The immune system normally fights off dangerous infections and bacteria to keep the body healthy. An autoimmune disease occurs when the immune system attacks the body because it confuses it for something foreign. There are many autoimmune diseases, including systemic lupus erythematosus (SLE).
The term lupus has been used to identify a number of immune diseases that have similar clinical presentations and laboratory features, but SLE is the most common type of lupus. People are often referring to SLE when they say lupus.
SLE is a chronic disease that can have phases of worsening symptoms that alternate with periods of mild symptoms. Most people with SLE are able to live a normal life with treatment.
According to the Lupus Foundation of America, at least 1.5 million Americans are living with diagnosed lupus. The foundation believes that the number of people who actually have the condition is much higher and that many cases go undiagnosed.
Symptoms can vary and can change over time. Common symptoms include:
- severe fatigue
- joint pain
- joint swelling
- a rash on the cheeks and nose, which is called a “butterfly rash”
- hair loss
- blood-clotting problems
- fingers turning white or blue and tingling when cold, which is known as Raynaud’s phenomenon
Other symptoms depend on the part of the body the disease is attacking, such as the digestive tract, the heart, or the skin.
Lupus symptoms are also symptoms of many other diseases, which makes diagnosis tricky. If you have any of these symptoms, see your doctor. Your doctor can run tests to gather the information needed to make an accurate diagnosis.
The exact cause of SLE isn’t known, but several factors have been associated with the disease.
The disease isn’t linked to a certain gene, but people with lupus often have family members with other autoimmune conditions.
Environmental triggers can include:
- ultraviolet rays
- certain medications
- physical or emotional stress
Sex and hormones
SLE affects women more than men. Women also may experience more severe symptoms during pregnancy and with their menstrual periods. Both of these observations have led some medical professionals to believe that the female hormone estrogen may play a role in causing SLE. However, more research is still needed to prove this theory.
Your doctor will do a physical exam to check for typical signs and symptoms of lupus, including:
- sun sensitivity rashes, such as a malar or butterfly rash
- mucous membrane ulcers, which may occur in the mouth or nose
- arthritis, which is swelling or tenderness of the small joints of the hands, feet, knees, and wrists
- hair loss
- hair thinning
- signs of cardiac or lung involvement, such as murmurs, rubs, or irregular heartbeats
No one single test is diagnostic for SLE, but screenings that can help your doctor come to an informed diagnosis include:
- blood tests, such as antibody tests and a complete blood count
- a urinalysis
- a chest X-ray
Your doctor might refer you to a rheumatologist, which is a doctor who specializes in treating joint and soft tissue disorders and autoimmune diseases.
No cure for SLE exists. The goal of treatment is to ease symptoms. Treatment can vary depending on how severe your symptoms are and which parts of your body SLE affects. The treatments may include:
- anti-inflammatory medications for joint pain and stiffness
- steroid creams for rashes
- corticosteroids to minimize the immune response
- antimalarial drugs for skin and joint problems
- disease modifying drugs or targeted immune system agents for more severe cases
Talk with your doctor about your diet and lifestyle habits. Your doctor might recommend eating or avoiding certain foods and minimizing stress to reduce the likelihood of triggering symptoms. You might need to have screenings for osteoporosis since steroids can thin your bones. Your doctor may also recommend preventive care, such as immunizations that are safe for people with autoimmune diseases and cardiac screenings,
Over time, SLE can damage or cause complications in systems throughout your body. Possible complications may include:
- blood clots and inflammation of blood vessels or vasculitis
- inflammation of the heart, or pericarditis
- a heart attack
- a stroke
- memory changes
- behavioral changes
- inflammation of lung tissue and the lining of the lung, or pleuritis
- kidney inflammation
- decreased kidney function
- kidney failure
SLE can have serious negative effects on your body during pregnancy. It can lead to pregnancy complications and even miscarriage. Talk with your doctor about ways to reduce the risk of complications.
SLE affects people differently. Treatments are most effective when you start them soon after symptoms develop and when your doctor tailors them to you. It’s important that you make an appointment with your doctor if you develop any symptoms that concern you.
Living with a chronic condition can be difficult. Talk to your doctor about support groups in your area. Working with a trained counselor or support group can help you reduce stress, maintain positive mental health, and manage your illness.