Is Lupus a Fatal Disease?

Lupus is an autoimmune disease, which means the body attacks its healthy cells and tissues.

• The immune system protects the body from foreign invaders and illness, but it malfunctions in a patient with lupus and assaults healthy, bodily components.
• As a result, numerous regions of the body might become inflamed and injured, including the joints, skin, kidneys, heart, and lungs.

Lupus is a chronic disease, but symptoms tend to vary between flares and symptom-free periods. It can cause a variety of health concerns and, in severe circumstances, can be fatal.

The four types of lupus include the following:

1. Systemic lupus erythematosus
   • Systemic lupus erythematosus (SLE) accounts for over 70 percent of all lupus cases and can range from mild to severe. Though there is currently no cure, managing the symptoms may improve the quality of life.
   • A major organ or tissue in the body, such as the kidneys, joints, blood vessels, brain, or heart, could be impacted in about half of the patients with SLE.
2. Cutaneous lupus
   • This kind of lupus solely affects the skin, which accounts for about 10 percent of lupus cases.
   • Cutaneous lupus frequently develops as both malar and discoid rashes. Rashes can appear as raised, scaly, red patches that do not itch. Others with cutaneous lupus may have the butterfly rash, which is a rash over the cheekbones and across the bridge of the nose.
   • Other rashes or sores may form when the skin is directly exposed to the sunlight on the face, neck, or scalp. Sores are seen in the mouth, nose, and vagina. Hair loss and skin color changes are additional signs of cutaneous lupus.
3. Drug-induced lupus
   • Drug-induced lupus, which is caused by high doses of specific drugs, accounts for about 10 percent of all lupus cases. Drug-induced lupus symptoms are comparable to systemic lupus symptoms, but symptoms usually diminish when the drugs are stopped.
4. Neonatal lupus
   • Neonatal lupus is an uncommon illness in which the fetus is affected by the mother's antibodies. The baby may have a skin rash, liver issues, or low blood cell counts at birth, but these symptoms usually go away after six months with no long-term consequences.

Lupus is a long-term condition that causes joint pain, skin rashes, and tiredness. There is no cure, but symptoms can improve if treatment starts early.

The ten symptoms of lupus include:

1. Swelling and pain in the joints and muscles
2. Sensitivity to light (direct contact to the skin causes rashes)
3. Extreme tiredness
4. Butterfly shaped skin rash over the nose and cheeks
5. Sores inside the mouth and nose
6. Chest pain with deep breaths
7. Headache
8. Fever of unknown origin (fever lasting more than two weeks with no known causes)
9. Hair loss
10. Raynaud’s phenomenon (bluish discoloration of fingers and toes as a result of cold environment or stress)

Lupus is a chronic autoimmune illness, and the actual cause is unknown. However, experts believe that people with genetic predispositions to the disease, in combination with external triggers, such as infections, drugs, or other environmental factors, may contribute to the flare-up of the disease.

• Sunlight: Sun exposure may cause lupus skin lesions or elicit an internal response in people who are predisposed to it.
• Infections: Infections (especially viral infections) can trigger lupus or induce relapse in certain people.
• Medications: Certain blood pressure drugs, antiseizure medications, and antibiotics can all cause lupus. When people with drug-induced lupus stop taking medicine, they usually recover better. In rare cases, symptoms may persist even after the medicine has been discontinued.

Risk factors of lupus

• Sex: Women are more prone to develop lupus than males.
• Age: Lupus affects people of all ages but is mostly diagnosed between the ages of 15 and 45 years.
• Ethnicity: Lupus affects African Americans, Hispanics, and Asian Americans more frequently.

Although physicians have not shown that stress causes lupus, it is known to promote flare-ups in patients who already have the condition.

Lupus-related health problems, such as kidney failure, infections, and heart disease, are the major causes of death in people with the condition.

