon exposure to cold or stress (Raynaud’s phenomenon).
  • Breathlessness.
  • Pain in the chest
  • Dry eyes.
  • Headaches
  • Mental disorientation.
  • Loss of memory.

Investigations for Lupus

It is difficult to diagnose lupus as symptoms vary from patient to patient, as they also resemble or can overlap other medical conditions. There is no single definite test for diagnosing lupus. A wide array of tests is done to diagnose lupus which consists of:
  • Complete blood count (CBC).
  • Erythrocyte sedimentation rate (ESR).
  • Blood tests to assess liver and kidneys.
  • Urinalysis.
  • Antinuclear antibody (ANA) test.
  • Chest x-ray.
  • Echocardiogram.
  • Biopsy.

Treatment for Lupus

Treatment depends on the signs and symptoms of lupus and includes:
  • NSAIDs or Nonsteroidal Anti-Inflammatory Drugs, such as naproxen and ibuprofen, which help in alleviating fever, pain and swelling of lupus. Side effects of NSAIDs are: Stomach bleeding, increased risk of heart disease and kidney problems.
  • Antimalarial medicines, such as hydroxychloroquine, also help in controlling the symptoms of lupus. Side effects include stomach problems and rarely retinal damage.
  • Corticosteroids, such as prednisone, help in inflammation of the lupus; however, they have some serious and long-term side effects, such as easy bruisability, weight gain, thinning of the bones (osteoporosis), diabetes, hypertension and increased vulnerability towards infection. The higher the dose and duration of corticosteroids, the higher are the risks of side effects.
  • Immunosuppressants, such as cyclophosphamide, mycophenolate methotrexate, are the drugs which suppress the immune system and are used in serious cases of lupus. Side effects include liver damage, increased chances of infection, increased risk for cancer and decreased fertility.

Lifestyle Modifications for Lupus

  • Getting adequate rest by lots of sleep and naps during the day is important, as patients experience constant fatigue.
  • Always wear a sunscreen with a minimum SPF of 55 and other protective gear, such as hat, long-sleeves and pants before stepping out in the sun, as it is one of the major triggering factors of lupus.
  • Always follow a healthy diet comprising of vegetables, fruits and whole grains.
  • Quitting smoking decreases the risk of cardiovascular disease and helps in recovering from flare ups more easily.
  • Regular exercise helps in recovering from flare ups, fights depression, decreases the risk of heart attack and helps in feeling good overall.

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