Lupus

What is this disease?

In lupus the immune system attacks the body’s own tissues. This causes inflammation and can leave permanent damage in the skin, joints, kidneys, heart, lungs, blood or brain. The exact cause is unknown. Genes, sunlight, viral infections, some medicines and smoking are among the factors that may set it off.

Lupus affects women about nine times more often than men and usually begins between ages 15 and 45, though it can appear at any age.

What are the signs?

The signs vary a great deal from person to person and can change over time. The main ones are:

• Joint and muscle pain
• Extreme tiredness that rest does not fix
• Rashes after sun exposure, often over the nose and cheeks

You may also have:

• Fever, hair loss and weight loss
• Sores in the mouth or nose, usually painless
• Fingers that change colour in cold or stress (Raynaud’s)
• Chest pain on deep breathing
• Swelling of the legs or around the eyes

Lupus usually comes in waves: it gets worse for some weeks and then settles. These flares cannot be predicted.

How is it checked?

Diagnosis is not always easy, because the signs resemble other conditions. Your doctor puts the symptoms together with blood and urine tests. If organs may be involved, imaging of the heart, kidneys or other organs is needed too. After diagnosis, regular blood and urine tests continue, to find anaemia and kidney problems early.

What does treatment generally look like?

Lupus ranges from mild, with skin and joint problems, to severe, with organ damage, and treatment follows the severity.

• Hydroxychloroquine: for tiredness and skin and joint problems. It takes several weeks to work. People who take it for a long time need regular eye checks.
• Anti-inflammatory medicines: for joint and muscle pain.
• Steroids: as tablets, injections or creams.
• Immunosuppressants and biologics: for severe disease.

Lupus has no definite cure, but the earlier it is found and treated, the better it is controlled.

What can you do yourself?

• Use high-factor sunscreen and wear a hat.
• Pace your tasks so you do not get too tired, and stay a little active even on bad days.
• Do not smoke, because it makes lupus worse.
• Eat a balanced diet and ask about calcium and vitamin D.
• Check your blood pressure. High blood pressure can be a sign of kidney involvement.

When should you get help urgently?

• Swollen legs or face, foamy urine or high blood pressure: tell your doctor soon, because the kidneys may be involved.
• Chest pain, breathlessness, seizures, confusion or fever: get help the same day.

See the full list of warning signs.