1. Kidneys
   • Lupus nephritis (inflammation of the kidney) occurs when systemic lupus erythematosus (SLE) damages the kidneys. It causes inflammation (swelling or scarring) of the tiny blood veins (glomeruli) in the kidney that filter waste.
   • Symptoms include:
     • Hematuria (blood in the urine)
     • Proteinuria (protein in the urine)
     • Edema
     • Weight gain
     • A rise in blood pressure
2. Heart
   • Patients with lupus have a higher risk of heart problems. Endothelial cells on the inner of blood vessels are damaged, so healing is delayed. This causes plaques, atherosclerosis, and coronary artery disease to develop earlier than in persons who do not have lupus.
   • Premenopausal women or women who are still menstruating have a decreased risk of heart disease. However, premenopausal women with lupus are not protected against heart diseases.
   • Lupus flares produce:
     • Acute chest pain with breathing and shortness of breath
     • Pericarditis (inflammation of the sac that surrounds the heart)
     • Endocarditis (inflammation of the inner lining of the heart)
     • Myocarditis (inflammation of the heart muscles)
     • Costochondritis (inflammation of the cartilage of the chest wall)
3. Blood
   • Lupus may lead to blood problems, including a reduced number of healthy red blood cells (anemia) and an increased risk of bleeding or blood clotting. It can cause inflammation of the blood vessels.
   • Blood-related issues are common in lupus patients. However, they do not usually generate observable symptoms. These issues can be serious and life-threatening.
     • Hemolytic anemia (anemia induced by red blood cell destruction)
     • Leukopenia (low white blood cell count)
     • Thrombocytopenia (low platelet count)
     • Both lupus and the medications used to treat it can cause anemia.
     • One out of every three patients with lupus produces antibodies that attack specific blood-clotting components, which result in mild to severe blood-clotting issues.
4. Lungs
   • One in every three patients with lupus develops inflammation of the tissue surrounding the lungs, which does not always result in symptoms. If produced, the symptoms include:
     • Severe breathing issues
     • Coughing
     • Chest pain
     • Inflammation of the chest muscle, cartilage or ligaments, or joints that link the ribs to the breastbone
     • Acute lupus pneumonitis (inflammation of lung tissues)
     • Pleurisy (inflammation of the lining of the lungs)
     • Some lupus patients develop an antibody called an antiphospholipid antibody that makes their blood clot more easily
     • Such patients may be at risk of developing pulmonary emboli (blood clots in the lungs)
     • Pulmonary edema is a rare complication; it accumulates fluid in the lungs, which might be caused by heart or kidney problems
5. Bone and joints
   • Lupus can induce joint pain (arthralgia) and inflammation in and around the joints, leading to conditions, such as arthritis, tendonitis, and carpal tunnel syndrome. Lupus-related joint disorders rarely result in long-term effects.
   • Lupus can induce joint inflammation, which is usually referred to as inflammatory arthritis, which causes:
     • Joint pain
     • Stiffness
     • Tenderness
     • Warmth
     • Swelling
   • Lupus arthritis most commonly affects joints located further away from the center of the body, such as the fingers, wrists, elbows, knees, ankles, and toes. Lupus arthritis may not cause persistent joint damage as seen with rheumatoid arthritis.
   • Patients with lupus are at an increased risk of osteoporosis. The glucocorticoid medications often prescribed to treat systemic lupus erythematosus can trigger significant bone loss. In addition, pain and fatigue caused by the disease can result in inactivity, further increasing osteoporosis risk. Studies show that bone loss in lupus may occur as a direct result of the disease.
6. Muscles
   • Myalgia or muscular ache and pain is a common complication of lupus. Lupus can cause myositis or muscle inflammation most commonly in the hips, thighs, shoulders, and upper arms.
   • Muscle weakness can be caused by several lupus medicines, such as steroids, which normally go away after you stop taking the drug that caused it.
7. Brain
   • Lupus-related neurological (nervous system) issues include:
     • Dizziness
     • Mild memory loss
     • Difficulty concentrating
     • Headaches, especially migraine headaches, mostly caused by stress and strain
     • Peripheral neuropathy (damage to the neurons that run throughout the body)
     • Seizures
     • Strokes range in severity from moderate to severe
     • Vision disruption
     • Many patients with lupus experience one or all the following symptoms
     • Anxiety
     • Depression
     • Psychosis
     • Hallucinations (false perceptions)
   • These symptoms may be caused by the disease or medications, such as sedatives, corticosteroids, or opioids.
   • Manic symptoms can arise as a result of lupus corticosteroid treatment and subside after the medication is stopped, such as:
     • Extremely high levels of energy and activity
     • Difficulty sleeping
     • Irritability
8. Digestive system
   • Some digestive issues are caused by lupus, whereas others are adverse effects of lupus medication. The doctor can run tests to see if the digestive issues are caused by lupus. Digestive problems are uncommon, but they might occur.
     • Abdominal pain, frequently accompanied by nausea and vomiting
     • Liver enlargement
     • Pancreatitis (inflammation of the pancreas)
     • Peritonitis (inflammation of the intestines)
     • Difficulty swallowing
     • Indigestion
     • Dry mouth

The American Rheumatism Association (ARA) reports that to confirm the diagnosis of lupus, the patient must be presented with at least four of the following conditions:

• Malar rash: A persistent butterfly-shaped red rash on the cheeks.
• Discoid rash: Red skin areas caused by scaling and clogging of hair follicles.
• Photosensitivity: Rash after sun exposure.
• Oral ulcers: Small lesions on the mucosal lining of the mouth and nose.
• Serositis: Inflammation of the fragile tissues that surround internal organs, accompanied by abdominal pain.
• Arthritis: A very common complication of lupus, causing discomfort in the joints and tendons.
• Renal disorders: These are usually diagnosed by standard blood and urine analysis.
• Neurological disorders: Seizures or psychosis, balance issues, and others.
• Hematological disorder: Hemolytic anemia, leukopenia, and thrombocytopenia.
• Immunologic disorder: Anti-DNA, anti-Smith antibodies, and antiphospholipid antibodies are tested.
• Antinuclear antibody (ANA TEST): When antinuclear antibodies are identified in the blood while the patient is not on any medications, it is a positive test for lupus in most cases. However, a positive ANA test does not always indicate lupus. A negative ANA test, however, considerably reduces the suspicion.

Other common but unclassified symptoms include:

• Hair loss or breaking, particularly around the brow
• Raynaud's phenomenon (color change in the fingertips in response to cold exposure)

Diagnosis is normally made by a rheumatologist, but other experts, such as dermatologists, kidney specialists, cardiologists, and obstetricians, could be involved.

The treatment for lupus depends on the organs involved, the symptoms present, and abnormalities in the blood workup. Most patients with lupus can expect to live a normal life with proper care, but many will endure some level of disability.

For more serious lupus health problems, such as kidney and neurological disorders, aggressive therapy is essential.

Blood count irregularities do not always require active therapy, although rashes, fatigue, arthritis, and other symptoms commonly react to one or more of the following treatments:

• Corticosteroids
• Nonsteroidal anti-inflammatory drugs
• Immunosuppressive drugs
• Plaquenil (hydroxychloroquine)
• Antihypertensives, such as angiotensin-converting enzyme inhibitors
• Antidepressants
• Antiseizure medications