Arthritis: Lupus
Introduction
Systemic lupus erythematosus (lupus) is a disease of the immune system.
Normally, the immune system protects the body from infection. In lupus, however,
the immune system inappropriately attacks tissues in various parts of the body.
This abnormal activity leads to tissue damage and illness.
Who gets lupus?
According to the Lupus Foundation of America, approximately 1.5 million people in the U.S. have lupus. People of African, Asian and Native American descent are more likely to develop lupus than are Caucasians. Although it can occur in both men and women, 90% of people diagnosed with the disease are women. Women of childbearing age (14 to 45 years old) are most often affected—as many as 1 in 250 may develop lupus.
What are the symptoms of lupus?
The symptoms of lupus differ from one person to another. Some people have
just a few symptoms, while others have many. In addition, there are many
different symptoms of lupus because the disease can affect any part of the body.
Some of the more common symptoms include:
- Achy joints (arthralgia)
- Unexplained fever (more than 100 degrees Fahrenheit)
- Swollen joints (arthritis)
- Prolonged or extreme fatigue
- Skin rash
- Ankle swelling and fluid accumulation
- Pain in the chest when breathing deeply (pleurisy)
- A butterfly-shaped rash across the cheeks and nose
- Hair loss
- Sensitivity to the sun and/or other light
- Seizures
- Mouth or nose sores
- Pale or purple fingers or toes from cold or stress
(Raynaud's phenomenon)
What problems can people with lupus have?
Many people with active lupus feel ill in general and
complain of fever, weight loss and fatigue. People with lupus also develop
specific problems when the immune system attacks a particular organ or area in the body. The following
areas of the body can be affected by lupus:
- Skin. Skin problems are a
common feature of lupus. Some people with lupus have a red rash over their
cheeks and the bridge of their nose—called a
"butterfly" rash. Hair loss and mouth sores are also common. One particular type
of lupus that affects only the skin is called "discoid lupus." With
this type of lupus, the skin problems consist of large red, circular rashes
that may scar. Skin rashes are usually aggravated by sunlight. A common lupus rash called subacute cutaneous lupus erythematosus is often worse after exposure to the sun. This type of rash can affect the arms, legs, and torso. An uncommon but serious form of lupus rash results in the development of large blisters and is called a "bullous" lupus rash.
- Joints. Arthritis is very
common in people with lupus. There may be pain, with or without swelling.
Stiffness and pain may be particularly evident in the morning. Arthritis may
be a problem for only a few days or weeks, or may be a permanent feature of
the disease. Fortunately, arthritis usually is not crippling.
- Kidneys. Kidney involvement
in people with lupus can be life threatening and may occur in up to half of
those with lupus. Kidney problems are more common when someone also has other
lupus symptoms, such as fatigue, arthritis, rash, fever and weight loss. Less
often, kidney disease may occur when there are no other symptoms of lupus.
- Blood. Blood
involvement can occur with or without other symptoms. People with lupus may have
dangerous reductions in the number of red blood cells, white blood cells or
platelets (particles that help clot the blood).
Sometimes, changes in blood counts may cause fatigue (low
red cell count, or anemia), serious infections (low white cell count), or easy bruising or bleeding (low platelet count). Many
patients do not have symptoms from low blood counts, however, so it is important
for people with lupus to have periodic blood tests in order to detect any
problems.
Blood clots are more common in people with lupus. Clots
often occur in the legs (called deep venous thrombosis) and lungs (called pulmonary embolus) and
occasionally in the brain (stroke). Blood clots that develop in lupus patients
may be associated with the production of antiphospholipid antibodies. These
antibodies are abnormal proteins that may increase the tendency of the blood to
clot. Blood can be tested for these antibodies.
- Brain and spinal cord. Brain involvement
is, fortunately, a rare problem in people with lupus. When present, it may
cause confusion, depression, seizures and, rarely, strokes. Involvement of the spinal cord (transverse myelitis) can cause numbness and weakness.
- Heart and lungs. Heart and
lung involvement often is caused by inflammation of the covering of the heart (pericardium) and
lungs (pleura). When
these structures become inflamed, patients may develop chest pain, irregular
heartbeat and accumulation of fluid around the lungs (pleuritis or pleurisy) and
heart (pericarditis). The heart valves and the lung itself are also affected by lupus, resulting in shortness of breath.
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