Most of the symptoms of lupus can be self-reported, but a doctor may notice a few things the patient did not report depending on what organs are attacked. If the nervous system is affected, they might present as confused, or they might not remember the things they should. If the patient’s skin is affected, a doctor could potentially notice a rash on the patient’s back they could not have seen on their own. Another potential thing a doctor could notice is depression, as it is possible the patient wasn’t really comprehending how they were feeling emotionally. A doctor could also notice that the patient seems very fatigued, but that could also be easily self-reported. Overall, a lupus patient would commonly present with a butterfly-shaped rash on their face, a fever, fatigue, joint pain, and gastrointestinal problems.
How it is transmitted:
Lupus cannot be transmitted from one person to another. The cause of lupus is still not completely known, yet scientists have ideas on how lupus is caused. Most scientists believe that lupus will develop with a combination of factors that are inside and outside of the body. These main factors include hormones, genetics, and environmental factors.
Currently, researchers are looking at the connection between estrogen and lupus, as lupus is much more common in women. Most women with lupus will have greater symptoms before menstrual periods or during pregnancy since estrogen levels are higher during these times. However, in studies with women with lupus taking estrogen pills there has been no increase in lupus symptoms. Now, researchers have shifted their focus to the differences between men and women that may make women more likely to have lupus.
There are now over 50 genes that researchers associate with lupus, but they have no been proven to directly cause lupus, only to contribute to it. Genes are not enough to solely cause lupus, and lupus can occur in families with no history of having the disease. Certain ethnic groups that may have similar genetics are also more likely to develop lupus.
In addition to genetics and hormones, the majority of researchers today believe that an environmental factor that comes into contact with a genetically susceptible person will trigger the development of lupus. Some of the most common environmental factors include UV light, infections (especially the Epstein-Barr virus), and exposure to silica dust. There are many other potential triggers, but it can be different for each person.
Is there a vaccine:
There is currently not a vaccine that is available to everyone, but the French have a study that is moving into phase III of testing, as it has shown to be successful. This study enrolled 185 people around the world with to severe lupus. This vaccine works by stimulating the patient’s immune system and causing it to produce antibodies against a certain protein called IFNa. In 2015, a Belgian treatment failed after going into phase III, and there is currently one vaccine on the market that uses monoclonal antibodies that arrived in the market in 2011. This vaccine however, is not very effective and it is not the first choice of many doctors.
What organ or organ system it attacks and how:
Lupus can attack many different systems of the body, and is different for each person diagnosed with it. 50% of lupus patients have antiphospholipid antibodies, which attack the phospholipids of the cell membrane, certain blood proteins that bind with phospholipids, and complexes formed from binding with phospholipids. In addition to antibody issues, lupus can affect the skeletal system, as it causes arthritis. This arthritis will present similarly to rheumatoid arthritis. Lupus can also attack the components of the cardiovascular system, and cardiovascular disease is actually the number one cause of death in lupus patients instead of lupus itself. One major system lupus attack is the immune system, as it causes the immune system to attack the body’s own cells, which can cause scarring and can prevent organs from working correctly. 50% of lupus patients will experience issues with their kidneys. In addition to kidney issues, 50% of lupus patients will experience issues with their lungs, with the five most common issues being pleuritis, acute lupus pneumonitis, chronic fibrotic lupus pneumonitis, pulmonary hypertension, and shrinking lung syndrome. Also, Lupus can attack the nervous system by attacking the antibodies that bind to nerve cells or blood vessels, or by interrupting the blood flow to the nerves. Another very common organ attack is the skin, as most lupus patients experience issues with their skin.
Stages or severity ranges and does it change over time:
Systemic lupus erythematosus itself does not have stages, doctors generally define lupus as mild, moderate or severe. However, a very serious complication of lupus, lupus nephritis has six stages. Doctors use the stages to determine how much kidney damage there is. The stages are as followed: stage I is minimal mesangial lupus nephritis, stage II is mesangial proliferative lupus nephritis, stage III is focal lupus nephritis, stage IV is diffuse lupus nephritis, stage V is membranous lupus nephritis, stage VI is advanced sclerosis lupus nephritis. Not much information is given on each specific stage, other than the name.
Lupus can change over time, yet lupus is a very unpredictable disease. Everyone’s disease is different, as it can present differently and affect different organs. In some people, they will have phases of flare-ups, the they will go into phases of remissions. These phases will be different lengths and different severities for each patient. In other people, their lupus will be very chronic and their symptoms could progress into a more severe lupus.
