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What is Lupus Disease? Lupus is a chronic autoimmune disease where the immune system becomes hyperactive and attacks healthy tissues. As a result, it can cause inflammation through your body, affecting many different body systems, including joints, skin, kidneys, blood cells, heart, lungs, and brain.  The signs and symptoms of lupus mimic those of other […] Read More

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What is Lupus Disease?

Lupus is a chronic autoimmune disease where the immune system becomes hyperactive and attacks healthy tissues. As a result, it can cause inflammation through your body, affecting many different body systems, including joints, skin, kidneys, blood cells, heart, lungs, and brain.  The signs and symptoms of lupus mimic those of other body ailments, thus making it difficult to be diagnosed. The most distinctive sign is a facial rash that resembles the wings of a butterfly unfolding across the two cheeks of its patients (lupus butterfly rash). However, this may not occur in all cases. Lupus ranges from mild to quite severe. It develops to severe when there is no proper treatment.  At present, lupus has no known cure. So concentration is always on managing the symptoms and reducing inflammation. Anyone can get lupus, but women between 15 and 44 are most affected. 
Picture Courtesy: Medicine net


Lupus is categorized into 4 types, namely:
  • Systematic Lupus Erythematosus (SLE).
SLE is the most common type of lupus. SLE typically affects several different organ systems of the body, such as kidneys, lungs, heart, skin, joints, nervous system, etc.  Systemic lupus erythematosus symptoms can range from mild to severe. It may get worse over time and then improve. It has flares (when the symptoms worsen) and remissions (periods when the symptoms improve or go away).
  • Cutaneous Lupus
This type is restricted to the skin. However, it may cause rashes and permanent lesions with scars. Different types of cutaneous lupus include: 
  1. Acute (red rash appearing on the cheeks and nose, causing the “butterfly rash”).
  2. Sub-acute (formed on body exposed to sunlight, leading to no scars).
  3. Chronic cutaneous lupus or discoid lupus erythematosus (causing purple or red rash, skin discoloration, scarring, and hair loss).
  • Neonatal Lupus
This is extremely rare and affects infants whose mothers have specific autoimmune antibodies transmitted from mother to fetus across the placenta.
  • Drug-induced Lupus (DIL)
This is developed through the long-term use of medications. Such drugs include:
  •  PPI’s such as: Esmolol, Lansoprazole, pantoprazole,omeprazole. NSAIDs: Aspirin, sulfasalazine, phenylbutazone, naproxen, piroxicam. Anti-inflammatories: Penicillamine. Ranitidine (antacids). Antiarrhythmics: Quinidine, tocainide, propafenone, procainamide, amiodarone [1]. Anti-tumor necrosis factors drugs: infliximab, etanercept, adalimumab [2]. Procainamidemethyldopa
  •  Hydralazine IsoniazidTerbinafine
 Chlorpromazine Minocycline QuinidineDIL usually goes away within weeks of stopping the medication that caused it to occur.  

Risk Factors

  • Gender
Lupus proves to be more common in women, as it is estimated that one man to every ten women (1:10) have lupus.
  • Age
Lupus affects almost all age groups, and it is most often diagnosed among the ages of 15 to 45.
  • Race
Lupus most commonly affects African-Americans, Asian-Americans, and Hispanics (Spanish-Americans). English, Dutch, German, French (etc.) Americans are most likely not affected by lupus.
  • Genetic factor [3]
  • Environmental factors: Smoking, infections, exposure to the sunlight, pollutants.


Inflammation due to lupus can affect many parts of your body, which includes :
  • Kidneys.
This can lead to severe kidney damage, including kidney failure, which happens to be a life-threatening disorder.
  • Lungs.
This could result from the inflammation of the chest cavity lining, leading to breathing difficulty, bleeding into the lungs, and pneumonia.
  • Heart.
This results from the inflammation of the heart muscle, arteries, and membrane, thereby increasing the risk of cardiovascular diseases and heart attack.
  • Blood and Blood Vessels. It may cause blood problems such as anemia, blood clotting, and inflammation of the blood vessels.
  • Brain and the Central Nervous System.
Lupus effects on the brain can cause headaches, dizziness, behavioral changes, vision problems, seizures, memory loss, and stroke. Apart from its effects on body organs, other risks of lupus include:
  • Infections.
The weakening of the immune system can cause the body to get exposed to a new wide range of infections. The most common infections are herpes, shingles, salmonella, urinary tract infections, etc.
  • Death of Bone Tissues.
The disease affects the blood supply to the bones, leading to their subsequent breakdown.
  • Cancer.
Lupus increases the risk of cancer.
  • Pregnancy Complications.
Lupus increases the risks of miscarriages, preterm babies, high blood pressure(preeclampsia), and premature death.

How is Lupus diagnosed?

Lupus, as mentioned earlier, is difficult to examine because it has many mimicking symptoms which are often mistaken for signs of other diseases. Most of the patients are not even aware of their disease. There is no such single confirmatory test available for diagnosing lupus disease. Based on the clinical examinations, medical and family history and other laboratory examinations help the doctor diagnose the disease.
  • Family history of lupus or other autoimmune diseases.
  • Medical History.
Based on the medical history doctor can diagnose the disease. 
  • Physical Examination.
The doctor examines the patient for physical or visual signs like rashes (especially the “butterfly rashes”).
  • Blood and Urine Tests
The antinuclear antibody (ANA) test, if confirmed positive, will make the doctor likely order more tests for antibodies that are specific to SLE. However, a positive ANA does not necessarily indicate the patient has lupus.
  • Biomarkers
  • Imaging tests
  • Skin or Kidney Biopsy
The tissue samples are viewed under a microscope to see signs of an autoimmune disease. In addition, these tests can help diagnose and rule out other diseases that cannot be confused with lupus.

