The Facts About Lupus

There's no true cure for the inflammatory disease lupus, but there are various treatments that can improve quality of life by controlling symptoms and mitigating flare-ups. Disease management can include medicines, but there are several lifestyle changes you can make to alleviate symptoms.

Lupus is a chronic autoimmune disease where the body's immune system attacks healthy tissue.

Inflammation caused by lupus can affect a variety of systems in the body, including skin, joints, kidneys, brain, lungs and heart. About 1.5 million people in the United States have lupus, according to the Lupus Foundation of America.

There are four primary forms of lupus:

• Systemic lupus erythematosus (SLE). It can affect the joints, skin, brain, lungs, kidneys and blood vessels.
• Cutaneous lupus. Lupus that affects the skin.
• Drug-induced lupus. Lupus caused by prescription drugs.
• Neonatal lupus. A rare type of lupus that affects infants.

The most common type is systemic lupus erythematosus, and when people talk about lupus, they are typically referring to SLE.

The signs and symptoms of lupus depend on what body systems are being affected by the disease. The most common signs and/or symptoms of lupus, though many of them are nonspecific, can include:

• A butterfly-shaped rash on the face 
• Chest pain
• Confusion
• Dry eyes
• Fatigue
• Fever
• Fingers and toes turn blue or white when cold 
• Headaches
• Joint pain and swelling
• Memory loss
• Shortness of breath
• Skin lesions that worsen with sun exposure

The exact cause of lupus is unknown. Genes, hormones and environmental factors are all believed to play a role in the development of lupus.

Some research has shown that siblings of people who have lupus have a 20-times greater chance of developing the disease than the general population. Having lupus-predisposing genes, however, does not guarantee a person will develop the condition. While researchers believe lupus is caused by genetic, hormonal and environmental triggers, they have not determined what factor sets the disease in motion or how all of these elements interact.

There is no universal diet for people with lupus. However, because lupus affects the entire body, eating a healthy and nutritious diet can help combat the disease symptoms by maintaining overall health.

Doctors and nutritionists often advise eating a diet that is roughly 50 percent carbohydrates, 15 percent protein and 30 percent fat. However, given that lupus patients frequently have symptoms such as weight loss or gain, inflammation, osteoporosis, kidney disease, high blood pressure and atherosclerosis, some specific nutritional issues also need to be taken into account. You should discuss your diet with your healthcare provider.

Systemic lupus erythematosus, the most common type of lupus, is more prevalent in women between the ages of 15 and 45. Other factors that may increase the risk are:

• Genes. The risk is greater in people who have other family members with lupus.
• Race and ethnicity. Asian, Black, Hispanic and Native American people are at higher risk than white people.

SLE is most likely caused by a combination of genetic and environmental factors. If an individual has the genetic predisposition, SLE might be triggered by:

• Bacterial and viral infections, such as Epstein-Barr virus
• Being around smoke or too much sunlight

If you have lupus, you may suffer from problems such as joint pain, vaginal dryness and genital sores, which can make having sex challenging, even painful. Some prescription drugs used to treat lupus can cause vaginal dryness and decrease sexual desire as well.

If lupus is causing sex to be uncomfortable, there are steps you can take to help, including:

• Do Kegel exercises, which can increase blood flow to the genital area, helping arousal
• Spend more time on foreplay
• Take a warm bath before sex to relax your muscles
• Try different sex positions that are more comfortable
• Use lubricant
• Use pillows for support

Lupus and some required treatments can have an impact on fertility.

The lupus medication cyclophosphamide (brand name: Cytoxan) has been linked to infertility. Cytoxan can cause premature ovarian insufficiency (POI), which occurs when the ovaries stop functioning before the age of 40. This condition can make it more difficult to get pregnant. It is possible to have a healthy pregnancy with lupus, though, but the disease does raise a woman's risk for complications during pregnancy.

Lupus can be difficult to diagnose because it has many nonspecific signs and symptoms, making it challenging to differentiate other diseases with similar presentations. Some people have lupus for years before they realize it.

No single test can tell if a person has lupus. However, there are a number of tests that can aid a doctor in making a lupus diagnosis, including:

• Biopsy
• Blood and urine tests
• Complete physical exam
• Family history
• Lupus autoantibody test
• Medical history
• Urinalysis

Lupus is a chronic disease that requires ongoing management. Treatment aims to reduce organ damage caused by the disease and put your symptoms into remission (where they are no longer present or active).

Unfortunately, lupus can strike without warning, and its effects may fluctuate over time. You need to see your doctor on a regular basis and modify your treatment strategy based on your symptoms.

Some lupus sufferers with minor symptoms might require only limited treatment. These people may experience symptoms that are monitored to make sure they do not worsen, but they do not currently require treatment. Others may require a vigorous course of treatment. These people typically experience more severe problems, including heart, lung and/or kidney complications.

Medications that can be used to treat lupus include:

• Azathioprine (brand name: Imuran)
• Belimumab (Benlysta)
• Cyclophosphamide (Cytoxan)
• Hydroxychloroquine (Plaquenil)
• Methotrexate (Rheumatrex)
• Rituximab (Rituxan)
• Steroids(corticosteroids, including prednisone)

How serious is lupus?

Lupus can range from a mildly debilitating condition to one that poses a serious risk of death.

Lupus can kill people in their 20s as a result of heart attacks and strokes if it develops into cardiovascular disease. Death stemming from infections linked to the immune-suppressing medications used to treat lupus is also possible.

Lupus does not affect a woman's ability to conceive, but it can increase the risk of miscarriage.

What causes lupus?

Researchers are unsure of the precise cause of lupus. They speculate that your environment, hormones and genetics may be at play.

Lupus is considered an autoimmune disorder because it causes your immune system—which normally defends you against bacteria, viruses and other external invaders that can harm you—to inadvertently target and harm the tissues in your body.

How do you test for lupus?

In some instances, doctors may perform a biopsy, which involves taking a sample of tissue from an area that's affected by lupus to confirm a diagnosis and help determine the best course of treatment.

There is no one test to diagnose lupus. Doctors use the results of several tests, as well as a thorough physical examination and a review of symptoms, family history and medications. They use a variety of lab tests to rule out other conditions and diagnose lupus, including:

• Antinuclear antibodies (ANA) test
• Complete blood count (CBC)
• Erythrocyte sedimentation rate (ESR) and C-reactive protein test
• Urinalysis