What is Lupus

If you watch house,you will probably have heard about lupus.This is a chance to find out a bit about it.

I hope you guys don't mind. I am a med student so things could get a bit sciencey.

What Is Lupus?

Lupus is a chronic autoimmune disease where the body's immune system becomes hyperactive ³and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.³

Systemic Lupus Erythematosus(SLE) affects about 5 in 10000⁴ people in the UK.

What Causes Systemic Lupus Erythematosus?

At present the cause of lupus is unknown.Researchers have identified a number of  mutations⁶ in the genes

The immune system defends the body against infection. Viruses and bacteria trigger an immune response.

In people with lupus, B cells stay in the body longer than normal. This is thought to be the result  excessive amounts of B-lymphocyte stimulator present in the body. These are called autoreactive B cells, autoreactive B cells react against the body . The autoreactive B cells produce autoantibodies. Unlike normal antibodies, which react against foreign invaders, the autoantibodies attack the body. This results in inflammation of body tissue.( red box figure 2)

Figure2: Top Left - Antibodies in a  normal person. Bottom right-Antibodies in a lupus sufferer.

 Risk Factors

 A persons chance of developing lupus are increased by certain factors.

Estrogen levels: Lupus is more common in female(figure3) than males. In addition to this almost all women

develop lupus whilst they are childbearing age³

Race-lupus is more common in Black and Asian people

Family history: Approximately 10% of people with lupus have a family member with lupus

Major stress or infection: In people who are  genetically  predisposed to get lupus, extreme stress or an infection may trigger onset of the disease

These risk factors are out of peoples control, and it is not possible to reduce the risk of getting lupus.

 Symptoms

How is Lupus Diagnosed

Systemic Lupus Erythematous is difficult to diagnose. This is because symptoms of SLE are sometimes similar to several other conditions, most of which are more common than SLE. Lupus patients often suffer unpredictable bouts of the disease (flares) followed by periods of 

remission ,further complicating diagnoses.

If SLE is suspected, a doctor will run the following blood tests

· Anti-nuclear antibody test

· Anti-DNA antibody test

· Complement level test

Prognosis

SLE is incurable, but available treatments enable sufferers to lead a high quality life⁷

In the 1950s, most people diagnosed with SLE lived less than 5 years.¹² Death within 5 years, of diagnosis is due to organ failure or overwhelming infections.⁷

Now over 90% now survive for more than 10 years after diagnosis.¹² Many  sufferers live relatively asymptomaticly.³  and 60-75% can expect to live a normal lifespan.

Prognosis is worse for men and children than for women.³ If symptoms first present  after  60, the disease runs a more benign course.

While there are no known root causes or cure, the 

progress of recent discoveries and treatments in development is encouraging. Scientists hope that with this 

information effective treatments can be made to prevent the disease.

 References

1  

1.       Lupus Foundation USA.Malar Rash.Lupus Foundation 2009
http://www.howdoyougetlupus.com/lupus-malar-rash-symptoms

2.       GlaxoSmithKline.Lupus Facts.GSK 20012
http://www.benlysta.com/benlysta-information/lupus-facts.html

3.       Lahita RG.Systemic lupus erythematosus. London : Elsevier, 2004

4.       NHS.Lupus.NHS,2012
http://www.nhs.uk/Conditions/Lupus/Pages/Causes.aspx

5.       Lupus UK.Image of Lupus Symptoms.Lupus Uk,2009
http://www.lupusuk.org.uk/

6.       Kamboh MI, Wang X, Kao AH, Barmada MM, Clarke A, Ramsey-Goldman R, Manzi S, Demirci FY. Genome-wide association study of antiphospholipid antibodies.Autoimmune Dis. 2013;2013:76

7.       Wallace DJ. The lupus book : a guide for patients and their families. Oxford : Oxford University Press, 2009.

8.       Frieri M. Mechanisms of disease for the clinician: systemic lupus erythematosus. Ann Allergy Asthma Immunol. 2013 Apr;110(4):228-32

9.       Tortora GJ, Derrickson B. Essentials of anatomy and physiology. 13th ed., Asia. John Wiley & Sons, c2011

10.   Al Arfaj AS, Khalil N.Clinical and immunological manifestations in 624 SLE patients in Saudi Arabia Lupus . 2009 18: 465-473

11.   Kan HJ, Song X, Johnson BH, Bechtel B, O'Sullivan D, Molta CT. Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. Biomed Res Int. 2013;. Epub ahead of print  

12.   Arthritis UK.What is Lupus. Arthritis UK.2010
http://www.arthritisresearchuk.org/arthritis-information/conditions/lupus/what-is-lupus.aspx

Rosario C, Seguro L, Vasconcelos C, Shoenfeld Y. Is there a cure for systemic lupus erythematosus? Lupus. 2013;22:417-21.