Autoimmune Diseases – Lupus

Normal functioning of the immune system allows the body to create antibodies to attack viruses and bacteria. Lupus is an autoimmune disease which causes the immune system to become hyperactive and enables it to decipher antigens from healthy cells. The immune system then accidentally attacks normal healthy tissue and organs. While there is no cure for lupus, treatment may help relieve the symptoms.

What are the types of lupus?

  • Systemic lupus erythematosus (SLE) – this type affects many parts or the body and may be mild or severe.
  • Discoid lupus erythematosus (DLE) – is a form of chronic skin disorder which results in a red, thick, scaly rash on the skin which may cause scarring.
  • Subacute cutaneous lupus erythematosus – this is characterised by skin lesions that are caused by sun exposure.
  • Drug-induced lupus – some medications for seizures, thyroid, high blood pressure and contraception may cause this type to develop. Once the medication is stopped, lupus disappears.
  • Neonatal lupus – this type, although rare, is developed in new-born babies due to autoantibodies in the mother's blood. This may cause a red skin rash, liver problems and a low blood count, however, is known to resolve itself once the child is around 6 months of age.

What are the symptoms?

The symptoms of lupus are different for each person and may be severe or mild, develop quickly or slowly and can be temporary or permanent. Symptoms are characterised as flares in which symptoms get worse for a period of time and then improver for a period of time.

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Depending on which type you have been diagnosed with, and what area of the body is affected, you may experience the following symptoms:

  • Fatigue
  • Fever
  • Pain, stiffness and swelling of the joints
  • A rash on the cheeks and bridge of the nose in the shape of a butterfly
  • Rashes and lesions on the skin
  • Lesions on the skin which worsen with exposure to the sun.
  • When exposed to stress or cold temperatures, fingers and toes turn blue.
  • Shortness of breath
  • Chest pain
  • Dry eyes
  • Headaches, confusion and memory loss

What are the causes of lupus?

It is believed that lupus is caused by a combination of genetics and the environment, and symptoms worsen after sun exposure, infections and types of medications are taken.

Because the immune system attacks healthy tissue, the following complications can occur:

  • Kidney damage, disease and failure
  • Problems with memory
  • Problems with inflammation of the blood vessels and blood clotting
  • Inflammation in the lining of the chest cavity
  • Inflammation of the heart muscles and arteries
  • Increased vulnerability to infection
  • Increased risk of cancer
  • Bone tissue death
  • Complications with pregnancy

Treatment options

While a cure for lupus does not yet exist, treatments may help manage and reduce the effect of symptoms on your quality of life. Depending on the severity of your symptoms and the type of lupus, Dr Machailo may alter treatment for each specific patient. As the symptoms flare and subside, medication will be changed.

The following medications are commonly used to manage lupus symptoms:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may treat pain and swelling.
  • Antimalarial drugs are able to interfere with the immune system and decrease flares of lupus symptoms.
  • Corticosteroids can counter inflammation associated with lupus.
  • Immunosuppressant can suppress the immune system and sequentially manage lupus symptoms.
  • Biologics and Rituximab (Rituxan) may ease symptoms.
  • Because lupus flare-ups are related to stress, a healthy lifestyle and managing stress may help reduce flares.

As a nephrologist, Dr Machailo works in conjunction with a multidisciplinary team to treat the symptoms, related diseases and complications of lupus while a cure is yet to be found.

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