Lupus is a chronic autoimmune disease that affects about five million people worldwide, according to data from the Lupus Foundation of America. Various factors influence the development of this disease, one of which is genetics, which has a very high influence, but is not absolutely decisive. There are some genes that cause those who have them to have a certain predisposition to have the disease, but it is not certain that it will develop. Other factors have been identified that contribute to the appearance of lupus, such as some hormonal or environmental causes. In this group we find estrogens, infections, emotional and physical stress, pregnancy, some drugs and ultraviolet light from solar radiation. All of them can activate the disease and start the symptoms.
There are several types of lupus. Systemic lupus accounts for about 70% of all lupus cases, and in about half of them, a major organ or tissue in the body, such as the heart, lungs, or brain, is affected. Cutaneous lupus affects the skin and accounts for 10% of all cases. Drug-induced lupus accounts for another 10% or so and is caused by taking high doses of certain medications. When treatment with these drugs is stopped, symptoms usually disappear. Finally, neonatal lupus is a rare condition characterized by the mother’s antibodies affecting the fetus. At birth, the baby may have a rash, liver problems, or low blood counts, but these symptoms usually go away completely after six months.
Lupus is especially focused on women of productive age, although men, children and adolescents can also have this disease. 90% of people living with lupus are women and most lupus patients develop it between the ages of 15 and 44. People with lupus often have symptoms such as pain, fatigue, hair loss, cognitive problems and physical deficiencies that pose a significant handicap to continue with their normal lives. Many of these people present a picture with cardiovascular diseases, strokes, severe rashes and painful joints. Others, on the other hand, do not show visible symptoms.
These symptoms are different depending on the patient and the way in which they appear. It can affect almost any organ in the human body, which is why it is considered systemic, and symptoms can come and go. These outbreaks that appear are different in each case and can be severe or mild in intensity and duration. This appearance of outbreaks is combined with other periods in which the patient is asymptomatic.
The symptoms of lupus are related both to its inflammatory basis and to the complications caused by the specific involvement in the different organs. During a normal outbreak of active disease, the most common symptoms are similar to those caused by the flu (fever, fatigue, weight loss, headaches, and muscle and joint pain). Virtually all patients (95%) suffer from joint pain without inflammatory signs, which makes it the most frequent symptom of this disease. The joint affection is usually symmetrical and affects, more frequently, the small joints. These symptoms last between 12 and 48 hours, although sometimes they last up to seven or ten days, and resolve without leaving sequelae.
The joint disease of lupus differs from rheumatoid arthritis in one very important key aspect: in lupus the joints are not damaged in the vast majority of cases. On the other hand, there is often muscle weakness, muscle pain, and muscle inflammation. When lupus affects the skin, it is called cutaneous lupus erythematosus (CLE) and can appear only in a specific part of the body or spread throughout the body. On some occasions, CLE is the initial expression of systemic disease. Other common symptoms are fever, which can be mild or reach very high temperatures, loss of appetite and, as a consequence, weight loss, and a generalized and constant feeling of tiredness.
Sometimes lupus inflames the lining membranes of the heart (the pericardium) and the lungs (the pleura) and causes pericarditis and pleurisy. In both cases, the symptoms are similar: chest pain and, sometimes, fever. Normally, they do not cause major problems and respond well to medical treatment, but there are times when they can create bigger problems because the lungs or heart valves are affected and heart or respiratory failure can result. These are problems that must be tackled as soon as possible, but they respond well to treatment and, furthermore, they do not appear too frequently.
When lupus attacks the kidney, a lesion called lupus nephritis occurs. It causes inflammation and, later, scarring of the small blood vessels that filter body waste in the kidney (glomeruli). In most cases, the evolution is positive, although patients sometimes require to continue with the medication for years. Lupus can also cause digestive, liver, neuropsychiatric, ocular, and hematologic problems.
