What Is Systemic Lupus?

Susan didn't want anyone to know she had systemic lupus erythematosus. She wasn't sure how her coworkers would react, knowing she had an "autoimmune disease," even though it's not infectious like HIV. She couldn't bare the thought of the pity-looks people would give her, knowing that her body's defense system was killing itself. Susan was diagnosed with systemic lupus in 1990. Back then, she felt like she had the flu for three weeks every three months. Later, she learned this was called a "flare up." In 2000, her central nervous system and brain were overwhelmed with all-encompassing, chronic pain. She was cold, she couldn't sleep, she couldn't breathe and she was hurting. For lupus patients, life can be managed, yet one's health must be constantly monitored to prevent serious complications.

So, you ask, what are the symptoms and signs of systemic lupus? In 5-10% of the patients with systemic lupus erythematosus, they develop red, bordered, non-itchy skin rashes on the face and scalp. This form of lupus is called "discoid lupus" and while painless, can cause permanent hair loss and scarring. Half the patients with systemic lupus have a red "butterfly rash" across the bridge of their nose and experience extreme sensitivity to sunlight. Most patients experience arthritis in their hands, wrists and feet. More serious inflammation of organs occurs in the brain, liver, and kidneys. White blood cells and blood clotting factors also can be decreased in SLE, thereby increasing the risk of infection and bleeding. Inflamed muscles, blood vessels, lungs, kidneys and other body parts can cause internal injuries resulting in chest pain, fluid retention, high blood pressure, kidney failure, loss of appetite, seizures, comas, personality changes, fatigue, fever, numbness, hair loss and Raynaud's phenomenon (lack of blood supply and pain in the fingers and toes). The symptoms vary, depending on which part of the body is affected and the severity of the condition, of course.

Doctors can diagnose systemic lupus using eleven criteria established by the American Rheumatism Association. If a patient has four or more symptoms, then a diagnosis is strongly urged. Symptoms of systemic lupus erythematosus are: malar (butterfly rash over the cheeks), discoid skin rash (patchy redness), photosensitivity (reaction to sunlight), mucus membrane ulcers (in the mouth, nose or throat), arthritis (swollen, tender joints), pleuritis/pericarditis (inflammation of the lungs/heart tissue), kidney abnormalities (excessive urine protein or cellular casts), brain irritation (seizures or psychosis), blood count abnormalities (low red or white blood cells), immunologic disorder (anti-DNA or abnormal activity) and antinuclear antibody (presence of ANA antibody). Blood tests, blood chemistry tests, body fluid tests and tissue biopsies can help uncover symptoms of lupus as well.

Medicines for systemic lupus come in many different varieties and are critical in diminishing chronic pain, preventing flare-ups and preventing long-term damage. Nonsteroidal antiinflammatory drugs (NSAIDs) like Ibuprofen produce the fewest side effects and reduce inflammation and pain in muscles, tissues and joints. When internal organs are affected by systemic lupus erythematosus, Corticosteroids are a more potent alternative to combat disease activity. Hydroxychloroquine is often prescribed for patients who suffer from fatigue, skin problems and joint disease. One drug in particular (Plaquenil) has been found to decrease the frequency of abnormal blood clots caused by phospholipid antibodies. For persistent skin disease, chloroquine, quinacrine, retinoic acid and hydroxychloroquine can be administered. Furthermore, immunosuppressive medications are given to patients with the most severe, damaging forms of systemic lupus when internal organs are at risk. For any medication, be sure to monitor how you're feeling each day in a journal.