Tag Archives: lupus

Treatments For Lupus

The 1.5 to 2 million people—primarily some combination of black, female, and under 40—who have been diagnosed with the autoimmune disease lupus have such a wide range of symptoms that it can sometimes be difficult to pin down what is and isn’t lupus. Unlike most autoimmune diseases, which have a specific target such as the thyroid or skin, lupus can affect almost any part of the body. In particular, it causes problems with connective tissue within the organs. The most common symptoms are rash and sensitivity to light, though almost any symptom someone experiences could be lupus, particularly if there seems to be no other explanation.

In particular, experts note that the initial symptoms of lupus, such as headaches and seizures, are difficult to distinguish from symptoms of neurological problems, despite lupus not being a disease of the nervous system directly. People who have lupus are at an elevated risk for stroke, because it affects the heart, and about one n three lupus sufferers has migraines as a result. In some patients, lupus can even cause them to hear voices or experience mood swings. These factors can cause doctors to erroneously treat patients for neurological conditions they don’t actually have. Unfortunately, once lupus is correctly diagnosed, the treatments themselves may have adverse neurological effects.

Now a new treatment technique is being investigated that involves taking a personal approach to treating patients with lupus. Each individual case of lupus is different, and using DNA sequencing, doctors hope to discover what specifically is behind the disease in each patient and address the specific manifestation of the disease that patient has. This targeted treatment, if feasible, would reach the particular genetic irregularities in an individual patient and treat the patient’s disease directly.

Until then there are other experimental treatments being developed for lupus. One is actually derived from parasitic worms. Researchers hope that the same molecule that the parasites use to hide from the immune system could do the same for the organs that set it off in autoimmune diseases such as lupus. This would shield the organs from the immune system, without turning it down to the point that the patient is vulnerable to actual infections.

Ending Lupus

Lupus is an autoimmune disease primarily affecting women, black people, and teenagers and adults under 40; people who are all three are not only at especially high risk for lupus, they are more likely to have life-threatening complications. All autoimmune diseases involve the immune system attacking a healthy organ as though it were foreign matter, but lupus is distinguished by its lack of specificity&mash;it can involve the skin, kidneys, lungs, heart, blood cells, joints, or even the brain. As a result, it can be difficult to spot. More precisely, it’s easy to spot, but difficult to rule out, due to the wide variety of symptoms that could, conceivably,be attributed to lupus and the tendency of different symptoms to appear in different patients. As a result, lupus is generally diagnosed only when other possibilities have been eliminated.

Treatment for lupus is centered around medications called glucocorticoids to fight inflammation and rein in the immune system. However, these medications can have severe side effects, including weight gain, high blood pressure, bruising, diabetes, bone loss, and heightened infection risk. Now a new study in Spain has found success with an old treatment. Drugs used to fight malaria, such as hydroxychloroquine, have been used for lupus since the Second World War, and have been shown to be effective&mash;in mild cases, patients taking hydroxychloroquine may not need any other treatment.

Other research is focused on more permanent treatments. In a study conducted in Chicago, synthetic proteins, called peptides, that imitate proteins that play a role in regulating the immune system. The synthetic peptides effectively stood down the immune cells that were working on the patients’ own healthy tissue, without the severe and dangerous side effects of the medications used against the disease.

Interestingly, a patient with both lupus and HIV was found to benefit from the combination&mash;the overactive immune response of lupus overcame the immune deficiency caused by HIV, and prevented the latter disease from having a strong effect. Researchers are exploring the phenomenon and trying to use what they are learning from studying this patient to develop a vaccine for HIV. However, the effects of HIV did not, in turn, modulate the lupus.

Lupus and Pregnancy

In studies, the autoimmune disease lupus strikes different people at different rates. It has long been known to be primarily a disease affecting women, African Americans, and teenagers and adults under 40, but a recent study at the University of Michigan found that the risk for people in all three of these groups is higher than was previously recognized. In addition, young African-American women are at higher risk than other groups for life-threatening complications from the condition, even with treatment. Scientists could not say definitively why this population was more prone to complications, though they said it might be related to being diagnosed younger.

The complications include kidney failure, anemia, blood clotting, stroke, and cardiovascular disease. Lupus is characterized by non-localized inflammation, which can cause a host of health problems, for example when it affects the brain, heart, or lungs. Among the more severe complications are bone necrosis that weakens the bone, usually in the hip, and infections due to a lupus-ravaged immune system. People with lupus are prone to urinary tract infections, salmonella, shingles, and herpes. In addition, lupus increases the risk of cancer.

