an autoimmune disease in which antibodies attack healthy tissue and cause inflammation of the skin, joints, or organs.
An estimated 1.5 million people in this country have the condition, and 16,000 new cases are reported each year. While men can have the disease, 90 percent of cases are in women.
The disease landed in the headlines this week when 24-year-old singer and actress Selena Gomez told People magazine that she’s taking time off from her career to deal with side effects related to the disease, including anxiety and depression.
Every case of lupus is different, but one telltale sign of the disease is a butterfly-shaped facial rash that spreads across the cheeks (as pictured above). Other symptoms may include fever, joint pain, fatigue, headaches, and shortness of breath.
Lupus can affect the nervous system via a complication known as neuropsychiatric systemic lupus erythematosus, or NPSLE. According to the Lupus Foundation of America, 90 percent of people with lupus experience the effects of NPSLE. And a study published in Lupus in February 2016 found that about a quarter of patients with NPSLE have suicidal thoughts. Studies have also linked lupus in women to adverse pregnancy outcomes.
Research published in June 2016 in Arthritis & Rheumatology found an increased cardiovascular risk among people with lupus. According to the study, hospitalizations for acute myocardial infarction and stroke in the United States rose among lupus patients over a 16-year period even as the rates decreased in the rest of the population.
Rheumatologist Anca Askanase, MD, MPH, founder and clinical director of Columbia University Medical Center’s Lupus Center in New York City, points out that symptom severity can range from annoying to crippling. The condition can surface as a one-time episode, come and go with periodic flares, or present chronic symptoms.
“How long it takes to diagnose depends on the initial manifestations of lupus,” Dr. Askanase says. “If someone has kidney swelling or fluid in the lungs or brain involvement, the lupus can be obvious.” But lupus can also be misdiagnosed because its symptoms often resemble other conditions.
“If a person is having more joint pain and fatigue, they might be labeled as having rheumatoid arthritis or chronic fatigue syndrome at first,” Askanase says. “If you’re short of breath, people think you have asthma. If you have a rash, they think you’re allergic to something.”
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So what causes lupus? Genetics likely play a role. Research published in March 2016 in Nature Genetics identified 10 distinct genes associated with the disease. The condition may also be triggered by environmental factors such as exposure to sunlight, infection, stress, or a reaction to certain medications.
There is no single test for lupus. The American College of Rheumatology has identified several criteria for diagnosis, including the presence of antinuclear antibodies (ANA) in the blood, skin rashes or mouth ulcers, heart or lung inflammation, arthritis, and neurologic problems.
Lupus is not curable. Depending on symptoms and severity, patients may be prescribed anti-inflammatory drugs, immune suppressants, or a combination of medications. According to astudy published in July 2016 in Arthritis Care & Research, the disease can go into complete remission for years, but then be followed by a relapse. Researchers found that “flares may continue to occur beyond 10 years of remission.”
As Askanase puts it, “It’s a complicated disease, and it’s not easy for people to grasp it.”
The Lupus Foundation of America provides information for patients and caregivers, a guide to local chapters, and other resources on its website.
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