Managing Lupus:All you need to know

At a Glance:

What is lupus?

Systemic lupus erythematosus (SLE), commonly known as lupus is an autoimmune disorder which is caused when the immune system of the body starts attacking its own organs and causes inflammation. Lupus is often known as a mystery disease owing to its uncertain characteristics;

• Unknown cause
• Sudden, confounding and varied symptoms: Lupus is characterized by a wide array of signs and symptoms. Lupus presents differently in every patient with symptoms usually appearing between 15 to 44 years of age.
• Difficulty in diagnosis due to the nature of symptoms: There is no single lab test to diagnose lupus, however, the rheumatologists look for certain criteria along with current symptoms, personal medical history and medical history of close relatives. They begin diagnosis begins with a simple blood test called the antinuclear antibody (ANA) blood test.
• Most importantly, no definitive cure. The treatment varies depending on the type of current flare-ups. 
• The target organs remain unidentified when the disease exists at multi-organ level. Thus making it one of the most challenging autoimmune diseases for medical professionals.

However, understanding, diagnosing and treating lupus for an individual becomes more easy and predictable over a period of time. Many people with lupus have a mild form of lupus with controllable flare-ups and productive lives.

How does one get lupus?

Our immune system protects us from the attack of foreign substances that may be an allergen (allergy-causing substance) or pathogen (disease-causing microorganisms). These substances are identified and destroyed by the cells of the immune system. In normal circumstances, the body has the ability to differentiate between own healthy cells and foreign cells or substances. However, due to the reasons unknown, and theories still under research, the body’s ability to differentiate between own and foreign cells is lost. The body, in such a scenario, starts attacking and destroying its own healthy cells. In patients with lupus, the immune system primarily targets the joints, muscles and skin. Such diseases are termed as auto-immune diseases and the reason for their occurrence largely remains unknown.

Is lupus contagious, can it be transferred from one person to another?

Like any other auto-immune disease, lupus is not contagious. Lupus is not transferred by touch or any physical contact. A contagious disease spreads from one person to another due to their similar impact on humans. For instance, bacteria have the ability to cause disease in an individual. However, this case is not true in auto-immune diseases. Although the reason is unknown, scientists believe that the cause of lupus is the combined effect of genetic changes and the environment.

Will lupus go away on its own?

Though the nature and severity of symptoms keep changing and may go away completely, it does not mean that lupus is cured. There is no complete cure for lupus, however with proper medication and care remission from symptoms may be achieved to improve the quality of life.

Lupus is an autoimmune disease. It has two well-defined stages. Flare-up stage of lupus is characterized by the presence of symptoms such as itching, muscle pain, and joint pain while the other stage i.e. the remission stage is characterized by the absence of any symptoms.

The research for the cure is on-going. In cases, wherein the lupus is caused due to drugs, discontinuation of the drug helps to improve the symptoms. However, these drugs may be critical to the health and thus required to be continued. They should not be stopped without consulting a doctor. The individual must report any new, change of symptoms or severity of symptoms to the healthcare team including rheumatologist for immediate change in medical care.

Why does a person with lupus feel tired? What can a person do about it?

The exact reason for tiredness in lupus is not known however it is believed that it may be due to the destruction of healthy cells by the immune system. Also, the severity of fatigue increases with the involvement of joints and muscles in lupus. Follow these tips to manage fatigue in lupus:

• Avoid overexertion; perform physical work within the tolerable limits.
• Slow down the work when you feel fatigued.
• Take a sound sleep as it will help the body to revive energy.

How does alcohol consumption affect a person with lupus?

Excess alcohol negatively affects the health of a person with lupus in various ways.

• It negatively impacts the liver which is already under stress and fighting against the immune system.
• During the metabolism of alcohol, various free radicals generate which adds up to the complexity of lupus.
• People with lupus require the administration of medicines of different therapeutic categories such as analgesics and steroids. Alcohol may interfere in the metabolism of these drugs and may lead to toxicity.
  

Is a person with lupus allowed to exercise?

Lupus negatively impacts the health of joints and muscle resulting in pain and fatigue. This can easily leave the person assuming that exercises will aggravate the condition, which is not true always. Patients with lupus may follow a customized exercise regimen under the guidance of a professional physiotherapist.  These exercises improve muscle strength, relieve stiff joints and reduce stress.

Does lupus affect sexual activity & fertility in men and women?

