Lupus (SLE) is a chronic, inflammatory autoimmune disorder that may affect many organ systems including the skin, joints, blood cells and internal organs, especially kidneys, and sometimes the brain. SLE affects women nine times more often than men and it usually occurs between the ages of 20-40 years. There is an increased incidence of lupus in persons of African, and Asian descent. The cause of lupus is not fully understood. It is thought to involve both an inherited component and a trigger that may be related to environmental factors and/or to hormones. Certain drugs may also cause SLE.
Lupus may co-exist with other autoimmune disorders, such as Sjögren’s Syndrome, thyroid disease, and the antiphospholipid syndrome.
Symptoms and signs of lupus are highly variable and include:
- Arthritis-like pain in one or more joints (but no or little joint damage)
- A red rash – particularly one resembling a butterfly across the nose and cheeks; sensitivity to ultraviolet light
- Persistent fatigue
- Mouth ulcers
- Muscle pain
- Hair loss
- There may also be inflammation and damage to organs and tissues including the kidneys, lungs, heart, lining of the heart, central nervous system, and blood vessels.
- Kidney disease is a frequent occurrence in patients with lupus. Lupus causes glomerulonephritis, a condition that affects the kidney’s ability to filter toxins, which can lead to kidney failure if untreated.
- Sometimes involvement of the nervous system may occur and can lead to complications including headaches, seizures, depression, or even psychosis.
Symptoms of SLE come and go, vary over time, and vary from patient to patient. They may worsen abruptly with flare-ups and then improve. Flare-ups may be triggered by changes in the patient’s health status, such as physical or emotional stressors and/or by outside stimulants such as exposure to ultraviolet light (many affected persons are sensitive to sunlight), infections, and sometimes exposure to oestrogens such as in the combined oral contraceptive pill. It is important not to stop contraception abruptly, but to discuss with your doctor. Pregnant women may experience flare-ups during pregnancy or shortly after giving birth.
Some patients with lupus may also be affected by the antiphospholipid syndrome, where the blood becomes more prone to clot: this can lead to clots in arteries leading to strokes, and in veins such as deep vein thrombosis in the legs, or pulmonary embolism (blood clot in the lung). The antiphospholipid syndrome also leads to an increased risk of miscarriages. Antiphospholipid syndrome can also occur in the absence of underlying lupus.