Lupus is a chronic autoimmune disease where the immune system is dysfunctional and mistakenly identifies the body’s own tissues as foreign invaders. In people with lupus, the immune system creates autoantibodies to attack the body’s tissues. These form immune complexes which cause inflammation and damage – possibly affecting the organs and/or the joints in some lupus patients. Lupus disproportionately affects females and people from Black African, Caribbean, and Asian ancestries.

Lupus is an uncommon, complex, and poorly understood disease. As such, many healthcare professionals, including General Practitioners, may not recognise the early signs resulting in a delay to referral and diagnosis. During this time, active lupus can cause damage to the kidneys, skin, heart, lungs and/or brain which may be irreversible.

The two most common symptoms of lupus are joint/muscle aches and pains and extreme fatigue – almost 90% of lupus patients report experiencing fatigue which can often cause substantial impairments in quality of life and work disability. Other symptoms include: rashes, anaemia, light-sensitivity, headaches/migraines, hair loss, oral/nasal ulcers, brain fog, depression and anxiety. An increased risk of miscarriage is a complication of lupus. However, with close monitoring, many people with lupus now have successful pregnancies. It is important to note that there are many manifestations of lupus, and it is rare for two people to share the exact same experience.

Lupus is an incredibly complex disease. It is common for people with lupus to have comorbidities (one or more additional conditions), these frequently include Sjögren’s syndrome, Raynaud’s phenomenon, and antiphospholipid syndrome, to name a few. Some symptoms of lupus – such as joint pain, fatigue and hair loss – are also commonly seen in other diseases such as thyroid disease, rheumatoid arthritis, fibromyalgia and dermatomyositis. This can make lupus more difficult to correctly diagnose. Learn more about lupus symptoms here – https://lupusuk.org.uk/the-symptoms/

No, lupus is neither infectious nor contagious.

This is still not fully understood, but there are some broad explanations: Many of the genes responsible for the functioning of the immune system are located on the X chromosome. As females have two X chromosomes, whilst men only have one, they are more likely to inherit gene mutations that cause immune dysfunction. It is also recognised that hormonal activity is an important trigger. Lupus can often develop around puberty, after childbirth, during menopause and usually occurs in females between the ages of 15 to 55.

A number of illnesses arise from a faulty immune system – two we know well are arthritis and rheumatism. Often the lupus patient has family members with these autoimmune conditions or others such as MS, thyroid problems, diabetes, Raynauds, scleroderma, Sjogrens and others.

Yes, and it’s more common in black and Asian women than white women.

In lupus the immune system produces far too many antibodies which, circulating through the bloodstream, cause reactions leading to inflammatory processes anywhere in the body.

A viral infection, strong medication, sunlight, trauma, around puberty, after childbirth and the menopause can all contribute. Environmental factors may also contribute in some way.   Any two or more of these can also combine to set off the illness.

The range of symptoms can mislead GPs but there are specific blood tests available.   The individual’s medical history gives good indications to lupus specialists, usually rheumatologists. Other specialists who may treat lupus patients include renal experts, obstetricians, dermatologists and cardiologists.   On balance, diagnosis is not easy and it would help enormously if family doctors were able to be better informed about lupus..

That’s far from easy – the immune system is very complex and doctors are still trying to fully understand its workings. For the present, any one or more of a range of medications is prescribed to attempt to control the illness and to dampen down its effects.

Lupus is generally treated using anti-malarials (such as hydroxychloroquine) and non-steroidal anti-inflammatory drugs. Steroids such as prednisolone have been vital in the improvement in lupus care and in some cases are life saving. Immunosuppressants are widely used in more severe cases. The most commonly used are azathioprine, methotrexate and cyclophosphamide.

Patients can certainly be positive in obtaining good information on lupus and in learning to ‘pace’ themselves – rest is very essential.   Being open with family and friends about the unpredictable pattern of lupus helps, and stress, depression and pain each need to be managed.   Avoiding direct sunlight always helps.   Seeking assistance at the right time from doctors or the family takes some resolve but is a ‘must’.

This is now much improved and most patients can anticipate a normal lifespan. The advent some years ago of steroids has saved the lives of many lupus patients.

There’s far more undiagnosed lupus out there being ‘put up with’ and we have to increase awareness hugely if these people are to be diagnosed and then get some quality back into their lives. Lupus is usually ‘for life’ at present, having an ongoing impact upon the patient and also upon her or his parents, children, friends and colleagues.

A qualified yes – the majority of young women with lupus suffer no problems on the oral contraceptive pill. However, it is now recognized that those women with antiphospholipid antibodies are at increased risk of thrombosis or migraine when taking the pill. Perhaps surprisingly, hormone replacement therapy, often given to treat osteoporosis in post-menopausal lupus patients, is generally well tolerated with few side-effects.

Bold initiatives such as stem cell transplants are being experimented with, and the genetic background puzzle of lupus is gradually being uncovered. More significant developments are likely and new medications are gradually being introduced.   Medical knowledge increases all the time and there’s no doubt that the lupus patient is having her/his illness under better control and management than ever before. Doctors are successfully tailoring medication now to individual patient need, and the future for the lupus patient looks ever more hopeful.

Emphatically yes! The many symptoms of lupus, differing from patient to patient, can easily cause the practitioner to lean towards a more comfortable or better-known ailment. Knowledge of the lupus condition is vitally needed for quick and accurate diagnosis that may prevent the onset of major organ damage.   IF YOU DON’T KNOW ABOUT IT – YOU DON’T DIAGNOSE IT……