Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
Lupus is an inflammatory disease that can affect organs all throughout the body. Technically called “systemic lupus erythematosus,” or sometimes “SLE,” lupus disease varies widely in its severity. For some people, it is a mild inconvenience, while for others it is completely debilitating.
Lupus is an autoimmune disease, meaning it’s an illness in which the body has essentially turned on itself. Whereas the immune system normally attacks viruses, bacteria, and other pathogens that invade the body’s tissues, in autoimmune diseases the immune system unleashes its inflammatory compounds and other weapons against healthy cells and tissues.
In a healthy person, countless biological processes are constantly playing out in which cells are damaged or destroyed, leaving behind waste materials that must be cleared away. In people who develop lupus, the body’s ability to remove those dead and damaged cells is impaired. That debris gives off chemical signals that invite an immune response. The result is inflammation of healthy tissue.
Researchers aren’t certain about why some people get lupus. There appears to be a genetic component, with some 90 genes involved in increased risk for the disease. And an identical twin has a 25% chance of getting lupus if his twin has it. Lupus is statistically more prevalent among people of Asian and African descent than those of European ancestry. And we also know that someone with one autoimmune disease, such as lupus, is at greater risk of also suffering from another, suggesting that some underlying autoimmunity trait is likely genetic.
According to one theory of the disease, having a genetic predisposition to lupus is like having an on/off switch that remains in the “off” position until some environmental stimulus flips the switch to “on.” Such triggers could include infections (which may be undetected), the sun’s ultraviolet rays, stress, medications, traumatic injury, exhaustion, and viruses.
Another theory being investigated is that imbalances of the bacteria in the gut microbiome lead to inflammation throughout the body, triggering or contributing to lupus and other autoimmune disorders.
Yet a third possible explanation is that certain viruses or bacteria play a trick on the immune system by producing antigens that appear identical to the body’s healthy proteins. When the immune system rushes in to identify and stamp out the threat, it is fooled by this feat of mimicry into memorizing healthy tissue as a threat that must be defended against.
The inflammation brought on by lupus can affect the muscles, brain, joints, kidneys, eyes, skin, and digestive system, although which organs are impacted, and to what extent, is quite idiosyncratic. Some people just experience achy joints, while others end up wheelchair-bound and unable to function independently.
Among the symptoms associated with lupus are light sensitivity, fever, mouth sores, fatigue, sore joints, anemia, difficulty breathing, and “lupus rash,” a butterfly-shaped discoloration on the face. With such a widespread constellation of possible symptoms…many of which overlap with those of other conditions…diagnosing lupus sometimes takes a long while. In fact, its diagnosis is so complex that the disease is sometimes referred to as “the cruel mystery.” There is no single “lupus test.” Instead, the diagnosis is made by considering all of the patient’s symptoms, performing a complete physical examination, and performing several blood and urine tests.
It’s possible to live with lupus for many decades while managing its symptoms. Occasionally flare-ups are severe enough to require hospitalization, but up to 90% of people with the disease live a normal lifespan. In many cases in which lupus is fatal, the disease has attacked the body’s organs, especially the heart and kidneys. Sometimes people with lupus die from infections because their immune systems are weakened either by the disease itself or by the medications used to treat it. People with lupus are also at increased risk of cardiovascular disease, independent of such risk factors as high blood pressure and high cholesterol. This is likely because high levels of chronic inflammation cause changes to the blood vessels that can lead to heart attack and stroke.
Lupus cannot be cured. Instead, doctors and patients work together to settle on a medication regime carefully designed to control the specific symptoms bothering the patient. Among the treatment choices available are:
