What is lupus and how is it treated?

O Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, autoimmune in nature, that can affect the skin, joints, kidneys, lungs, nervous system and several other organs.

The cause of lupus is an inadequate reaction of the immune system, whose antibodies produced, instead of fighting the disease, will attack the cells of the body’s own tissues and organs. This can lead to serious complications and, in the most severe (and rare) cases, to death.

Lupus can occur at any age, including in children or people over 65, but it is most common in young women, especially between the ages of 16 and 49. The disease is also more common in Africans, Asians and Hispanics.

Women are, in fact, the group most affected by lupus, as nine out of ten patients are women.

In most patients, the disease affects only the skin and joints and is easily manageable, with no significant impact on their future. However, patients’ survival and quality of life vary according to the severity of the disease. Hence the importance of regular monitoring and strict adherence to treatment.

Lupus is not a contagious or hereditary disease. However, there are certain genetic factors – not yet fully proven – that may contribute to a greater predisposition.


Understanding Lupus

Symptoms

There are four groups, the main ones being:

  • Cutaneous (or discoid), which manifests as patches on the skin, usually reddish or erythematous. These patches appear mainly on areas that are more easily exposed to the sun, such as the face, ears, neckline and arms.
  • SystemicWhich involves one or more organs.

Lupus manifests itself in many ways, so it is not always easy to identify. Symptoms may be mild or intense, temporary or permanent, primarily affecting:

  • Joints;
  • Skin;
  • Cells and blood vessels;
  • Serous membranes (pericardium and pleura);
  • Kidneys;
  • Nervous system.

Signs and symptoms of the presence of lupus are:

  • Fever;
  • Skin patches;
  • Red nose and cheekbones, forming an image resembling the wings of a butterfly ;
  • Sensitivity to sunlight;
  • Small sores in mouth and nose (aphthosis);
  • Joint pain;
  • Fatigue, lassitude, malaise;
  • Difficulty breathing;
  • Palpitations;
  • Dry cough;
  • Headache (headache);
  • Epileptic seizures;
  • Depression, anxiety;
  • Changes in blood cells.

These complaints can occur singly or together. The most common manifestations are fatigue, fever, weight loss, loss of appetite, easy skin sensitivity to sun exposure and skin and joint damage (pain/swelling).

Patients with lupus may alternate between periods of increased disease activity and periods without any symptoms (which may last for weeks, months, or years).

Causes

Lupus is a disease of unknown cause. However, it is accepted that several factors are simultaneously involved in its origin: genetic, hormonal, immunological and environmental.

Sun exposure seems to play a crucial role in the onset of the disease and in triggering periods of increased activity.

Diagnosis

The diagnosis of lupus is not always easy to establish, because of the wide variety of symptoms that are also typical of other similar diseases. There is no specific test for SLE.

Therefore, it must be performed by an experienced physician and involves the recognition of the characteristic signs and symptoms of lupus, coupled with the results of a series of laboratory tests, associated with predefined diagnostic criteria.

Treatment

Ideally, a long-term illness with the characteristics of lupus should involve follow-up by a multidisciplinary team that incorporates:

  • GP;
  • Rheumatologist;
  • Dermatologist;
  • Ophthalmologist;
  • Nephrologist;
  • Psychologist;
  • Physiatrist.

In most patients, treatment minimizes or resolves symptoms by reducing inflammation and helping to restore compromised body functions.

In addition, a range of other measures and care can help reduce the risk of disease activity or worsening.

The most commonly used medications are:

  • Corticosteroids (cortisone);
  • Antimalarials;
  • Immunosuppressants (azathioprine, metrotexate, cyclophosphamide and mycophenolate mofetil).

For patients with lupus, it is also very important to use skin photoprotectants that should be applied to all sun-exposed areas.

Prevention

There is no way to prevent the onset of lupus. However, it is possible to prevent peaks or worsening of the disease by adopting a number of precautions.

Some examples include:

  • Avoiding the consumption of alcoholic beverages;
  • Do not smoke;
  • Avoid sun exposure, even if you use sunscreen;
  • Do not take oral contraceptives without medical advice;
  • Do not take live vaccines (such as oral polio vaccine or yellow fever vaccine, for example);
  • Plan pregnancy according to medical recommendations and during periods of inactivity of the disease;
  • Exercise during periods of inactivity due to illness;
  • Manage energy expenditure to better cope with fatigue by decreasing or stopping tasks before you get tired;
  • Thinking that fatigue is part of the disease and not blaming yourself for it;
  • Take quiet walks in the open air, in quiet, pleasant places;
  • Avoid isolation, seek the company of positive and optimistic people;
  • Choose non-stressful hobbies that distract from the illness;
  • Learn how to use makeup to camouflage rashes.

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