Systemic Lupus Erythematosus or lupus is a chronic autoimmune condition. Our immune system goes haywire, produces auto antibodies that cause damage to healthy tissues like skin, joints, heart, kidneys etc.
How common is it?Not a very familiar term, unless someone in the family or a close
friend circle gets affected with it. It affects 3 in 100000 population in
India. 9 out of 10 are women.
Lupus symptoms:Common symptoms are rashes, hairfall, fever, fatigue, weight loss, joint
pains etc. Photosensitive skin rash on the face, across the nose, called the
butterfly rash is characteristic. Mouth ulcers and severe fatigue are common.
Kidney disease if notpromptly diagnosed and treated may result in
dialysis or transplant. Some people with lupus may have antiphospholipid
syndrome which causes a blood clotting tendency in arteries and veins and
Anxiety, depression usually accompany. Migraine, dizziness, memory
loss, confusion, fits may be signs of brain involvement. Patients with lupus
are more likely to develop heart attack due to cardiovascular disease.
Diagnosis:It is through a combination of history, physical examination, blood
and urine tests and sometimes a biopsy of affected tissue like kidney. Most if
not all patients with lupus have a positive anti nuclear antibody, detected on
a blood test.
What are the treatment
options available? Is there a cure? there is no
cure, however several drugs are available for treatment. Steroidsare used for
life threatening emergencies. Hydroxychloroquine is given to all patients for
skin and joint disease, reducing cholesterol and preventing clots. Mycophenolate
mofetil, azathioprine, tacrolimus are used for different indications. Biologic
therapies like rituximab and belimumab are used for severe and resistant cases.
There is ongoing research in the quest for newer and better therapies.
What is the outlook for
lupus patients? The outlook has changed due to
availability of better medications. Early referral to a rheumatologist makes a
lot of difference. Delay in treatment can lead to organ and life threatening
Pregnancy and lupus Most patients can have a normal pregnancy. It should be plannedwhen
lupus has been quiet for at least 6-12months and whilst on minimal medications.
Active kidney disease is a contraindication.
Does diet play a role? A number of studies have shown link between the gut microbiome and
immunity. Foods rich in omega3 fatty acids like fish oil, salmon, tuna, olive
oil and flaxseeds help. Moderate protein and fibre intake is essential. Salt
intake should be less than 3g per day. Curcumin or turmeric has an anti inflammatory
effect and should be liberally used in cooking.
Some Do’s and Dont’s:
- Avoid sunlight, use a hat, a
sunscreen with SPF 50 or above
- If you are on medications
suppressing your immune system, avoid close contact with anyone having
- Avoid live vaccines like yellow
fever, typhoid, oral polio whilst on immunosuppressants
- Take a vaccination for
pneumonia and a yearly flu vaccination
- Do not smoke
- Avoid hormonal pills and oral
- Eat a balanced healthy diet,
exercise regularly and get adequate rest
with lupus Lupus can have a significant impact
on patients as it may affect their social life, relationship with family and
peers. Joining lupus support groups may
be extremely beneficial to patients. Everyone’s journey is different. Sharing
experiences with others may help and boost confidence. Of course the friendly
rheumatologist will be always ready to offer any help or advise, tackle many
World lupus day is marked on the 10th
may of every year. It is a global health problem. Understanding the disease
better will help patients have a better control over it.