Lupus (Systemic Lupus Erythematosus or SLE) is an autoimmune disease that triggers an attack on the body’s own cells, tissues, and organs. Lupus is an interesting name, stemming from the thirteenth-century physician Rogerius, who coined it from the Latin word for wolf. In this context, lupus depicts the typical symptomatic facial lesions/rash reminiscent of a wolf's bite.
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How does lupus occur?
Usually, the body’s immune system can identify diseases and bacteria that it regards correctly as ‘foreign invaders’. When it senses these invaders, the body will generally attack and destroy them effectively. With lupus, the immune system is confused and unable to distinguish between healthy cells and germs or viruses. It mistakes parts of the body as foreign and releases proteins called autoantibodies that attack healthy cells. The skin, muscles, and joints are most commonly affected. In severe cases, lupus disease can cause damage to the brain, lungs, kidneys, and heart.
Lupus causes pain, inflammation, rashes, and swelling (though not necessarily all of these). As there is no cure, treatment focuses on control - protecting the body’s organs and relieving symptoms.
Statistics show that around one in 900 people in New Zealand contract lupus. Maori, Pacifica, and Asian people are more likely to be affected than Caucasians, and women are ten times more susceptible than men. Lupus can develop at any age but is more common between the ages of 20 and 45.
Lupus symptoms
Symptoms vary from person to person and may develop suddenly or very gradually. Some people might experience a mild episode - called a flare - when signs of lupus temporarily worsen but then improve, or possibly even disappear for a time.- The most common signs are:
- Fever, fatigue
- Headaches, memory loss, and confusion
- Chest discomfort, pain, shortness of breath
- Stiffness and swelling of joints
- Skin lesions that get worse with sun exposure
- Toes and fingers that turn white or blue when cold or under stress
- A butterfly-like rash which spreads over the nose and cheeks; rashes elsewhere.
What causes lupus?
Some people are born with a genetic tendency towards developing lupus. The disease can be triggered by lifestyle and environmental situations, including the stress of giving birth, divorce, illness, surgery, traumatic injury, certain drugs, or sunlight. Though gene analysis continues to advance tremendously, the specific causes of many autoimmune disorders persist in challenging the medical profession.
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How lupus is diagnosed
A physical examination along with a suite of comprehensive laboratory tests will lead to an accurate lupus diagnosis. The tests include one or more of the following:
Blood and urine analysis
- A complete blood count will indicate whether or not you have anaemia - a common indicator for lupus.
- The tests will also indicate how well your kidneys and liver are functioning.
- Your urine may show increased levels of red blood cells or protein, particularly if your kidneys have been affected.
- An antibody test, if positive, will indicate a stimulated immune system. If you test positive, your doctor might recommend more specific antibody testing.
- Abnormal shadows will suggest inflammation or fluid in your lungs.
Echocardiogram
- Real-time images of your heart will reveal possible signs of lupus.
Biopsy
- It may be necessary to take and test a small sample of kidney tissue to determine if lupus has caused any damage to these organs.
- A skin biopsy may also be necessary to confirm lupus.
Treatment and management of lupus
Prompt, professional care significantly improves your ability to manage lupus in New Zealand. Once diagnosed, your doctor will advise you of the treatments available, and explain the relative benefits and risks involved. A plan tailored to your symptoms will be devised; because those symptoms might fluctuate, your doctor will possibly recommend changing your medication or varying the dosage occasionally.
The medications most commonly used to manage lupus are:
- Non-steroidal anti-inflammatory drugs (NSAIDs) - Over-the-counter medicines such as naproxen and ibuprofen deal with pain, fever, and swelling. Side effects can include kidney issues, stomach bleeding, and the risk of heart problems.
- Corticosteroids - Prednisone and other such steroids are often used to manage lupus in the kidneys and brain. Easy bruising, weight gain, high blood pressure, diabetes, and risk of infection are side effects, which increase with higher dosages and longer-term treatment.
- Immunosuppressants - Medications such as Imuran, Azasan, Cellcept, Trexall, and Neoral work by suppressing the immune system and can be helpful in serious lupus cases. Potential side effects may include liver damage, decreased fertility, and an increased risk of general infection and cancer.
- Antimalarial drugs - Medications such as Plaquenil are commonly used to treat malaria but can also help decrease lupus flare-ups. Stomach upsets and (rarely) damage to the retina of the eye are possible side effects. Eye examinations are strongly recommended when these drugs are taken.
- Biologics - Benlysta (administered intravenously), Rituxan, Truxima, and Voclosporin reduce symptoms in many people. Typical side effects include nausea, diarrhoea, infections, and a worsening of depression if that condition already exists.
People sometimes choose alternative medicines - such as fish oil, DHEA supplements (dehydroepiandrosterone), and acupuncture - to treat their symptoms. While these therapies may ease the effects of lupus, they have not been shown to alter its course.
Private health insurance options for managing lupus
Now is the time to think about investing in private health insurance cover that will give you or someone you love the most outstanding support possible in the event of an illness such as lupus.
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Management of lupus symptoms
Make the right lifestyle adjustments
If you have lupus, there are simple things you can do to help prevent flare-ups:
- Make regular visits to your doctor - Ask if you need vitamin D and calcium supplements.
- Be sun smart - Ultraviolet light can set off a lupus flare very quickly, so wear protective clothing when outside and use a high-protection factor sunscreen of at least SPF55.
- Exercise regularly - Exercise will greatly help with your fitness, strength, and overall wellbeing.
- Don’t smoke - Your risk of cardiovascular disease increases with lupus. Smoking potentially worsens its effects on lungs, heart, and blood vessels.
- Ensure you are on a healthy diet - Fruit, vegetables, and whole-grain foods are essentials.
Your support and coping mechanisms: what you need to do
If you find you have lupus, there are things you can do to feel more confident about dealing with the disease:
- Educate yourself about lupus - knowledge is power and gives you the confidence to cope.
- Work with those close to you to better understand lupus and how you can manage your condition.
- Communicate with others who have lupus to strengthen your support group. Your combined understanding and sharing will help you cope.
- Consult your doctor as often as you need to monitor your progress.
Why you should choose Policywise for your health insurance
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Disclaimer: This article is for general information only. Nothing in this blog or on this website is intended as medical, dietary, or financial advice. Although we aim to update our content regularly, you are advised to consult a Policywise adviser, health professional, or an appropriate specialist before acting on any information herein. They can factor in your personal circumstances or preferences and help guide your decision-making process.