Systemic Lupus Erythematosus (SLE), a.k.a “lupus,” has been back in the news lately, with actress/singer Selena Gomez and vocalist Toni Braxton making headlines for their experiences with the autoimmune disease. Earlier this year, Gomez began openly discussing the effects of lupus, which she was diagnosed with in 2015; more recently, Braxton, who was diagnosed in 2008, has publicly shared her experience with lupus and one of its major complications, lupus nephritis, where the disease affects the kidney.
The Mayo Clinic defines lupus as Lupus can be defined as Lupus is “a disease that occurs when your body's immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems – including your joints, skin, kidneys, blood cells, brain, heart and lungs.”
With May being Lupus Awareness Month in the U.S., it is worth discussing the potential symptoms of, as well as treatments for, this disease whose name might be familiar but whose details may be murky for many readers.
The Lupus Foundation of America (LFA) reports that about 1.5 million Americans have the disease, with an estimated 16,000 new cases diagnosed each year. Worldwide, over five million people have some form of lupus. While it is most common in women between the ages of 18 and 45, it can also affect men; in addition, the disease currently affects an estimated 5,000 to 10,000 children.
Lupus can affect almost any organ in the human body; not just the kidney, but also the skin, blood, joints, heart, lungs, and brain. Fatalities directly attributable to the disease are few; with close follow-up and treatment, 80-90% of people with lupus can expect to live a normal life span, according to the LFA.
There is no cure for lupus, and the exact cause(s) of contracting it are yet to be conclusively identified. However, there appears to be a genetic factor at play; while no single gene or gene group has been proven to cause the disease, it can appear in some families. People of African, Asian, Pacific Island, Hispanic/Latino, Native American or Native Hawaiian descent are more susceptible to lupus, again indicating a possible genetic factor.
Common triggers of the disease include infection or injury; overwork/lack of sleep; and prolonged exposure to the sun or fluorescent/halogen light. Symptoms may include:
- Muscle and joint pain
- Prolonged fever
- Rashes
- Chest pain
- Hair loss
- Sun or light sensitivity
- Kidney issues
- Mouth sores
With all of this uncertainty, how can one tell if they do have lupus? The prolonged presence of these symptoms – especially if one more than one is present at a time – should be taken seriously. A visit to your physician should quickly be arranged; blood and urine tests can screen for the disease, and you may ultimately need to be referred to a rheumatologist, who can confirm the diagnosis and prescribe a treatment, tailored to your clinical presentation.
If you are found to have lupus, there are many treatments available. Depending on the person and the severity of the case, these range from antimalarials, such as hydroxychloroquine, to the corticosteroid prednisone, all of which can help reduce swelling, tenderness and pain. Immunomodulators such as azathioprine and mycophenolate can also prove effective, and for severe cases, targeted biologic immunotherapy may be recommended.
In any event, close supervision by a rheumatologist is highly advised. They can help find the right approach to the disease for you and guide you on what may be a difficult – but not necessarily life-threatening – journey.
Dr. Petros Efthimiou is a board-certified rheumatologist and a published lupus expert at WPHPA of Larchmont. For an appointment, call 914-849-7400.