What is Lupus?
Systemic Lupus Erythematosus (SLE) or Lupus as it is commonly known as a complex autoimmune disease. It is a chronic, debilitating illness disease which can vary from mild to life threatening. It has many features. It can affect one or many organs such as the skin, joints, brain, heart, kidney. Symptoms and signs range according to the organ systems that are affected. It is also marked by remissions and relapses during its course through a lifetime. SLE cannot be cured but it can be managed.
Have you heard of Lupus before?
SLE affects people worldwide though the incidence varies from country to country. The prevalence of SLE is highest in North America where African-Americans are thrice more likely to have the disease. In India, the prevalence is not very high. Females all over the world are significantly more affected than males, around more than 6 times.
There is a general lack of awareness about SLE. That coupled with the fact that symptoms can mimic many other diseases more often than not leads to a delay in diagnosis. It can also be wrongly diagnosed on the basis of positive blood tests. Lupus has recently come into the limelight after singer Selena Gomez opened up about her illness on social media. She is just one of the 1.5 million Americans that are estimated to have some or the other form of lupus.
What are the factors responsible for Lupus?
The factors responsible for the development of SLE are puzzling. As with other autoimmune diseases in SLE antibodies are produced against and attack the body's own healthy tissues but why this happens is unclear.
Genetic tendency seems to play an important role. Certain ethnic groups seem to be more vulnerable to developing lupus. Caucasians are less susceptible than non-Caucasians. Even the course, presentation of the disease and survival rates varies between these groups. For instance, black patients present more with discoid lesions and nephritis might be more common in Asians with the disorder.
Does Lupus affect women more than men?
The disease also has a strong predilection for women, especially of childbearing age. The incidence rises after menarche, peaking at age 30 to 35 and declining after the menopause. This suggests that the female hormones may be partially responsible for the onset of the disease.
Environmental factors like sunlight, Mercury, fungi, and infections also seem to influence the development of the disease.
Cytomegalovirus (CMV), Herpes Zoster and Human Retroviruses (HIV and HTLV-1) have all been implicated in the causation of lupus as well as immunisations against pneumococcus, tetanus, Haemophilus B, hepatitis B, and influenza. However, there is no sound backing to these claims.
It has been well seen however that certain drugs cause a lupus like disorder. More than 80 drugs like minocycline, hydralazine, procainamide, isoniazid, quinidine, chlorpromazine, methyldopa cause lupus like symptoms but there are certain differences. Usually, both older women and men are affected and Caucasians more than others. The disease takes a safer course as symptoms disappear after the medication is stopped.
Though it is unclear as to what exactly causes lupus it is clear that the disease can be triggered by certain factors.
Exposure to sunlight in those who are predisposed is one such factor. Stress, and smoking and getting pregnant are other common triggers.