Lupus is an autoimmune disease that affects millions of people around the world, but is still widely misunderstood and challenging to diagnose. Although the disease can cause extreme illness and even death, little is known about its cause. In the midst of Lupus Awareness Month, an expert at Baylor College of Medicine explains the facts that are known about the disease.
“There is still a lot to be taught to the general population and often even to the medical community about lupus,” said Dr. Kalpana Bhairavarasu, assistant professor of medicine and rheumatology. “The rareness of the disease is increasing, which is a good thing, but with that comes the problem of misdiagnosis.”
Common symptoms of lupus include a butterfly rash triggered by sunlight, experiencing fatigue, joint pain and hair loss. More severe signs of lupus include blood or protein in the urine and presence of Raynaud’s phenomenon, a condition where hands turn a blue white and red, often sequentially, even at room temperature, Bhairavarasu said.
Here are some of the top facts you should know about lupus:
Lupus mainly occurs in women
According to the Lupus Foundation of America, the disease is 90 percent more common in women. Bhairavarasu explains how it primarily affects them during their childbearing years between the ages of 18 and 45, and that the age factor can sometimes make it more challenging to treat than other autoimmune diseases. It is still being researched on why lupus is more present in women.
“Lupus does occur in men and can sometimes be more challenging to manage when it does as it can be aggressive,” Bhairavarasu said. “In both men and women, it varies widely in terms of symptoms and management but early detection, treatment and avoiding stressors can make a significant impact.”
Symptoms are different for each person
The symptoms of lupus do not present the same in each affected person, which can make it difficult to treat. Bhairavarasu said that 70 to 80 percent of patients have skin and joint symptoms, but there also is a large percentage that will experience kidney problems, low blood count and miscarriages.
“When the disease starts in the younger population, it can have a more aggressive course,” Bhairavarasu said. “Older patients may not have as much of the skin and joint symptoms but they can have fluid around the heart or the lungs and low blood count.”
Lupus is both genetic and environmental
It is believed that lupus is influenced by genetics and environmental factors, such as being triggered by stress, sun exposure and medications. “It’s a combination of both genetic and environmental factors, but we haven’t really identified all of the aspects,” Bhairavarasu said. “Two people, even twins, could have the exact same antibodies and still have different clinical presentations and response to treatments. There is a genetic component but there is still a lot of work going on for gene studies to see what dictates the different clinical response.”
A mere blood test can diagnose lupus
It is possible to diagnose lupus from a positive blood test, but Bhairavarasu recommends visiting a primary care doctor or a rheumatologist if there are signs that could relate to lupus.
“It is technically possible to know you have lupus from just a blood test,” she said. “But then again, we don’t want that. We would actually like to have the clinical scenario in the right setting.”
The disease is treatable
Bhairavarasu said the most important aspect to understand is that while there is no specific cure to the disease, it can still be properly managed and treated. Bhairavarasu compares lupus and its treatment process to conditions such as diabetes and hypertension.
“Often when someone is diagnosed with lupus they are devastated with the diagnosis, which is understandable, but they should realize that this is a completely treatable disease,” she said.
Bhairavarasu encourages patients to not fear treatments and neglect the disease until it becomes advanced. She explains that lupus can lead to chronic inflammation, such as skin scarring and joint swelling, as well as more serious conditions such as heart disease, abnormal kidney function and pregnancy issues.
The treatment process depends on which symptoms are present in the person’s condition. Common treatments include use of antimalarial drugs and types of chemotherapy drugs.
“If you look at most diseases whether it’s asthma, diabetes or heart disease, all of these are treated,” she said. “There are very few diseases that can actually be cured, and lupus is no different. There will be good days, there will be bad days. With good proper medication, care and follow-ups it can be managed.”