Lupus does not affect fertility significantly. However, sexual activity becomes challenging as the person may get exhausted easily due to problems such as fatigue, muscle pain, achy bones, and stiff joints.

Can a woman with lupus get pregnant and deliver a child?

Although maintaining pregnancy and delivering a healthy child may involve complications, with proper care, routine monitoring, and healthy diet, most of the women with lupus successfully deliver a healthy child. Talk to your rheumatologist about your plans of having a baby. Medications for lupus may be modified by your rheumatologist accordingly prior to and during your pregnancy.

Why is kidney biopsy done in lupus?

Lupus is associated with kidney diseases in most of the cases. The kidney is an extremely vital organ in the human body. When the kidney gets affected by lupus, the tissues become swollen and inflamed. This condition is known as lupus nephritis and is presented by symptoms such as edema and increased waste retention in the body. In the early stages, lupus nephritis remains undetected due to the absence of symptoms and is detected in a routine urine examination. If not treated on time, nephritis may lead to permanent damage to the kidney and chronic kidney disease. Therefore, a biopsy is important to assess the presence and extent of inflammation in the kidney.

Why should a person with lupus be wary about heart disease?

Lupus and heart diseases tend to influence each other in two primary ways. Firstly, lupus significantly impacts the heart health and may lead to inflammation in the lining of the heart and heart muscle. Due to which, lupus may significantly increase the risk of developing coronary artery disease. Further, heart disease is one of the leading causes of death in patients with lupus. Secondly, various medications for heart diseases have the potential to cause or aggravate the symptoms of lupus. However, stopping these drugs may increase risk of death due to heart diseases. Patients should regularly visit the healthcare team including rheumatologist and cardiologist for constant guidance to manage both the conditions effectively.

Does a person with lupus need medications every day?

A person with lupus is prescribed with medications that need to be taken on a regular basis. Routine monitoring is required while taking the medications for lupus. Some are to relieve the symptoms of the active disease while others are to prevent the transformation of lupus from remission stage to flare-up stage. The symptomatic medications are administered only to treat the symptoms such as itching. Various researchers believe that the drugs which keep lupus in remission stage should be taken for a long time. These medications are generally prescribed once or twice daily.

Where can one get good quality, affordable treatment from the best rheumatologist in Hyderabad?

Lupus is manageable with proper care and treatment. Exclusive lupus clinic at Yashoda Hospitals, Secunderabad is open every Wednesday to treat patients with lupus. The team of rheumatologists is available 9 am to 11 am, every Wednesday. Consult our expert rheumatologists for medical advice.

Yashoda Group of Hospitals is renown for providing the services of expert pediatric rheumatologists in Hyderabad. Lupus is an autoimmune disease involving different organs such as the kidney, heart, lungs, joints, muscles, and skin. Therefore, our the lupus care team at lupus clinic at Yashoda Hospitals is a multidisciplinary team of rheumatologist, nephrologist, hematologist, pulmonologist, cardiologist, endocrinologist, and nutritionist and orthopedist. Further, to accelerate the recovery from joint and muscle pain, a common problem associated with lupus, the hospital is equipped with dedicated physiotherapy department.

Lupus treatment in Hyderabad is available at few facilities as it requires the synchronization of various departments. The rheumatologists of this hospital have undergone advanced training in diagnosing and managing lupus. Yashoda Hospitals with the latest and sophisticated facilities and a comprehensive team provides the best treatment for SLE in Hyderabad.

References:

• Lupus Foundation of America. Understanding lupus. Available at: https://www.lupus.org/understanding-lupus. Accessed on March 27, 2019
• Lupus Foundation of America. Lupus facts and statistics. Available at: https://www.lupus.org/resources/lupus-facts-and-statistics. Accessed on March 27, 2019
• Mayo Clinic. Lupus. Available at: https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789. Accessed on March 27, 2019
• Johns Hopkins Lupus Center. Causes of Lupus. Available at: https://www.hopkinslupus.org/lupus-info/lupus/. Accessed on March 27, 2019
• Arthritis Foundation. It’s Lupus, Not Laziness. https://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/lupus-questions/diagnosing-lupus.php. Accessed on March 27, 2019

About Author –

Dr. Keerthi Talari, Consultant Rheumatologist, Yashoda Hospital, Hyderabad
MD, DM (Rheumatology)

Dr. Keerthi Talari

MD, DM (Rheumatology)

Consultant Rheumatologist

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