Lupus patients are also more vulnerable to complications during pregnancy, such as preeclampsia, and are more likely to miscarry or to deliver prematurely. Their children are also more likely to have autism spectrum disorders. Prenatal exposure to certain types of the proteins called cytokines is a significant risk factor for autism, and women with lupus frequently have the cytokines involved, and children of lupus sufferers were diagnosed with spectrum disorders more than twice as often as children of healthy women.

Treatment for lupus includes immune suppression to stop the immune system from attacking healthy tissue. Antimalarial drugs can also help fight the disease, as can anti-inflammatories. These medications can be costly, and can have severe side effects—immune suppression can boost infection risk, like lupus itself does—and some patients have been found to be taking only a third of the prescribed amount of medication.. The medication not only treats the symptoms of the disease but also slows its progress.

Fighting Kidney Failure

About one third of the 1.5 million Americans with lupus will develop kidney disease at the time they’re diagnosed, and another 25 percent will develop it in the first ten years after diagnosis. The American College of Rheumatology recently issued new guidelines to help doctors diagnose and treat lupus nephritis and improve patients’ lives.

Lupus affects not only the skin, but the internal organs as well, notably the kidneys. Most lupus patients develop kidney disease, a condition called lupus nephritis, and it can significantly lower chances of survival, particularly in African-American men. There is no known way to prevent kidney damage, though flares can be minimized Medical treatment can help slow or even stop kidney failure from deteriorating once it has been detected.

The ACR’s guidelines were developed after reviewing nearly half a century of research on kidney failure due to lupus. Recommendations include diagnostic testing for vascular disease in nephritis patients, aggressively treating kidney problems in pregnant women, and the use of blood pressure medication in lupus patients with signs of protein in urine. Although lupus can raise blood pressure, certain hypertension drugs also have a protective effect on the kidneys that can help lessen the severity of and danger from lupus nephritis.

The organization also recommended biopsies for previously untreated patients with nephritis. That means doctors are encouraged to study tissue samples in patients who have kidney disease to help determine the proper course of treatment.

Incidence of end-stage renal disease due to lupus has been on the rise over the past 30 years. Doctors aren’t sure what is behind this, but it is hoped that the new guidelines will help reverse the trend.

It is particularly important for patients with lupus nephritis to pay attention to heart health. That means no smoking, watching LDL cholesterol levels, eating right, and getting proper exercise.

If you have foamy or bloody urine, swelling, or signs of high blood pressure, contact a healthcare professional. Doctors can test for signs of lupus nephritis or other conditions and help you get proper treatment.

Lupus: A History

The disease lupus got its name in the 13th century. A physician named Rogerius, from Salerno in what is now southern Italy gave it the name– the Latin word for “wolf”– because the facial lesions were thought to resemble a wolf’s bite.

A number of physicians wrote about the rashes and other dermatological signs of lupus over the ensuing centuries. The first modern description of the disease, including a discussion of the less visible effects, was created by the dermatologist Moritz Kaposi in 1872.

Kaposi was the first to recognize multiple types of lupus. In some patients, lupus manifests primarily on the skin, while in others the disease affects the entire body, including internal organs. This is what causes the fever and fatigue associated with the disease. Kaposi wrote that lupus:

[M]ay be attended by altogether more severe pathological changes […] and even dangerous constitutional symptoms may be intimately associated with the process in question, and that death may result from conditions which must be considered to arise from the local malady.

This insight was proven correct in studies in Baltimore and Vienna in 1904. It was vital to helping patients receive proper care, including preventative measures to protect the kidneys, heart, and brain from damage.

The next major finding was the discovery in 1948 of a cell in bone marrow– an important part of the immune system– associated with lupus. This demonstrated for the first time that lupus is a disease of an overactive immune response. Other studies in the 1950s showed that lupus patients tended to have false positives on tests for viral and bacterial illnesses that worked by looking for a characteristic immune response.

It was also in the 1950s that researchers noticed that family history of lupus was a good predictor of the disease. That was when it was determined that the condition could be passed from parent to child. More recent studies have focused on searching for genetic markers for lupus, and could lead to predicting its presence before symptoms begin to appear.

Strides in Detecting and Treating Lupus

Lupus is a notorious mimic. The autoimmune disease is difficult to diagnose because it has such a wide variety of symptoms that two people seldom present with the same set, while at the same, time, there are very few symptoms a patient can display that are definitely not lupus.

