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Systemic Lupus Erythematosus
(SLE or Lupus)

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

Lupus Symptoms in Women

One Patient's Story

A husband describes his wife's battle with lupus.By Mr. D.R.
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

So many people have had comments like, "I had no idea Susan was so sick." That was because Susan did not want anybody to know.

Because lupus is such a crafty disease and flies under the general public's radar, this is a good opportunity to clear things up.

Lupus is an autoimmune disease, not an infectious disease like HIV. People with lupus have an overactive immune system. The body's defenses actually attack healthy tissue. This has been happening to Susan for 30 years or more.

She was diagnosed around 1990, but she had symptoms way before then. Originally, the disease would manifest itself as flu-like symptoms for about three weeks out of every three months, with fatigue extending a month after every flare-up.

In 2000, lupus attacked her central nervous system and involved her brain. The original result of this new development was pain. From late in January 2000 until the day before she died, she was in pain. On the scale of 1 to 10, there was no day that she didn't feel pain on an 8 to 10 level. (With 10 being all-encompassing.)

Lupus attacked her lungs, causing shortness of breath, sleeping problems, and more pain in the form of pleurisy. In addition to Hashimoto's thyroiditis (causing cold extremities) and Sjogren's syndrome (extremely dry eyes) and a few more isms that I have forgotten, life was getting difficult.

Read on as Susan battles lupus »


What is lupus? What are the types of lupus?

Lupus is an autoimmune disease characterized by acute and chronic inflammation of various tissues of the body. Autoimmune diseases are illnesses that occur when the body's tissues are attacked by its own immune system. The immune system is a complex system within the body that is designed to fight infectious agents, such as bacteria and other foreign microbes. One of the ways that the immune system fights infections is by producing antibodies that bind to the microbes. People with lupus produce abnormal antibodies in their blood that target tissues within their own body rather than foreign infectious agents. Because the antibodies and accompanying cells of inflammation can affect tissues anywhere in the body, lupus has the potential to affect a variety of areas. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and/or nervous system. When only the skin is involved, the condition is called lupus dermatitis or cutaneous lupus erythematosus. A form of lupus dermatitis that can be isolated to the skin, without internal disease, is called discoid lupus. When internal organs are involved, the condition is referred to as systemic lupus erythematosus (SLE).

Both discoid and systemic lupus are more common in women than men (about eight times more common). The disease can affect all ages but most commonly begins from 20-45 years of age. Statistics demonstrate that lupus is somewhat more frequent in African Americans and people of Chinese and Japanese descent.

What causes lupus? Is it hereditary?

The precise reason for the abnormal autoimmunity that causes lupus is not known. Inherited genes, viruses, ultraviolet light, and certain medications may all play some role.

Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis, and autoimmune thyroid disorders are more common among relatives of people with lupus than the general population. Some scientists believe that the immune system in lupus is more easily stimulated by external factors like viruses or ultraviolet light. Sometimes, symptoms of lupus can be precipitated or aggravated by only a brief period of sun exposure.

It also is known that some women with SLE can experience worsening of their symptoms prior to their menstrual periods. This phenomenon, together with the female predominance of SLE, suggests that female hormones play an important role in the expression of SLE. This hormonal relationship is an active area of ongoing study by scientists.

More recently, research has demonstrated evidence that a key enzyme's failure to dispose of dying cells may contribute the development of SLE. The enzyme, DNase1, normally eliminates what is called "garbage DNA" and other cellular debris by chopping them into tiny fragments for easier disposal. Researchers turned off the DNase1 gene in mice. The mice appeared healthy at birth, but after six to eight months, the majority of mice without DNase1 showed signs of SLE. Thus, a genetic mutation in a gene that could disrupt the body's cellular waste disposal may be involved in the initiation of SLE.



Next: What is drug-induced lupus? »

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Lupus - Symptoms at Onset of Disease

The MedicineNet physician editors ask:

The symptoms of lupus can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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Lupus

What are the different types of common skin rashes?

Whether it is used by patients or doctors, the word rash does not have an exact meaning or refer to a specific disease or kind of disorder. It's a general term that means an outbreak of bumps on the body that changes the way the skin looks and feels. Rashes can be localized to one area or else be widespread. The way people use this term, a rash can refer to many different skin conditions. Common categories of rash are

  • scaly patches of skin not caused by infection,
  • scaly patches of skin produced by fungal or bacterial infection,
  • red, itchy bumps or patches over the body, such as on the chest and back.

Although rashes are seldom dangerous, self-diagnosis is not usually a good idea. Proper evaluation of a skin rash requires a visit to a doctor or other health-care professional. The following guidelines may help you decide what category your rash falls into....

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