The systemic lupus erythematosus (SLE) or Lupus as it is commonly called is an autoimmune disease where the body’s immune system mistakenly attacks healthy tissue. This disease is a multi-organ disease which can affect the skin, joints, kidneys and brain, just to name a few. Although the cause of lupus is not clear, it is believed to be linked to factors such as genetic, environmental, hormonal and even certain medicines.
It has been found to be more common in women, occurring at any age but most often appears between the ages of 15 to 44. The ethnic groups tending to be most affected by the disease are Africans and Asians. The symptoms of lupus vary from person to person, may come and go and sometimes can be as non-specific as joint pain and swelling, mimicking arthritis. SLE frequently affects the joints of the hands, wrists and knees. Other symptoms may include chest pain, tiredness, fever, general malaise, hair loss, weight loss, mouth sores, swollen lymph nodes, brain and nervous system disorders, gastrointestinal issues and heart and lung problems. However, lupus is almost pathognomonic of a “butterfly” rash which is a rash that is seen over the cheeks and bridge of the nose that gets worse in sunlight. Discoid lupus is the term used to describe people who have only skin symptoms. Since symptoms of lupus can be non-specific and varied, it is of utmost importance that persons raise their awareness about this life-threatening disease.
Increased awareness allows for early diagnosis and by extension, improved treatment outcomes. The diagnosis of lupus must include a thorough physical examination by your doctor who will look for common signs of the disease. After the initial assessment is made, specific investigations will be recommended to confirm the diagnosis of SLE. Tests requested will be namely Complete Blood Count, Kidney function test, Chest X-ray, Urinanalysis and sometimes Kidney biopsy and CT scans. Since there is no cure for lupus, the goal of treatment is to control symptoms. Each person with SLE will need an individualized treatment plan that will be based on the activity of their disease, the part of the body that is affected and the severity of the disease. In recent years, the outcome for people with SLE has improved. Many people have mild symptoms and therefore do well. The disease tends to be more active during the early years of diagnosis and in people under 40 years. Kidney failure, blood clots, anaemia, inflammation of the heart, pregnancy problems, stroke and bowel damage are just some of the possible complications that may develop if lupus is not managed properly. It is important to recognize that the management of lupus must involve counselling and support as this may help with the emotional issues that accompany the disease. Lupus affects both the life of the person with lupus as well as the people living with them. A better understanding of the illness can help a person know what to expect and it can help caregivers cope and provide better support.
Dr. Raymala Maharaj