The symptoms:
Lupus symptoms are different in every case, as symptoms can be mild or severe, or even temporary or permanent. They can even come on slowly or rapidly. Some people experience “flare ups” that can exacerbate symptoms for a period of time, and then they will lessen or completely disappear. The symptoms are also dependent on which systems of the body are affected. The most common symptoms include, fever, fatigue, joint pain/swelling/stiffness, depression, anxiety, Sjogren’s syndrome (when tears do not form correctly), gastrointestinal issues, thyroid issues, osteoporosis, butterfly-shaped rash on the face or rashes elsewhere, skin lesions that appear with sun exposure, Raynaud’s phenomenon (when fingers or toes turn blue or white in stressful situations), shortness of breath, chest pain, dry eyes, headaches, confusion, and memory loss. Again, symptoms of lupus differ greatly between patients depending on what organs are affected by their disease.
The method of prevention:
There is no prevention to having lupus as it is caused by a combination of genes, hormones, and environmental factors. There are some links of the cause of lupus to certain toxins and viruses such as cigarette smoke, silica, mercury, the Epstein-Barr Virus, and the herpes zoster virus, so avoiding these toxins and viruses if possible is suggested. Although it is difficult to prevent having lupus, it is more possible to prevent flare-ups by having treatment for lupus. See methods of treatment.
Is it a live or dead vaccine:
The French study vaccination uses polyclonal antibodies, which target all of the binding sites on a disease-causing compound. A positive to using polyclonal antibodies is that the vaccination is less likely to lead to resistance after long periods of time. Research does not say if the use of polyclonal antibodies as a vaccine are live or dead.
Methods of treatment, when they started, how they’ve changed:
Lupus is treated based on the severity of the case, and the symptoms that a patient has. However, there are many common drugs that are taken by lupus patients. For mild flare-ups, patients are told to take NSAIDs to reduce some of the inflammation in their tissues and joints. Some very important drugs that are necessary to manage lupus long-term are antimalarial drugs, which decrease the risk of having flare-ups. Steroids can also be used, but are generally for more severe cases of lupus in which NSAIDs and antimalarials are not as effective. The steroids work to decrease the overall inflammation in the body. Immunosuppressive drugs can also be used in more serious cases of lupus and are generally prescribed once steroids are not effective anymore. DHEA is prescribed for certain conditions caused by lupus, such as osteoporosis, alopecia, joint pain, and fatigue. Another type of medication that can be used are biologics, which can be used to reduce some symptoms. In cases of resistant lupus, a medication called Rituxan can be used.
In 1894, Payne discovered that quinine was beneficial in treating lupus, which marks the first treatment. In 1894, salicylates began to be used in addition to quinine. In the mid-20th century, Hench discovered a modern-day treatment of lupus, which were steroids. Antimalarials, immunosuppressants, and biologics are relatively new treatments that are considered to be very modern, but the date of these discoveries is not given.
The biggest change that has occured with the treatment of lupus is that there are more drugs that are used, and the prevention of flare-ups has more options for treatments. Another big change is that there are many more studies going on to find a better treatment, a vaccine, or even a cure for lupus.
Where it is found in the world:
Lupus can be found anywhere in the world, and it is estimated that at least 5 million people worldwide have some form of lupus. Although lupus can affect anyone in the world, certain races are more likely to have lupus. In the United States, people of color are more likely to have lupus, including African Americans, Hispanics, Asian Americans, Native Americans, Native Hawaiians, and Pacific Islanders.
Is it a threat to the population:
Lupus is a very serious disease, yet it should not be considered a threat to the population since it is not extremely common and cannot be transmitted between people. People diagnosed with lupus can live a normal lifespan with the correct treatment and management. Only 10-15% of people diagnosed with lupus will die a premature death from complications from lupus.
What are the statistics of this disease, population, incidence, data, etc:
Most of the statistics found are for the United States and are from the National Resource Center on Lupus. It is estimated that 1.5 million people in America have lupus, and at least 5 million people worldwide. It is also estimated that there are 16,000 new cases diagnosed each year. Lupus is most common in women that are in the age of childbearing, and it will develop in most people in the ages of 15-44. Lupus is actually 2-3 times more common in women of color. Statistics show that 1 in 57 black women are affected by lupus. In addition to 1/57 black women being affected by lupus, a new study shows that they will have a more serious disease with more organ development. Also, 1 in 3 lupus patients will have more than one autoimmune disease. Another very interesting statistic is that 73% of Americans between the ages of 18-34 have never heard of lupus or do not know what it is.
Overall thoughts on the disease:
I think that lupus is a fairly scary disease since it can have so many symptoms and conditions. It does bring me a little comfort that it cannot be transmitted, and that it affects less people than some other immune disorders, such as AIDS. Even though lupus is scary now, I think that it has a bright future, especially if the vaccine from the French continues to be successful in its study. I think that in the relatively near future, there will be either a successful vaccine, a cure, or a much more comfortable treatment for lupus.