Lupus

Lupus is an autoimmune disease — a condition in which the body mistakes its own healthy tissues as foreign invaders. As a result, the body wrongly attacks its own cells, which leads to inflammation and damage to various body tissues. Lupus can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain.

Lupus affects one out of every 185 North Americans, with more than 16,000 people developing the condition each year. Although lupus can occur at any age and in both men and women, 90 percent of those diagnosed with lupus are female. In addition, African Americans, Latinos, Asians and Native Americans are at an increased risk. The cause of the disorder is unknown. However, research indicates that a combination of genetic, environmental and possibly hormonal factors are involved.

Although the severity and range of symptoms of lupus differ for each person, common symptoms include:

  • Painful or swollen joints and muscle pain
  • Unexplained fever
  • “Butterfly” rashes, most commonly across the bridge of nose and cheeks
  • Chest pain when breathing deeply, called pleurisy
  • Unusual hair loss
  • Sensitivity to the sun
  • Swelling, or edema, in the legs or around the eyes
  • Swollen glands
  • Extreme fatigue

The treatment of lupus involves preventing flares and reducing their severity and duration when they occur.

Treatment can include corticosteroids and anti-malarial drugs. Certain types of lupus nephritis such as diffuse proliferative glomerulonephritis require bouts of cytotoxic drugs. These drugs include cyclophosphamide and mycophenolate.

Due to the variety of symptoms and organ system involvement with lupus, its severity in an individual must be assessed in order to successfully treat it. If required, non-steroidal anti-inflammatory drugs and antimalarials may be used.

Disease-modifying anti-rheumatic drugs (DMARDs) are used preventively to reduce the incidence of flares, the process of the disease, and lower the need for steroid use. When flare-ups occur, they are treated with corticosteroids.

Many new immunosuppressive drugs are being actively tested for lupus. Rather than suppressing the immune system nonspecifically, as corticosteroids do, they target the responses of individual immune cells.

Moderate pain is typically treated with mild prescription opiates such as dextropropoxyphene and co-codamol. Moderate to severe chronic pain is treated with stronger opioids, such as hydrocodone or longer-acting continuous-release opioids, such as oxycodone, MS Contin, or Methadone. Opiate addiction is not typically a concern, since the condition is not likely to ever completely disappear. Thus, lifelong treatment with opioids is fairly common for chronic pain symptoms, accompanied by periodic titration that is typical of any long-term opioid regimen.

If you are suffering from any of the symptoms listed above, consult a physician as soon as you can.