Common lupus symptoms include

  • Chest pain
  • Fatigue
  • Fever
  • Hair loss
  • Mouth sores
  • Sun sensitivity
  • A general feeling of being sick.

Unfortunately, these are all common symptoms, which could indicate any of a variety of underlying conditions. The most characteristic symptom of lupus, a butterfly-shaped rash on the face that gets worse in sunlight, is present in about half of lupus patients.

Now, however, new immunological studies are helping doctors better detect and treat lupus. For example, researchers at the University of Alabama at Birmingham recently found that the immune response that causes lupus is the same as that triggered by parasitic worms, but different from the response to viral infections. That could mean that more narrowly targeted immunosuppressant drugs could someday be developed that only reach that particular type of immune activity.

Greater awareness of lupus is also helping get faster diagnoses. Since doctors know to look for lupus, patients with symptoms that may be the disease can be referred for testing to determine if it is.

If you have lupus symptoms, contact a health care provider. Even if you don’t have lupus, chest pains or sustained fever should not be ignored; those symptoms are likely to indicate something.

Treating Lupus

The chronic inflammatory autoimmune disease lupus is estimated to afflict over 1.5 million Americans, mostly minority women between 15 and 44 years old. If you have lupus, you may know there’s no cure. However, you can work with your health care provider on treatments and strategies that will lessen the severity and frequency of flares and help reduce symptoms.

The usual medical approaches are:

  • Aspirin helps reduce inflammation and blood pressure, preventing the coronary artery problems characteristic of lupus.
  • Acetaminophen can alleviate pain, but it has no effect on inflammation, and sustained use can cause liver damage.
  • Prescription or over-the-counter NSAIDs reduce inflammation and help with joint stiffness. NSAIDs are a class of medications, and some may be more effective than others. If you’re taking NSAIDs, be sure your doctor is aware of it, because they can produce urine test results similar to those of a lupus flare.
  • Your doctor may prescribe corticosteroids. These drugs, including prednisone, fight inflammation, but can be habit-forming; you’ll need to taper rather than go off corticosteroids suddenly. In addition, these drugs can have side effects that include acne, enhanced appetite, and irritability.
  • Antimalarial drugs work in tandem with other medications to enhance their benefits while reducing the side effects. These drugs are particularly useful against the characteristic rashes of lupus.
  • Immunosuppressant drugs tone down the body’s immune response, lessening the severity of autoimmune disorders such as lupus, but leaving the patient more vulnerable to infection.
  • Monoclonal antibodies are a new lupus drug that attacks a protein associated with the disease. This is a class of drug called biologic medications that are being investigated for autoimmune diseases.

In addition to medications, pain management methods such as meditation and breathing techniques can offer some patients relief. A medical professional can help you find a solution that works for you.

What is Lupus?

At least 1.5 million Americans have the chronic inflammatory disease lupus. Most of these people are women of childbearing age, though symptoms can appear earlier than that. However, by the nature of lupus, the actual number of cases may be unknowable.

Although some drugs for hypertension or arrhythmia can cause lupus, usually it is an autoimmune disease affecting the kidneys and other internal organs. It can be difficult to detect, because the symptoms often mimic those of other illnesses. As with other autoimmune diseases, it seems to have a genetic component, with a family history of lupus being considered a risk factor.

Other risk factors are being a woman– more than 90 percent of lupus patients are– and not being white, Lupus among African Americans, Asian Americans, Pacific Islanders and Native Americans is more common, often more severe, and typically strikes younger than with white patients. Most women with lupus experience symptoms between the ages of 15 and 44.

The disease lasts a lifetime, but has periods of flare-up alternating with periods of remission. Symptoms of a flare-up include fatigue, fever, light sensitivity and a skin rash, often butterfly-shaped on the face. Long-term there can be mouth sores and hair loss. In some patients, fingernails crack or fall off, and the nail bed can change color or turn puffy. The first sign, however, is often joint pain.

However, lupus symptoms can be very different in different patients, and the disease often resembles other illnesses. Even testing isn’t always a sure thing, and there is in fact no lupus test. Instead, doctors do a variety of tests to gather information about the patient, and will consider the patient’s medical and family history, to determine if lupus may be a specific patient’s illness. These tests include a complete blood count, of all the components of blood; a sedimentation test, timing how long it takes red blood cells to settle in a test tube, which helps measure general health; and a urine test, to measure kidney function.

Because lupus is so hard to identify and distinguish from other ailments, doctors don’t recommend getting any sort of testing unless symptoms are present. If you do have symptoms, however, including a butterfly rash or joint pain, talk to your health care provider.