Treatment of Lupus

Lupus does not have a cure. Treatments done can only help a patient feel better and reduce symptoms. This means that you can manage it, but it would not go away entirely. The treatment depends on your symptoms and needs, and it is aimed at preventing flare-ups, treating symptoms whenever they appear, and reducing organ damages and other disorders. The treatment might include medications to:
  • Reduces pain and swelling.
  • Reduce or prevent organ damages.
  • Reduce or prevent damage to the joints.
  • Calm the immune system, preventing possible attacks on body organs and tissues.


Common lupus medications include:
  • Non-steroidal Anti-inflammatory Drugs (NSAIDs).
 NSAIDs such as ibuprofen and naproxen help reduce mild pains and swelling in the joints and muscles.
  • Anti-malaria Drugs.
These treat malaria, skin rashes, joint pains, fatigue, and lung inflammation. They include hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen).
  • Corticosteroids.
Corticosteroids, such as prednisone, reduce swelling, tenderness, and pain. High doses can calm the immune system. They come in pills, injections, or creams. Then, they are withdrawn in lowered doses until it is no longer needed. Stopping corticosteroid therapy suddenly can result in bodily harm, but they are very effective for treating the symptoms of lupus.
  • BLyS-Specific Inhibitors.
These drugs (B-lymphocyte Stimulator-specific inhibitors) limit the number of abnormal B cells (in the immune system, which creates antibodies) found in lupus patients. In addition, Belimumab (a common type of BLyS-specific inhibitor which treats lupus symptoms) blocks the actions of a specific protein in the body that is important in the immune response.
  • Immunosuppressive Agents and Chemotherapy
These are used in severe cases of lupus when lupus affects significant organs, and other treatments do not work. They cause serious side effects because they lower the body’s ability to fight off infections.
  • Biologic drugs: These are the drugs that mimic natural proteins such as Benlysta(Belimumab), Rituxan(rituximab), etc. [4].
  • Vitamins and Supplements.
  • Acupuncture: for pain and fatigue management 
  • Other Medicines.
Some diseases linked with lupus (such as high blood pressure and osteoporosis) need to be treated. In addition, other associated conditions like blood clots (which lead to stroke or heart attack) should be treated.  The doctor may prescribe anticoagulants (blood thinners), such as warfarin or heparin, to easily prevent the blood from clotting. However, it is essential to note that pregnant women should avoid taking warfarin. While on these treatments, it is deemed necessary to maintain regular communication with the doctor:
  • If you have new symptoms.
  • If you have become pregnant.
  • About any side effects of the drugs.
  • About any vitamins or herbal supplements.
  • If the medicines are no longer helpful to your symptoms.


The prognosis nowadays is far better than before. Looking closely at the close follow-ups and treatments, it is estimated that about 80%─90% of people with lupus can expect to live in an average life span. However, unfortunately, evidence abounds that medical science or experts have not developed a cure for lupus yet, and some people die from this dreadful disease.



The signs of lupus usually depend on the part it affects in your body. It can also vary depending on the individual. The symptoms may be:

  • Permanent.
  • Disappear suddenly.
  • Flare-up occasionally.

Even though no two cases of lupus are the same, the most common symptoms and signs among them include:

  • High fever.
  • Body aches.
  • Joint pains.
  • Chest pain when taking a deep breath.
  • Rashes (plus butterfly-shaped rash on the face).
  • Loss of appetite.
  • Nausea.
  • Diarrhea.
  • Vomiting.
  • Weight loss.
  • Mouth ulcers.
  • Fatigue.
  • Skin lesions (infected injuries or wounds).
  • Headaches.
  • Hair loss.
  • Confusion.
  • Swollen glands.
  • Shortness of breath.
  • Dry eyes.
  • Memory loss.
  • Sun sensitivity.
  • Pericarditis and pleuritis (both can cause chest pain).
  • Joint inflammation, stiffness, and pains.

Lupus inflammation affects various organs and tissues, and can be obvious in the:

  • Joints.
  • Skin.
  • Blood.
  • Kidneys.
  • Lungs.
  • Heart.
  • Brain.

The inflammation can also cause complications in various organs, such as the:

  • Lungs.
  • Kidneys.
  • Blood.



The exact cause of lupus is not known. It is thought to be a combination of many underlying factors, which may include:

  • Genetics.

More than 50 genes have been identified to be associated with lupus. Having a family history places you slightly at a higher risk for having lupus.

  • Hormones.

Abnormal hormone levels, such as increased estrogen levels may contribute to lupus.

  • Environment.

Potential triggers like smoking, stress, and exposure to certain toxins, like silica dust, are likely to cause lupus.

  • Infections.

Infections like cytomegalovirus and Epstein-Barr are linked with the causes of lupus.

  • Medications.

Long-term medications such as hydralazine (Apresoline), procainamide (Procanbid), and quinidine, have been linked with causing a type of lupus called drug-induced lupus erythematosus (DIL). 

Also, TNF medications for conditions like rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and ankylosing spondylitis, can develop DIL. Tetracyclines like minocycline that is used to treat acne and rosacea, can likewise cause DIL. 

Sometimes, lupus patients don’t experience any of the listed potential causes of lupus.