Systemic lupus erythematosus (SLE) or simply lupus is a chronic autoimmune disease characterized by the immune system going into overdrive and attacking antigens and healthy tissue alike. This leads to inflammation affecting multiple organs like the kidneys, heart, lungs, and brain and also causing problems in the joints and blood. Lupus mostly affects women between ages 15-40 years and is found prevalent among African-Americans, Hispanics, and Asians. According to data by the Lupus Foundation of America, 1.5 million Americans suffer from systemic lupus erythematosus, and 15% of these individuals are children.
Lupus Symptoms and Complications
Lupus isn’t easily diagnosed at first because it mimics symptoms of other ailments, but when established, it’s important for the patient to know and understand its symptoms and how it affects the body in the short and long term. Here are some common lupus manifestations:
Fatigue and joint pain
This is the most common symptom among individuals living with lupus.
Short-term Effect: Even when occurring mildly, it’s still difficult for lupus patients to perform their activities of daily living when fatigue strikes. Increased fatigue is often a sign of an impending flare.
Long-term Effect: The inflammatory process of lupus arthritis can eventually result in irreversible joint and muscle weakness and deformity. It could also lead to a decreased bone mineral density that could lead to osteoporosis.
Skin problems and photosensitivity
The malar rash is a symptom unique to lupus. It’s a facial butterfly-shaped rash spreading across the cheeks through the bridge of the nose.
Short-term Effect: SLE patients are sensitive to light and exposure to ultraviolet radiation can cause rashes or, worst case scenario, flares.
Long-term Effect: Although skin rashes associated with lupus do not generally cause itching or other more serious skin conditions, constant exposure to sunlight may trigger more flares that could lead to more irreparable damage to other organ systems.
Confusion, headaches, and mood changes
When lupus antibodies cross the blood-brain barrier, nerve tissues get damaged leading to cognitive and behavioral problems.
Short-term Effect: Lupus patients sometimes experience what’s called “lupus fogs,” a collective term used to describe cognitive problems associated with lupus like trouble concentrating, memory impairment, and confusion.
Long-term Effect: Flares can cause inflammation of blood vessels in the brain called vasculitis. This results to a myriad of more dangerous central nervous system symptoms like seizures, psychosis, and even coma.
Lupus progression and complications
As lupus progresses, it leads to more serious complications indicative of grave organ damage. Here are lupus complications that warrant immediate and consistent medical attention:
- Blood complications. There are a number of different things that could go wrong in the blood of patients with lupus. Below are some of them:
- Autoimmune hemolytic anemia (AHA). This is a type of anemia characterized by the immune system’s destruction of red blood cells.
- Antiphospholipid syndrome (APS). This disorder refers to a set of conditions related to the presence of lupus anticoagulants and anti cardiolipins, which react against phospholipids and cause the blood vessel to become narrow and have anomalies. This, in turn, increases the chances of developing blood clots, putting the patient at higher risk for deep vein thrombosis (DVT) and pulmonary embolisms (PE).
- Acute Lupus Hemophagocytic Syndrome. This is a rare blood complication commonly found in SLE patients of Asian descent. This syndrome is characterized by a sudden drop in blood cells and platelets, causing fever for a relatively short period of time.
Cardiovascular complications. The primary cause of death among lupus patients is heart disease. Chronic inflammation brought about by lupus inflicts severe injury to cardiac tissue and blood vessels, disrupting normal heart function and blood circulation. Moreover, SLE treatments— primarily corticosteroids —affect the cholesterol levels and weight, as well as by extension, the heart. Here are some cardiovascular complications lupus patients develop:
- Atherosclerosis or plaque buildup in the arteries
- Heart failure
- Pericarditis or inflammation of the heart sac
- Myocarditis or inflammation of heart muscle
Lung complications. The lungs are also vulnerable to autoimmune attack during lupus flares. Complications may include:
- Pleurisy or inflammation of the membrane lining of the lungs caused coughing and shortness of breath
- Pleural effusion or accumulation of fluid in the lungs
- Lupus pneumonitis or inflammation of the lung tissue which, in rare cases, can cause lung scarring that inhibits proper oxygen delivery to the blood
- Pulmonary hypertension in which damage to blood vessels in the lungs causes high blood pressure rarely happens in the lupus patients
Kidney complications. Lupus antibodies can sometimes attack and inflame healthy kidney tissue causing a condition called lupus nephritis. About 50% of SLE patients experience this kidney complication that results to poor kidney function and, in worse cases, kidney failure.
Infections. Infections are a major cause of death among lupus patients as the body’s immune response is ineffective despite being hyperactive. This makes the patient susceptible to a myriad of common yet potentially deadly infections of bacterial, fungal, and even parasitic nature. The problem gets worse with SLE treatments augmenting vulnerability to infections.
Flares and Remissions: How to Stay Alert
Lupus can either be active or dormant. In the active stage called flare, symptoms manifest depending on the body system being attacked. During the dormant stage called remission, the body seems to be normal, which makes lupus dangerous as it lulls the patient into a false sense of security. It’s next to impossible to predict when a flare is going to take place, so the best course of action on the patient’s end is always to be prepared. Here are some ways you can stay on top of lupus:
- List down all your daily activities that a flare could disrupt. This includes activities at home, school or work, and community.
- From that list, rank up all the essential responsibilities that need priority attending. Then, mark those items that you can hold off or give up.
- List down people that can help you out when you have flares and share your list with them. This could be a family member or a friend. As much as possible, find someone you trust to aid you in your time of need.
- Organize. The last thing you want to do during a flare is looking everywhere for your medical documents. Keep all your health information in one easily accessible place and share it with a trusted family member or friend in case you need them to assist you during an emergency.
You need all the help you can get when you’re dealing with lupus, especially during flares, so don’t be afraid to ask for assistance. Also, make reading up on your condition a habit. This not only increases your awareness but also helps you cope with the emotional distress that comes with dealing with lupus. Dealing with lupus or any chronic disease is difficult, especially when done alone. A number of reputable organizations are making efforts to establish support groups for lupus patients all over the world. Aside from solid health care programs, there are also social workers who are dedicated to assist lupus patients in the psychosocial challenges posed by the disease. Living with lupus can be miserable not only for you but also for your loved ones. Medicine is doing everything it can to find a cure. In the meantime, it’s on you to continue the fight, but you don’t have to do it on your own. Support is your leverage against lupus, so seek for it. You’re not in this alone.