The Early and Late Manifestations of Lupus

Recently, there was a headline in the Miami Herald that read, “She traveled to Honduras to visit relatives. Now she’s lying in a Miami hospital bed.” As soon as we read such headlines, our minds are filled with thoughts of a whole array of infectious diseases, from dengue fever to malaria, various heard and unheard of tropical infections and parasitic diseases. We have all been cautioned about the risks of catching such maladies while visiting tropical paradises like those of Latin America.

This is the story of a 12-year-old Hispanic girl who was flown back to the U.S. with a life-threatening condition. She had a swollen tummy and red spots all over her body, along with difficulty breathing and problems with her heart. It really looked as though she had caught some rare and serious tropical infection, which the local doctors in Honduras failed to understand. But all presumptions were proven wrong when she was diagnosed with an autoimmune disorder called lupus, along with associated acute kidney disease.

Although not many think about it, the acute onset of lupus  is quite a common occurrence. It is not rare for it to start off with manifestations in the kidney. There are multiple factors for the development of lupus, including genetic conditions, age, environmental factors, gender, and ethnicity. There are still ways in which an individual can prevent an autoimmune disease from occurring, even if they have genes that predispose them. Below is a list of the various environmental factors that are known to be associated with the development of many autoimmune diseases.

Some of the chemical factors are chemicals from dyes and cosmetics, pesticides, hydrazines, use of certain kinds of drugs, prolonged exposure to the sun or harmful ultraviolet rays, and smoking, which can be either direct or second-hand. A few of the dietary factors include alfalfa sprouts, or L-canavanine, and an increased intake of saturated fats. The infectious agents consist of viruses such as the Epstein-Barr virus and bacterial DNA, or endotoxins. It can also be triggered by the use of hormonal replacement therapy as well as oral contraceptive pills. These are just a few of the commonly known environmental risk factors, but the list goes on from there.

There is no one correct picture of lupus, and the reason is due to the high variance in the disease’s manifestations among different individuals, ethnic groups, nationalities, and age groups. However, through analyzing a large amount of data, one can at least get a general view of this disease. In one survey conducted, the top ten manifestations of lupus were found to be arthritis, a butterfly rash on the face or cheeks, kidney disorders, photosensitivity, problems with the neuro region, onset of fever, certain changes in skin color (which can be a reaction to temperature), ulcers in the mouth, thrombosis, and discoid lesions. The above are all early manifestations of the disease.

One need not panic when they are diagnosed with lupus as it is not considered a life-threatening disease if the diagnosis is made in time and the treatment is aggressive. However, it is important that an individual be well aware of the various risks since, in certain cases, this condition can lead to a shortened lifespan for the individual. Lupus is known to be dangerous or fatal when it is diagnosed at an early age, but when it develops later in life, it is generally milder in form, such as in the case of post-menopausal women. By undergoing proper treatment along with having a proper knowledge of the disorder, an individual can expect to have a long-term remission of the disease. In a few cases, there can be instances of flare-ups, which can lead to complications. In general, the rate of survival is ten years post-diagnosis. Three of the most common factors associated with 70 percent of fatal outcomes are complications concerning active lupus, thrombosis, and infections.