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Lupus

It’s an autoimmune disease and with such diseases, the body’s immune system attacks its own tissues and organs. Inflammation of tissues throughout the body occurs, as a result of auto-antibodies being produced in large amounts. However, because it’s autoimmune, it isn’t contagious.

We have come across three cases at the Clinic, and I also remember one of my Confirmation teachers whose battle at times scared us, because of the immune system breaking down and making her terribly ill.

In the first case, it’s a thirty-something year old and her case is severe, to the extent that because of the joint pains, it’s difficult for her at times to walk. Her feet swell and lesions with excessive inflammation occur from time to time. She is unable to work or do much in general due to the various issues surrounding her case.

Case two is another Lupus patient, thirty-something again    and in her case it has terribly affected her skin (especially face), along with the toenails.

Case three is someone who is hypertensive, has one kidney and had just retired. She started experiencing black outs and weight loss. A battery of tests was done, but it took a while to diagnose due to the symptoms being common to many other ailments/diseases. Her pressure was affected, she was immobilised many days, she can’t be exposed to sunlight because the blackout spells will still occur, and her kidney is being affected; she’s on medication. A repeat client before the lupus discovery, her reason for coming into us now is because her toenails started “eating away”, as a result of the lupus.

Symptoms

The signs and symptoms of lupus will vary from person to person.

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterised by episodes called flares, when signs and symptoms get worse for a while, then improve or even disappear completely for a time.

The most common signs and symptoms include:

  • Foot pains/cramps
  • Nervousness/Depression
  • Fatigue and fever
  • Joint pain, stiffness and swelling
  • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose
  • Skin lesions that appear or worsen with sun exposure
  • Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud’s phenomenon)
  • Shortness of breath
  • Chest pains
  • Dry eyes
  • Headaches, confusion, memory loss
  • Low blood count
  • Loss of appetite
  • Miscarriages
  • Alopecia (hair loss)

Causes

Given it’s an autoimmune disease, there’s a defect in the body’s immune system which usually produces antibodies to fight off infections; diseases such as Lupus attacks the body making it weak and its defences low. The actual cause of lupus is unknown, however some triggers are:

  • Sunlight – Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people, sometimes causing blackout spells.
  • Hormone changes – Menopause can be one such change.
  • Medications – Lupus can be triggered by certain types of anti-seizure medications, blood pressure medications, and antibiotics. People who have drug-induced lupus sometimes see their symptoms go away when they stop taking the medication.

Complications

Inflammation caused by lupus can affect many areas of your body, including your:

  • Kidneys – Can be seriously damaged; kidney failure is one of the leading causes of death among people with lupus. Signs and symptoms of kidney problems may include generalised itching, chest pain, nausea, vomiting and leg swelling (edema).
  • Brain – If affected, you may get headaches, dizziness, behaviour changes, hallucinations, and even strokes or seizures. Many people experience memory problems and may have difficulty expressing their thoughts.
  • Blood and blood vessels – May lead to blood problems, including anaemia and increased risk of bleeding or blood clotting. It can also cause inflammation of the blood vessels.
  • Lungs – Your chances of developing an inflammation of the chest cavity lining increases, which can make breathing painful.
  • Heart – Inflammation of your heart muscle, arteries or heart membrane is possible. The risk of cardiovascular disease and heart attacks increases greatly as well.

 

Other types of complications

Having lupus also increases your risk of:

  • Infection – You are more vulnerable to infection because both the disease and its treatments weaken the immune system. Infections that most commonly afflict persons include urinary tract, respiratory, yeast, herpes, and shingles.
  • Cancer – Your risk for cancer could heighten.
  • Bone tissue death – This occurs when the blood supply to a bone diminishes, often leading to tiny breaks in the bone and eventually to the bone’s collapse. The hip joint is most commonly affected.
  • Pregnancy complications – The risk for miscarriage is greater, as well as for high blood pressure during pregnancy (pre-eclampsia), and pre-term birth. To reduce the risk of these complications, doctors recommend delaying pregnancy until your disease has been under control for at least 6 months.

Types of Lupus

  • Cutaneous – This affects the skin on your feet and other parts of the body.
  • Systemic – This affects the joints of your toes, blood vessels, blood flow and nerves in your feet as well as other body organs.

Tests and Diagnoses

The symptoms of this disease may mirror other illnesses such as rheumatoid arthritis and multiple sclerosis. Usually a series of test has to be done for it to be confirmed.

These urine and blood tests include:

  • Antinuclear antibody (ANA)
  • Complete blood count
  • DNA antibodies
  • Chest x-ray
  • Kidney and liver assessment
  • Echocardiogram
  • Urinalysis
  • Biopsy

 

 

Treatment and Lifestyle Change

For some people lupus is mild, whereas with others, it attacks the organs in a serious way. There isn’t a cure; however, there are drugs and lifestyle changes that can help contain the flares.

Medication

  • Immune suppressants
  • Corticosteroids (steroids)
  • Anti-malarial drugs
  • Non-steroidal anti-inflammatory drugs

 

Changes

 

  • Reduce sun exposure – walk with an umbrella and wear sunscreen
  • Rest
  • Healthy diet
  • Exercise
  • No smoking or drinking

 

In between flares, many lupus patients are quite fine. Follow your physician’s guidelines to enjoy as best a quality of life as possible.

 

Your feet mirror your general health . . . cherish them!

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