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Lupus: A difficult diagnosis

Note: April 1 is Lupus Alert Day.

A friend of mine was recently diagnosed with lupus. What is lupus and how will it affect her life?

Lupus is a chronic autoimmune disease that can cause inflammation in various parts of the body, most often the skin, joints, blood, and kidneys.

Although lupus affects both men and women, 90 percent of cases are in women, and most commonly, women in their childbearing years. Upward of two million people in the United States have lupus and symptoms can range from very mild (minor fatigue, arthritis, or rash) to life-threatening (triggering extensive swelling of major organs). Lupus is more common in people of African descent and its symptoms come and go, are sometimes nonspecific, and may mimic other ailments.

Although there is no cure for lupus, it is treatable. According to Joseph Korn, M.D., head of the Rheumatology Section at Boston Medical Center and professor of medicine and biochemistry at Boston University School of Medicine, the disease usually responds well to corticosteroid therapy; however, potent immunosuppressive drugs may be necessary in some cases. He adds that between 80 and 90 percent of patients with lupus can look forward to living relatively normal, healthy lives.

According to Korn, lupus is an overactivation of the immune system. "A person's immune system will turn inward and attack itself by making antibodies to that person's own DNA, RNA, blood cells, and platelets," he says. Many researchers believe that some people have a genetic predisposition to lupus and that environmental factors could play a critical role in triggering symptoms of the disease.

Although lupus has been around for centuries, physicians have had incomplete information on the disease. "However, advances in technology, specifically genetic research, are now allowing physicians to pinpoint the causes of lupus with greater accuracy," says Korn. "Better diagnosis is now common; beforehand, some patients may have been diagnosed with chronic fatigue, arthritis, or one of the other symptoms of lupus." Contrary to some beliefs, lupus does not cause cancer, and it is not infectious.

Because lupus is difficult to diagnose, Korn says that those who suspect they may have the disease should have a careful clinical evaluation as well as blood tests. "The clinical evaluation is vital," he says, "because a positive ANA test does not necessarily mean that a person has lupus."

There are a number of ways patients with lupus can help prevent flare-ups of symptoms:

• Avoid excessive sun exposure. It is believed that sunlight may trigger some of the symptoms. Those in the direct sun for long periods of time should use sunscreen to prevent rashes.
• Exercise regularly to help prevent muscle weakness and fatigue.
• Be immunized against specific infections.
• Make the most of support groups and counselors. By talking to family members, friends, and doctors, patients can help alleviate the effects of stress.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on lupus or other health matters, call 617-638-6767.

30 March 2001
Boston University
Office of University Relations