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Lupus Disease – Causes, Symptoms and Treatment

Lupus is a chronic autoimmune disease in which the immune system attacks healthy tissue. It can affect the skin, joints, and internal organs.

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Things worth knowing about "lupus disease"

Lupus is a chronic autoimmune disease in which the immune system attacks healthy tissue. It can affect the skin, joints, and internal organs.

What is Lupus?

Lupus (medically known as Systemic Lupus Erythematosus, or SLE) is a chronic autoimmune disease. This means the body's immune system mistakenly attacks healthy tissue and organs instead of fighting off pathogens. Lupus can affect nearly any part of the body, including the skin, joints, kidneys, heart, lungs, and brain. The disease follows a relapsing-remitting course, meaning periods of active symptoms alternate with phases of remission.

Causes

The exact cause of lupus is not yet fully understood. It is believed to result from a combination of factors:

Genetic predisposition: Certain gene variants increase the risk of developing lupus.
Hormonal factors: Lupus is significantly more common in women of childbearing age, suggesting an influence of estrogen.
Environmental triggers: UV radiation, infections, certain medications, and stress can trigger flares or contribute to the onset of the disease.
Immune system dysfunction: Abnormalities in the immune system lead to the production of autoantibodies that attack the body's own tissues.

Symptoms

The symptoms of lupus are highly variable and differ from person to person. Common signs and symptoms include:

Butterfly-shaped rash across the cheeks and nose (malar rash)
Joint pain and swelling
Fatigue and exhaustion
Unexplained fever
Sensitivity to sunlight (photosensitivity)
Hair loss
Mouth sores
Chest pain when breathing deeply (pleuritis)
Kidney involvement (lupus nephritis)
Neurological symptoms such as headaches or cognitive difficulties

Diagnosis

Diagnosing lupus can be challenging because its symptoms overlap with many other conditions. Physicians rely on a combination of approaches:

Clinical examination and medical history
Blood tests: Detection of autoantibodies, particularly antinuclear antibodies (ANA), anti-dsDNA, and anti-Sm antibodies
Urine analysis to assess kidney function
Imaging studies (e.g., ultrasound, MRI) when organ involvement is suspected
Tissue biopsy in cases of suspected kidney or skin involvement

The classification criteria of the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) are used worldwide for diagnosis.

Treatment

There is currently no cure for lupus, but the disease can be effectively managed. The goals of treatment are to reduce flares, protect organs, and improve quality of life. Treatment is tailored to the severity of the disease and the organs affected:

Medication-Based Therapy

Antimalarials (e.g., hydroxychloroquine): Considered the cornerstone of lupus therapy; reduce flares and prevent organ damage.
Corticosteroids (e.g., prednisone): Used during acute flares to quickly suppress inflammation.
Immunosuppressants (e.g., azathioprine, mycophenolate mofetil, methotrexate): Help control the overactive immune response.
Biologics (e.g., belimumab): Newer targeted therapies that interfere with specific pathways of the immune system.

General Measures

Sun protection (UV protection is especially important)
Regular medical check-ups and monitoring
Healthy diet and adequate rest
Stress management
Avoiding smoking

Prognosis and Outlook

The course of lupus varies greatly between individuals. With appropriate treatment, many people with lupus lead largely normal lives. However, severe organ involvement -- particularly of the kidneys -- can be life-threatening. Regular follow-up care is therefore essential. Thanks to modern therapies, the life expectancy of people with lupus has improved significantly over recent decades.

References

Fanouriakis A. et al. - 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Annals of the Rheumatic Diseases, 2019.
Aringer M. et al. - 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis and Rheumatology, 2019.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - Lupus: Diagnosis, Treatment, and Steps to Take. www.niams.nih.gov.

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