About five million people worldwide have lupus, and about 90 per cent of them are women 15-45 years old. People of African-Caribbean descent are more likely to have lupus than those in other ethnic groups.
Lupus is an auto-immune disease. Auto-immune implies that our immune system, which is designed to protect us against viruses, bacteria and germs, cannot tell the difference between these foreign invaders and our body cells. So, our immune system attacks our body cells, that is, the body turns against itself. This 'mistaken identity' can cause severe damage to the tissues and organs in the body and, in some cases, death.
Two main forms of lupus
The disease was named lupus, which in Latin means 'wolf', because many people who have the disease develop a butterfly-shaped rash over the cheeks and nose giving a wolf-like appearance. Although there are several forms of lupus, it mainly presents itself as:
Discoid Lupus Erythematosus (DLE) - a less dangerous form which confines itself to the skin and hardly attacks other organs. Reddish rashes appear on the face, scalp, ears, chest or elbows. If untreated, the rash enlarges over time, leaving severe scarring, which may cause permanent bald patches on the scalp.
Systemic Lupus Erythematosus (SLE) - this is the most common form of lupus, and it affects many systems in the body. The severity of the symptoms varies greatly from mild to life-threatening. High fever, fatigue, rashes on the cheeks, joint pains (like arthritis), vasculitis (inflamed blood vessels), mouth sores, kidney trouble, seizures (fits), depression and excessive sensitivity to sunlight, are just some of the typical symptoms.
Management and treatment
Treatment depends on which organs are affected, and whether the symptoms are mild or severe. The aim is to control symptoms, minimise damage to organs, and prevent flare-ups. First of all, people with lupus are advised to take things easy (physically and psychologically) by reducing work load and stress. Protecting the body from the sun is important, since sun exposure is known to cause symptoms flare-ups.
Vitamin B-5 (pantothenic acid) and Vitamin E in daily doses may lead to improvement in symptoms. Low-fat, low-salt and low-animal protein diets are easy on the kidneys and immune system and are therefore recommended. Regarding the use of herbs and other supplements, however, we must bear in mind that some supplements may interact in a bad way with the medications which doctors prescribe.
Side effects seem worse than symptoms
For mild cases, the doctor prescribes pain killers (anti-inflammatory drugs) like ibuprofen. Anti-malarial drugs, like hydroxyl-chloroquine, alleviate skin and joint symptoms associated with lupus. For severe cases, steroids, such as prednisone, and drugs which suppress the overactive immune system (like azathiaprine and cyclophosphamide), are employed to calm down the attack on the body.
Fancy, new, cutting-edge investigational drugs used for rheumatoid arthritis are being used with some success in lupus. These include biologics, immune modulators and mono-clonal antibodies. The truth is that sometimes the drugs used to treat lupus carry side effects that may seem worse than lupus symptoms themselves. However, the outlook for the future of lupus looks bright - more help is on the way.
Dahlia McDaniel is a pharmacist and final-year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.