Recent studies have suggested another indicator that might help to identify an underlying lupus diagnosis. The study called “High Health Care Utilization Preceding Diagnosis of Systemic Lupus Erythematosus in Youth,” which is published in the journal Arthritis Care & Research, states that, in young patients, there is a sharp increase in visits to healthcare facilities prior to receiving their formal lupus diagnosis.
When it comes to treating lupus, advances in technology and treatment methods have allowed patients to live, for the most part, pain-free lives. However, when it comes to a positive prognosis of the disease, one of the most detrimental factors is still the difficulties in promptly identifying and diagnosing the disease early on. When it comes to physical symptoms, the lupus diagnosis is often preceded by many different factors. However, attributing them to lupus is complicated, since some of the common symptoms can often be linked to other conditions. Furthermore, the serology tests that lupus is identified by are expensive and not widely available.
For these reasons, researchers looked elsewhere to identify patterns that could help to identify lupus early on, and arrived at the frequency of healthcare visits in the year prior to the diagnosis of the disease as a reliable lupus risk factor. The study in question followed the cases of 682 young lupus patients between 10 to 24 years of age, who received their diagnosis between 2000 and 2013. Researchers pulled up the health records of each participant, including ambulatory, emergency, and inpatient visits, and compared them to the records of 1,364 healthy and age-matched controls.
The results showed a substantial increase in healthcare visits in youths with lupus in the year preceding their formal diagnosis, in comparison to the healthy controls. Also, it was concluded that this increase in visits was associated with initial presentations of lupus. As far as numbers are concerned, young lupus patients had at least 2.5 times more ambulatory visits, 3.4 times more emergency visits, and 3 times more inpatient visits, in relation to their healthy counterparts.
The most common causes of hospital visits in lupus patients were venous thromboembolism, thrombocytopenia, chest pains, fevers, and kidney problems. Lastly, medical visits associated with psychological and psychiatric disorders common in the early stages of lupus were also frequent in the aforementioned medical visits.
This research has shown that, by examining the patterns of healthcare visits in young patients in the years preceding a formal lupus diagnosis, as well as examining the psychiatric comorbidity of said patients, better care can be administered to them even before arriving at a formal diagnosis of their condition.
A further understanding of systemic lupus erythematosus
Systemic lupus erythematosus, or simply lupus, as it is referred to by most specialists and patients alike, is a rare autoimmune disease in which the patient’s immune system actively develops antibodies that can target any structure in the body, causing a wide variety of symptoms. In a normal, healthy body, the immune system is meant to produce antibodies to counteract foreign bacteria and viruses from taking refuge within and enabling disease to take place.
However, in lupus patients, these very same antibodies are the ones that target the person’s very own tissues and structures that, as expected, can lead to great damage. Due to the wide variety of structures that may be attacked by the immune system, the symptoms of lupus are greatly varied, and the disease may consequently manifest differently from person to person. That being said, any two given cases of lupus are rarely alike, though most may coincide on certain symptoms.
The most common lupus symptoms, which are shared among most patients of the disease, are joint pain and inflammation, alongside high fevers, chest pains, mouth ulcers, swollen lymph nodes, constant fatigue, and possible hair loss. Ine of the most characteristic symptoms of lupus is the ‘butterfly’ rash that appears across the patient’s face, starting from their nose and spreading across both cheeks in the shape of a butterfly. In most cases, lupus symptoms often come in periods of flaring, and they can also subside for some time.
Though it is clear that lupus symptoms are caused by an autoimmune assault on the body, the cause behind said assault still remains a mystery. Some professionals theorize that lupus is triggered by a combination of genetic and environmental factors. The disease affects around 20 to 70 individuals out of 100,000 inhabitants, on a global scale. Like many other autoimmune diseases, lupus is much more common in women, at a rate of about 9 to 1. Some factors that have been known to contribute to the development of lupus are the effects of female sex hormones, as well as excessive exposure to sunlight, smoking or excessive exposure to secondhand smoke, vitamin D deficiency, and the exposure to some infections.
As was mentioned, inflammation is one of the most common symptoms, which is shared across most lupus patients. This is because the antibodies that are created by the immune system, and which target the body’s healthy tissues and structures are often of anti-nuclear nature, which often results in inflammation as they attack their targets.
One of the largest complications when it comes to lupus lies in its difficulty to diagnose it. As of right now, one of the best ways to identify the disease is through serologic testing, including performing antinuclear antibody testing and anti-extractable nuclear antigen. In a laboratory setting, this is best achieved via immunofluorescence, in which the samples are studied for their patterns of fluorescence. Said patterns can determine the type of antibodies present in each individual’s serum, which in turn can confirm or deny whether said patient is suffering from lupus.
Another method of diagnosis is via the testing of skin that is not regularly exposed to the sun. When said skin is tested, it is possible to observe the so-called lupus band, which is a pattern of immunofluorescence that manifests in the person’s skin upon being exposed to direct sunlight, and which reveals an underlying lupus condition.
Because these symptoms are linked to other diseases, lupus patients are not formally diagnosed for a long period of time. With this new study, researchers have a further understanding of a new indicator of lupus, which may, actually, prompt an earlier diagnosis.