Lupus

Diagnosing Lupus

Lupus is a chronic inflammatory disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems including your joints, skin, kidneys, blood cells, brain, heart and lungs. It most commonly affects women between the ages of 15 and 40. If you’re African American, Hispanic and Asian, your risk factors increase.

 

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases.

 

Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms.

The most common symptoms of Lupus include:

      Fatigue and fever

      Joint pain, stiffness and swelling

      Butterfly-shaped rash on the face that covers the cheeks and                 bridge of the nose

      Skin lesions that appear or worsen with sun exposure

      Fingers and toes that turn white or blue when exposed to cold               or during stressful periods (known as Raynaud's                                         phenomenon)

      Shortness of breath

      Chest pain

      Dry eyes

      Headaches, confusion, memory loss

 

What causes Lupus?

Lupus occurs when your immune system attacks healthy tissue in your body. It's likely that lupus results from a combination of both your genetics and the environment. It appears that people with an inherited predisposition for the disorder may develop it when they come into contact with something considered a trigger. Some potential triggers include:

 

Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response.

 

Medications

Medications including certain types of anti-seizure medications, blood pressure medications and antibiotics can trigger lupus. People who have drug-induced lupus usually see their symptoms go away when they stop taking the medication.

 

How to diagnose Lupus

There isn’t one test that can diagnose lupus. To properly diagnose, a combination of tests may be performed and include:

 

     Complete blood count. This test measures the number of red              blood cells, white blood cells and platelets as well as the amount          of hemoglobin, a protein in red blood cells. Results may indicate            you have anemia, which commonly occurs in lupus. A low white            blood cell or platelet count may occur in lupus as well.

    Erythrocyte sedimentation rate. This blood test determines the        rate at which red blood cells settle to the bottom of a tube in an            hour. A faster than normal rate may indicate a systemic disease,          such as lupus. The sedimentation rate isn't specific for any one              disease. It may be elevated if you have lupus, another                              inflammatory condition, cancer or an infection.

    Kidney and liver assessment. Blood tests can assess how well            your kidneys and liver are functioning. Lupus can affect these                organs.

     Urinalysis. An examination of a sample of your urine may show            an increased protein level or red blood cells in the urine, which              may occur if lupus has affected your kidneys.

    Antinuclear antibody (ANA) test. A positive test for the presence     of these antibodies, produced by your immune system, indicates a           stimulated immune system. While most people with lupus have a         positive ANA test, most people with a positive ANA do not have             lupus. If you test positive for ANA, we may advise more-specific             antibody testing.

 

If we suspect that lupus is affecting your lungs or heart, we may suggest:

 

•             Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs.

             Echocardiogram. This test uses sound waves to produce real-time images of your beating heart. It can check for problems with your valves and other portions of your heart.

•             Biopsy. Lupus can harm your kidneys in many different ways and treatments can vary, depending on the type of damage that occurs. In some cases, it's necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle, or through a small incision.

 

 

Treatment

Treatment for lupus depends on your signs and symptoms. Determining whether your signs and symptoms should be treated and what medications to use requires a careful discussion of the benefits and risks with your doctor. As your signs and symptoms flare and subside, you and your doctor may find that you'll need to change medications or dosages. The medications most commonly used to control lupus include:

 

Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen (Aleve) and ibuprofen (Advil, Motrin, others), may be used to treat pain, swelling and fever associated with lupus.

 

Antimalarial drugs. Medications commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), also can help control lupus.

 

Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus, but often produce long-term side effects  including weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection.

 

Immune suppressants. Drugs that suppress the immune system may be helpful in serious cases of lupus. 

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