Systemic Lupus Erythematosus (Lupus)

What is lupus?

Systemic Lupus Erythematosus, usually referred to as SLE or lupus, is sometimes labeled the “great imitator.” Why? Because of its wide variety of symptoms, it can often be confused with other disorders. Lupus, which affects the joints, kidneys, and skin, can be fatal. However, there is much reason for hope. Improvements in therapy have significantly increased these patients’ quality of life and their life expectancy.

Lupus or SLE is a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, nervous system, and other organs of the body. Usually, patients have skin rashes and arthritis, as well as fatigue and fever. Lupus attacks can vary from mild to severe, and usually alternate between periods of activity and periods when the disease is mostly quiet.

What causes lupus?

The immune system normally protects the body by producing antibodies that attack foreign germs and cancers. With lupus, the immune system misfires. Instead of producing protective antibodies, the autoimmune disorder begins manufacturing “auto‐antibodies” which attack the patient’s own tissues. (Doctors refer to this as a “loss of self‐tolerance.”)

As the attack continues, other immune system cells join the fight. This leads to inflammation and blood vessel abnormalities (vasculitis). These antibodies then end up in the immune system of cells in organs where they cause tissue damage.

Why this inflammatory reaction begins is not known. It is probably the result of a combination of inherited tendencies and environmental factors (such as viruses, the ultraviolet rays in sunlight, Silica dust, and allergies to medications). People affected by lupus may also have an impaired process for clearing old and damaged cells from the body, which then causes an abnormal reaction in the immune system.

Who gets lupus?

Lupus typically develops in people in their 20s and 30s, and 10 times more often in women than in men. It is more common in certain ethnic groups, particularly blacks and Asians, who also tend to be more severely affected.

Patients with lupus typically experience:

• Fever, fatigue, and weight loss
• Arthritis lasting for several weeks in multiple joints
• Butterfly‐shaped rash over the cheeks or other rashes
• Skin rash appearing in areas exposed to the sun
• Sores in the mouth or nose lasting for more than a month
• Loss of hair, sometimes in spots or around the hairline
• Seizures, strokes, and mental disorders (depression)
• Blood clots
• Miscarriages
• Blood or protein in the urine or tests that suggest poor kidney function
• Low blood counts (anemia, low white blood cells, or low platelets)