Published Sep 25, 2015
A: Lupus is an autoimmune disease in which antibodies attack healthy tissue and cause inflammation of the skin, joints, or organs. The Lupus Foundation of America estimates that 1.5 million people in this country have the condition, and 16,000 new cases are reported each year. While men can have the disease, 90 percent of cases are women.
Every case of lupus is different, but one telltale sign of the disease is a butterfly-shaped facial rash that spreads across the cheeks. Other symptoms may include fever, joint pain, fatigue, headaches, and shortness of breath.
Lupus can affect the nervous system – a complication known as neuropsychiatric systemic lupus erythematosus, or NPSLE. According to the Lupus Foundation of America, 90 percent of people with lupus experience the effects of NPSLE; and a new study published in the journal Lupus found that about a quarter of patients with NPSLE have suicidal thoughts.
Anca Askanase, MD, a rheumatologist and clinical director of Columbia University Medical Center’s Lupus Center, points out that symptom severity can range from annoying to crippling. The condition can surface as a one-time episode, come and go with periodic flares, or present chronic symptoms.
“How long it takes to diagnose depends on the initial manifestations of lupus,” Dr. Askanase says. “If someone has kidney swelling or fluid in the lungs or brain involvement, the lupus can be obvious.” However, lupus can be misdiagnosed because its symptoms often resemble other conditions.
“If a person is having more joint pain and fatigue, they might be labeled as having rheumatoid arthritis or chronic fatigue syndrome at first,” Askanase says. “If you’re short of breath, people think you have asthma. If you have a rash, they think you’re allergic to something.”
So what causes lupus? While genetics likely play a role, research suggests that the condition could be triggered by environmental factors such as exposure to sunlight, infection, stress, or a reaction to certain medications.
There is no single test for lupus. The American College of Rheumatology has identified several criteria for diagnosis, including the presence of antinuclear antibodies (ANA) in the blood, skin rashes or mouth ulcers, heart or lung inflammation, arthritis, and neurologic problems.
Lupus is not curable. Depending on symptoms and severity, patients may be prescribed anti-inflammatory drugs, immune suppressants, or a combination of medications.
“It’s a complicated disease, and it’s not easy for people to grasp it,” Askanase says.
The Lupus Foundation of America provides information for patients and caregivers, a guide to local chapters, and other resources on its website.