Apparently, in the thirteenth century, physicians thought that the skin lesions of patients with this condition resembled the reddened bite of a wolf and so named it “lupus.” The complete name for this condition is Systemic Lupus Erythematosus (SLE) with “erythema” equaling “redness.”
Lupus affects approximately 1.5 million Americans with 16,000 new cases each year and 5 million cases worldwide. Most cases of lupus involve women aged 15-44 and women of color have a two to three times greater risk of developing the disease (www.lupus.org). Teenagers and males can also develop lupus.
One of those affected by lupus is Selena Gomez the teen idol and famous singer who is now 24 years old. She announced in August of 2016 that she was diagnosed with Lupus back in 2013 when she was forced to take time off.
According to an interview on CNN Selena had to undergo chemotherapy to treat her symptoms and was afraid of having a stroke (patients with lupus, especially younger patients, have an increased risk of strokes probably due to inflammation of blood vessels in the brain; i.e. vasculitis and increased risk of blood clots).
Lupus is an autoimmune disease whose cause is unknown in which the body’s own immune system attacks the body’s normal cells. Some organs which can be affected include the skin, the kidneys, the lungs, the central nervous system, the heart, the blood and the blood vessels and the joints (www.lupusresearch.org).
Normally, elements of the body’s immune system (antibodies) recognize foreign cells and infectious entities which are different from “self” and destroy them in combination with the other cells of the immune system. Foreign invaders normally include disease-causing bacteria and viruses.
In an autoimmune disorder, the body “turns on itself,” confusing “self” and “non-self,” with cells of the immune system attacking the nucleus of normal cells in many different organs causing the destruction of the cells.
Symptoms of lupus can include, a “butterfly skin rash” over the nose and cheeks, sun intolerance, blood in the urine, muscle pain, joint pain and stiffness, fatigue, unexplained fever, hair loss, respiratory symptoms, and anemia.
Episodes of lupus can include flair and remit and can lead to kidney failure if untreated. A “lupus crisis” can also ensue in which the patient decompensates causing multiple organ failures (often with sepsis) with the patient becoming severely ill and ending up in an intensive care unit and possibly dying.
Tests to screen for lupus include the ANA (Anti-Nuclear Antibody) blood test to detect autoantibodies, checking for blood in the urine to detect kidney damage, conducting blood tests to test for kidney and blood clotting function and kidney and skin biopsies.
Treatments for lupus are aimed at decreasing inflammation and suppressing the immune system.
Systemic steroids are used to decrease inflammation. Anti-malarial drugs help decrease production of autoantibodies.
As seen in Selena Gomez’s case, drugs such as methotrexate and cyclophosphamide (which are typically used as chemotherapy in cancer) are used to treat lupus because of their immunosuppressive effects.
These drugs along with the immunosuppressive drug Imuran are all part of the treatment regimen for lupus.
Newer treatments include monoclonal (cloned) antibodies which disrupt the activation of B lymphocytes which normally secrete antibodies thus decreasing destruction of normal cells.