By: Howard Smith, MD
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When I mention lupus to my patients, sometimes I get a confused look because it’s not a well-understood condition. People wonder why the body would attack itself, as is the case with lupus and other autoimmune diseases.
Here are five things many people don’t know about lupus:
1. Lupus affects nine times more women than men, and more women of color than white women
I’ve diagnosed men, senior citizens and toddlers with lupus. But women of childbearing age — 13 to 49 — are far more likely to be affected.
Genetics also plays a role. If you’re a woman with no family history of lupus, your chances of getting lupus are about one in 400. If your parents or a sibling has lupus, your chances jump to one in 25.
African-American and Latina women with no family history of lupus have about a one in 250 chance of developing the disease.
2. Lupus symptoms can differ greatly from person to person
Some symptoms are common to other conditions, too, which can make diagnosis difficult. Common lupus symptoms include:
- Constant fatigue
- Achy joints
- A butterfly-shaped rash around the cheeks and nose
- Hair loss
- Blood clots
- Sensitivity to light
- Chest pain when breathing
- Mouth sores
- Swelling in the extremities or around the eyes
3. Lupus is a disease of flares and remissions
Lupus flare-ups can be mild, or they can be severe. At least 75 percent of people with lupus have arthritis and skin rashes. Half have kidney problems. Lupus patients are also more vulnerable to infection than most people.
4. Lupus may often be diagnosed with some simple tests
When I suspect lupus, I will order an ANA (antinuclear antibody) blood test.
A negative ANA test usually rules out lupus.
We know that ANA tests will come back positive in virtually everyone with lupus. However, some people will have a positive result even though they do not have lupus. When the test comes back positive, other criteria has have to be measured.
In those cases, I compare the patient’s symptoms with a list of 14 criteria for lupus. If they meet four or more of the criteria, they are usually diagnosed with lupus.
5. Treatment depends on the type of flare-ups you have
Mild swelling and joint pain may be treated with acetaminophen or a non-steroidal anti-inflammatory drug like naproxen, or ibuprofen.
Plaquenil, an anti-malarial drug, treats skin rashes, arthritis, and sometimes fatigue.
Rashes may be treated with topical steroid creams. And corticosteroids like prednisone and immunosuppressants (chemotherapy type drugs) treat serious kidney problems.
It’s good to remember that diagnosis and treatment of lupus keeps getting better. Ninety-five percent of lupus patients have a five-year survival rate today, compared to 5 percent in the 1950s.
And many people with lupus have a mild form. I tell my patients that proper medication can even help people with severe lupus control their flare-ups and live productive lives.