Patient focus: A look at lupus

October is lupus awareness month!

Lupus can generally be undiagnosed, so here’s a quick look at what to check for:

What is it?

Lupus is a chronic and incurable illness of the immune system, where the body’s defence mechanism begins to attack itself through an excess of antibodies in the blood stream. This can cause inflammation and damage in the joints, muscles and other organs.

The condition has been found to affect mainly women between the ages of 15 and 55. The main trigger of lupus is hormonal activity and change, and lupus can often trigger after childbirth, at the menopause or during puberty.

What does it look like?

Diagnosis for Lupus is highly variable. Symptoms can either mimic other diseases like multiple sclerosis or rheumatoid arthritis, or can come and go.

Common clinical symptoms include:

• malar rash (a facial rash)
• oral ulcers
• joint pain
• photosensitivity
• kidney impairment
• seizures
• haemolytic anaemia (anaemia due to red blood cell loss)
• fever
• thrombocytopenia (decreased platelets).

Other acute manifestations include:

• fatigue, fever, joint pain, weight change
• renal failure, kidney disease
• seizures
• psychosis
• pleurisy, pleural effusion, pneumonitis
• nausea, dyspepsia, abdominal pain,
• pericarditis, myocarditis
• anaemia.

 

What I should I do about it?

It’s best to have a high level of suspicion of the above acute problems when treating a person who has lupus and is suffering from pain, fitting, ‘acting strangely’, has hypotension, is generally unwell or short of breath or has chest pain.

There is unfortunately no cure for lupus, but with an agreed treatment programme the condition can be controlled.

Patients can be on medication such as: anti-inflammatory drugs (NSAIDS) who are suffering joint or muscle pain; aspirin, heparin or warfarin can be prescribed if patients need anticoagulation treatment; anti- malarials can help with skin and joint movement and with fatigue; steroids such as prednisolone have a profound effect on inflammation and have profoundly helped many patients control their condition; immunosuppressants are widely used in more severe cases, and the most commonly used are azathioprine, methotrexate and cyclophosphamide.

 

Lupus is a rare condition – the Trust has produced a ‘rare conditions handbook’ that covers this, and other rare illness, to help with your clinical decision making. You can download a copy here.

Published 8th October, 2015