What to know about Lupus, the disease of 1,000 faces

Lupus, also known as the disease of 1,000 faces due to its complex features comes with different signs and symptoms that involve the joints, skin, kidneys, blood cells, brain, heart and lungs.

It is a lifelong systemic autoimmune disease that occurs when the body’s immune system becomes hyperactive and attacks its own normal healthy tissues and organs which causes a lot of inflammation that affect many different body systems

The disease affects as many as 1 in 1,000 people, and is caused by the immune system mistakenly attacking healthy cells. But its wide variety of symptoms and manifestations can make it difficult to tell who is sick, or what they’re actually suffering from.

According to the Lupus Research Alliance, about half of all people with lupus experience cognitive difficulties with thought processes and around 1 in 5 people experience headaches, memory loss, mood swings, and stroke. Blood clots might also develop which may lead to dangerous complications, such as stroke.

Globally, research reveals that about five million people have lupus and about 90 percent of people with lupus are women between the ages of 15 to 45 years.

A Clinical Director at Our Lady of Guadalape Health Foundation and Autism Centre, Abuja, Dr Doris Izuwa says, Systemic Lupus Erythematosus (SLE), is a condition that has an impact throughout the body, though not contagious but women with lupus may give birth to children who develop neonatal lupus, which is also rare.

Dr Izuwa said the effect of lupus depends on the severity of the disease, adding that some people who have severe flare-ups could be at greater risk of their lupus being life-threatening.

She stated the prevalence rate of the disease as 4–250 in 100,000 people, explaining that the disease’s onset before eight years of age is unusual, although lupus has been diagnosed even in the first year of life.  “It is more in females than males with a ratio of 4: 1 before puberty to 8: 1 afterwards.”

According to Dr Izuwa, no two cases of lupus are exactly alike because signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent depending on body systems that were affected. “Most people with lupus have mild disease characterised by episodes called flares when signs and symptoms get worse for a while, then improve or even disappear completely for a time.”

She said the general symptoms of lupus are fatigue, skin lesions that appear or worsen with sun exposure (photosensitivity), anorexia, weight loss, prolonged fever, and lymphadenopathy while the symptom on the face includes; butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body.

And the musculoskeletal symptoms are: Joint pain, stiffness and swelling, fingers and toes that turn white or blue when exposed to cold or during stressful periods and arthritis.

Others are cardiovascular effect such as shortness of breath, enlarged liver, diarrhoea, inflamed bowel disease, hepatitis, blood in stool and also respiratory, central nervous system and others.

Dr Izuwa said the diagnosis of lupus is confirmed by the combination of 4 of 11 criteria of clinical and laboratory manifestations revealing multisystem disease because no single test can diagnose lupus.

She also said treatment and drugs for lupus depend on the signs and symptoms, the severity and areas of the body affected, adding that most patients need medication for pains and inflammation, drugs to suppress the immunity (immune suppressants such as cytotoxic drugs) especially in severe cases, corticosteroids, hydroxychloroquine and others under the guidance of the doctor as most of the drugs have side effects.

“The most important aspect of management of lupus is meticulous and frequent re-evaluation of clinical signs and laboratory data, especially for renal and serologic flares of the disease. Prompt recognition and treatment of disease flare is essential to patient outcome. Lupus is a lifelong illness, and patients require monitoring indefinitely.”

She added that patients that are already diagnosed of the diseases could also apply home remedy such as; taking care of their bodies, regular medical check-ups, reducing stress, good diet and exercise, wearing protective clothing — such as hat, long-sleeved shirt and long trousers and use sunscreens. Others include stopping smoking and eating a healthy diet, taking supplements such as vitamin D, calcium supplements and fish oil acupuncture.

This therapy uses tiny needles inserted just under the skin. It may help ease the muscle pain associated with lupus, work on coping mechanism and reducing mental stress such as anxiety, stress and low self-esteem as well as learning more about the condition and looking for support group.

On whether it is a life-threatening disease, she said untreated lupus may be followed by spontaneous remission, years of smouldering disease, or rapid death adding that the natural history of lupus is highly variable, ranging from acute, life-threatening disease to many years of symptoms.

Dr Izuwa further said currently, the 5-year survival rate is greater than 90 percent as a result of early diagnosis and treatment. “Early diagnosis and treatment tailored to the problems of each individual patient greatly improves the course of the disease,” she stated.


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