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What is LUPUS and Can I Live With It?
|Posted by Administrator (admin) on Feb 02 2010|
|Ask Dr. Sharon >> Ask Dr. Sharon|
Dear Dr. Sharon,
I am a 36 year old female that has been going back and forth to the doctor for over 1 year with the same symptoms. I feel very tired all of the time, I had some hair loss, sores in my mouth and low blood counts. My first doctor told me that I was anemic (low blood) and that I needed to take iron tablets. When the tiredness did not get better and my knees started to hurt, he told me to lose weight and suggested that I see a psychologist. I eventually went for a second opinion and after talking to the new doctor and taking several blood tests—I have been diagnosed with Lupus. I have read some things about Lupus but I am very afraid because I cannot be “cured” of it and will have to live with this the rest of my life. I have been on steroids and have gained about 8 pounds in the last 2 weeks but am beginning to feel better. Can you tell me how I got this, what is going to happen to me and should my children be tested for this disease?
L. Coombs Washington, DC
Dear Ms. Coombs
I am glad that you did not stop with your first doctor and sought an additional opinion. Once you are properly diagnosed, you have won half of the battle with lupus. It is estimated that 500,000 to 1.5 million Americans have been diagnosed with lupus. Although lupus can strike men and women of all ages, 90% of individuals diagnosed with the disease are women, and 80% of those afflicted with systemic lupus develop it between the ages of 15 and 45. Lupus is two to three times more prevalent among people of color, including African Americans, Hispanics, Asians, and Native Americans. This is especially important for Black women as it is estimated that 1 in every 250 black women has or will develop lupus.
The most common type of lupus is Systemic Lupus Erythematosis (SLE), and is a chronic inflammatory disease that can affect virtually every part of the body, but particularly the joints, skin, blood and kidneys. In simple terms, your body’s immune system has begun to fight against itself. Our immune system protects us from viruses, bacteria and other materials that could hurt us. When persons have Lupus, your body begins to fight itself because it cannot distinguish between you and any foreign material. The body begins to develop immune complexes which build up in the tissues and can cause inflammation, injury to tissues, and pain. The cause of lupus, except for drug-induced is not known and is thought to be a combination of factors. As it relates to your children, we do know that approximately 5% of children born to parents with lupus will develop the disease. Therefore, making sure that your children know your history is important but the risk to them is low.
TYPES OF LUPUS:
There are three types of lupus: discoid, systemic, and drug-induced.
Discoid (cutaneous) lupus only affects the skin. The classic finding is a rash that may appear on the face, neck, and scalp. Your physician will diagnose Discoid lupus by examining a biopsy of the rash. Approximately 10 % of lupus cases are Discoid lupus.
Systemic lupus is the most common form of lupus with over 70% of cases being this type. When people use the term lupus, they are generally referring to this type. This type is usually more severe than discoid lupus, and can affect almost any organ or organ system of the body. The disease is different in everyone and this is one of the reasons that it is so difficult to diagnose.
Drug-induced lupus is the rarest form and occurs after the use of certain prescribed drugs. The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure) and procainamide (used to treat irregular heart rhythms). Drug induced lupus is unique in that it is more common in men. It is important to note that only a very small percentage (less than 4%) of persons that take the drugs will develop lupus and that this type of lupus is “cured” by simply stopping the drugs.
Table of Symptoms (from the Lupus Foundation of America website)
Achy joints (arthralgia)
Fever more than 100 degrees F (38 degrees C)
Arthritis (swollen joints)
Prolonged or extreme fatigue
Pain in the chest on deep breathing (pleurisy)
Butterfly-shaped rash across the cheeks and
Sun or light sensitivity (photosensitivity)
Abnormal blood clotting problems
Raynaud's phenomenon (fingers turning white
Mouth or nose ulcers
Unfortunately, your story is very common as it relates to diagnosis, because many lupus symptoms appear as other medical problems which may come and go. Further, if doctors are not seeing a lot of minority patients and/or patients at risk for lupus—the diagnosis will generally be prolonged. The steps to diagnosis are usually made by a careful review of a person's entire medical history with current and past symptoms as well as a set of lab tests. We advise that patients with any of the above symptoms talk with their doctor about being fully evaluated for lupus. This evaluation entails the patient being open about the symptoms and committing to getting the proper blood work completed. It is important to note that currently there is no single lab test that can definitively make the diagnosis.
Living with lupus is a reality of many persons in this country and each of their stories are different. There are periods of lupus “flares” and periods of “remission”, work to keep your body in remission and enjoy life. However, you can do your best to live a healthy life, make sure that you get enough rest, take your daily multivitamins, eat green leafy vegetables, drink plenty of water and exercise to keep your weight down as the fundamental building blocks of healthy living. However, we would also suggest that you speak and/or see your doctor regularly for care and evaluation, take medications as prescribed, be in tune with your body. Unfortunately, lupus is a chronic condition but you can live healthy and live a relatively normal life with the disease. It would be great for you to speak with someone who is actually living with lupus and I will provide you information or you can visit also www.lupusfoundation.org to learn more about the disease and the resources available to you.
Last changed: Feb 02 2010 at 3:31 PMBack
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