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Frequently Asked Questions |
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Frequently Asked Questions |
Lupus is a chronic autoimmune ('auto' meaning 'self') disease in which the body's immune system becomes 'hyperactive' and attacks the body's normal tissues. It is much like the body being allergic to itself. Lupus is not contagious.
While the exact cause of lupus is unknown, it is possible that a combination of environmental elements and genetics may be to blame.
While there is not one specific test for lupus, there is a screening test for lupus called the 'antinuclear antibody' test (ANA). The ANA in conjuction with other tests and symptoms help establish a lupus diagnosis.
Lupus is diagnosed through an complete examination of lab tests, medical history (current and past) and criteria established by the American College of Rheumatology.
At what age does lupus begin? Does lupus affect men?
Lupus can begin at any age; as young as 1, as old as 111. However, lupus is most common among women of child-bearing age, between the ages of 15 to 44. Lupus is 10 times more common in women than in men.
What are the 'criteria' for lupus?
The criteria is a list of eleven problems that are specific to lupus. According to the National Institute of Health, "if at least 4 of the 11 criteria develop at one time or individually over any period of observation, then the patient is likely to have SLE". The criteria are as follows:
1) Malar Rash - The 'butterfly-shaped' rash across the cheeks and nose.
2. Discoid Rash - Round, scaly spots often appearing on face, arms, scalp, ears, and upper back. It may be aggravated by sun exposure.
3. Photosensitivity - Sensitivity to light (ultraviolet A & B, resulting in rash, fever, fatigue and other lupus symptoms.
4. Oral Ulcers - These are recurrent sores in the mouth and nose.
5. Arthritis - Swelling and inflammation of the joints.
6. Serositis - Inflammation of the lining of the lung (pleuritis) or the heart (pericarditis.)
7. Renal (kidney) Disorder - Found through urine samples. May include protein in the urine.
8. Neurologic Disorder - May include seizures and/or psychosis without no other explanation.
9. Blood Abnormalities - This may include anemia, low white blood cell counts, low platelet counts.
10. Immunologic Disorder - Blood testing showing anti-DNA, LE Prep, positive anti-Sm, and false-positive syphilis result.
11. Positive ANA blood test - About 95% of all lupus patients have a positive ANA test (autoantibodies to cell nuclei.)
Why should the sun and ultraviolet light be avoided?
Ultraviolet A and Ultraviolet B can actually damage DNA near the surface of the skin, altering the DNA and causing the formation of antibodies, thus, creating a lupus flare. Some individuals with lupus report rash, fatigue and aching upon exposure to the sun.
While there is not scientific proof that lupus is hereditary, it is suspected that some people may be more susceptible to lupus through genetics. 10% of people with lupus have a close relative with lupus or relative(s) who may develop lupus. Much research in this area is currently taking place.
People of all races can get lupus. However, lupus is 2 to 3 times more common among African-Americans, Hispanics, Asians, and Native Americans than other races. Among African-American women, as many as 1 in 250 young women will develop lupus.
Certain factors may act as a trigger such as Ultra-Violet light, hormones, infection and possibly stress. While stress has not been proven to be a trigger factor in lupus, most people living with lupus will confirm stress is a major factor in the illness.
While there is still no cure for lupus, it can generally be controlled with medications. Research for a cure is ongoing and promising.
Can I continue a normal lifestyle with lupus?
A large percentage of people with lupus carryout a normal lifestyle and lifespan. Many people with lupus have careers and family just like people without lupus. Some may find themselves with limitations and lifestyle changes due to lupus. The situation is different for each individual.
Many employers are willing to make changes in the work place to accomodate their employees with lupus. Some people will find that vocational rehabilitation help them find a career suited to their physical needs. When working is no longer possible, there are state and federal disability programs in place for individuals with lupus who meet the ACR criteria.
I have lupus. Will my child develop lupus, too?
Approximately 5% of children born to mothers with lupus will develop lupus.
Lupus and AIDS are basically complete opposites. The individual with lupus has an 'overactive' immune system, while an individual with AIDS has a 'underactive' immune system. Also, it is important to note that lupus is NOT contagious, while the AIDS virus is contagious.
ANA stands for "antinuclear antibody". The ANA test is a blood test run primarily on individuals suspected of having an autoimmune disease, such as lupus. An ANA can be positive in other diseases, but is almost always positive in lupus patients. A positive ANA does not constitute a positive lupus diagnosis - it is just one "tool" in the diagnosis process. A titer of more than 1:80 is considered positive. The ANA test measures antibodies circulating in the blood. The higher the titer, the more times it takes to dilute the blood - basically a higher concentration of antibodies present
How many types of lupus are there?
There are three forms of lupus: systemic lupus, discoid lupus, and drug-induced lupus.
Cutaneous lupus is limited to the skin, whereas systemic lupus can affect the body's internal organs. There are 3 categories of cutaneous lupus: 1) subacute cutaneous lupus erythematosus (SCLE); 2) acute cutaneous lupus erythematosus (ACLE); and 3) discoid lupus erythematosus (DLE).
SCLE is non-scarring, whereas discoid lupus can result in scarring. Discoid lupus appears as a thick, scaly rash with plugging of the hair follicles and signs of inflammation. Patients with discoid lupus can also have a positive ANA, joint pain and other symptoms. Treatment includes steroid creams, antimalarial drugs, avoiding the sun and sunscreens.
Most patients with ACLE have active SLE with skin inflammation.
Drug induced lupus (DILE) is just that - lupus "brought on" by a particular medication. These certain medications (approximately 70 different meds) can create the formation of antinuclear antibodies. DILE is self-limited; once the offending drug is stopped, the formation of antibodies also stops and the DILE improves or resolves within days to weeks.
99% of all cases are associated with 6 medications in particular:
- hydralazine
- procainamide (Pronestyl)
- methyldopa (Aldomet)
- isoniazid (INH)
- chlorpromazine (thorazine)
- d-penicillamine
It is important to note that not all individuals who take these medications will develop DILE and that concerns over these meds should be thoroughly discussed with your physician. If you develop a rash, fever, swollen joints or any other unusual symptom while taking these medications, you should contact your physician immediately.
When used to treat rheumatoid arthritis or lupus, (Plaquenil) hydroxychloroquine acts as a mild immunosuppressant. It accumulates in white blood cells and inhibits many enzymes involved in tissue destruction.
Where can I find information about Prednisone?
Prednisone plays a vital role in the treatment of many lupus patients. While it's always best to discuss treatments and medications with your physician, offered here is an excellent website with thorough information on Prednisone. Be sure to check out their entire website for excellent info.
Lupus Canada - Side Effects of Prednisone
If I have lupus can I get a tattoo?
While there is no specific problem with an individual with lupus getting a tattoo, there are things to keep in mind that could create potential problems. While the risks are small, Hepatitis B and C or possible reaction to tattoo dyes are a couple of things that could create problems for people with lupus, as well as people without health issues. It's important to realize that taking immunosuppresants can slow healing time and increase the chance of infection. Again, it is wise to consult with your physician prior to any procedure, including tattooing, to assure your disease activity is under control.
If I have lupus can I donate blood?
There are several factors that may determine if you may or may not donate blood. First, donation centers have their own set of guidelines, so check with them first. For instance, while the American Red Cross allows individuals with lupus (even those on some meds) to donate, the National Institute of Health does not. Second, a person with lupus should not donate blood if they are anemic. Lastly, it is important to discuss the matter of blood donation with your physician as they are aware of your health status and the effect donation may have on your health.
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