Symptoms of SLE Continued

3. Discoid lupus is a scaly, raised rash that appears on the face, scalp, ears, chest or arms in 25% of SLE patients. The rash, if untreated, may leave permanent scars. Involvement of the hair roots on the scalp may also cause permanent damage in the form of bald spots but widespread or total baldness is rare. The rash is photosensitive (it will get worse after being in the sun) but this can be avoided if the proper sunscreens are used. In Canada, patients typically experience the reappearance or worsening of discoid lesions during spring and summer. The use of a sunscreen for protection and appropriate treatments can usually reduce or control this problem. It is important to be aware that approximately 10% of discoid lupus patients will eventually develop a usually mild form of SLE. As a result, discoid lupus patients are tested for SLE from time to time.



4. Mucosal ulcers are small sores that occur on the mucous lining of the mouth or nose in as many as 40% of SLE patients. Mouth ulcers most often occur on the roof of the mouth and, because these are usually painless, the patient may not notice them except, perhaps, when eating spicy foods. Painful canker sores happen to lupus patients too but are different from lupus ulcers. Nose ulcers are usually painless but they may cause nosebleeds which, if frequent, should be brought to the physician's attention.



5. Arthritis is very common in SLE. In fact, it is unusual for patients with SLE not to have arthritis sooner or later. It causes pain in the joints of the hands, wrists, elbows, knees or other joints in the arms and legs. (Lupus arthritis does not cause back pain although patients may experience back pain from other causes.) The pain may be migratory, meaning that it goes from one joint to another, and it may occur in the same joint on both sides of the body. Signs of inflammation (swelling, redness, heat) may not show up but, when SLE is very active, the inflammation and pain may be severe.Both the patient and the physician can become very frustrated by the arthritis of SLE. Because the pains move from joint to joint and can appear and disappear quite quickly, the patient may not have any signs of arthritis at the time of their appointment. As a result, diagnosing arthritis in the patient can take quite a long time.
Lupus arthritis is usually not crippling and patients should not fear becoming wheelchair bound (although the use of a wheelchair is sometimes necessary in SLE due to causes other than arthritis). Changes (deformities) in the fingers do sometimes happen as a result of arthritis but this does not usually cause a major loss of function.



6. Pleuritis is inflammation of the pleura, the lining of the lungs, and pericarditis is inflammation of the pericardium, the lining of the heart. These problems may occur alone or together and affect at least 50% of all SLE patients. Pleuritis, and sometimes pericarditis, cause a particular type of chest pain that gets worse when breathing in and gets better or goes away when breathing out. Patients may also have less pain when sitting or standing and more pain when lying down. If the pain is severe, the person may be limited to shallow breathing only. Lupus patients who experience a second bout of pleuritis or pericarditis later in the course of their disease often readily point out that "...the pain is like it was the first time...".
While there are many benign (not serious) causes of chest pain, it is wise to inform your doctor immediately if you experience such a pain. By examining you, and performing tests such as a chest x-ray, heart ultrasound and electrocardiogram (ECG), your physician will be able to make a diagnosis and, if necessary, start treatment.



7. Kidney involvement ranges from very mild to very serious. It is believed that most, if not all, patients with SLE have at least some mild degree of kidney (or renal) involvement. When mild, this involvement is usually not a problem. However, in 50% of patients, kidney damage may occur and this is of concern because it may lead to a loss of the kidney's ability to clean the blood. An upsetting feature of SLE kidney involvement is that it tends to remain silent (the patient will not have any symptoms) until damage has already occurred. Then the patient will complain of weight gain and swelling, particularly in the feet and legs. Doctors call this fluid retention or oedema and it is the most common symptom of major kidney involvement.
It is very important to detect kidney involvement early because some of the deaths caused by SLE are related to severe kidney involvement. For this reason, regular tests of kidney function (simple urine and blood tests) will be ordered by your physician. Urine analysis and tests of kidney function are best performed from time to time, even when lupus seems to be quiet. Regular testing of the kidneys is absolutely necessary whenever lupus is active. Urine analysis can show various signs of inflammation in the kidney such as clumps of red blood cells (called cylinders or casts) or the presence of an excessive amount of protein. To determine how much involvement is present, doctors measure the amount of protein and the performance of the kidneys on all your urine collected over a 24 hour period. In this way, early involvement of the kidneys can be discovered and, if necessary, treatment can be started.Although most patients with SLE never develop kidney involvement that requires the use of artificial blood filtration (dialysis), some patients clearly will. Because kidney involvement can be so serious, affected patients should be evaluated by a nephrologist, a physician who specializes in treating diseases of the kidney.



8. Seizures (epilepsy) and psychosis are serious problems caused by central nervous system (CNS) involvement in SLE, and occur in 15-25% of patients. These problems can be caused by many disorders other than SLE so doctors must take the time to rule out other conditions before deciding that SLE is the true culprit. It is important to be aware that, with CNS involvement, other types of problems may occur which are not as serious as seizures or psychosis.Seizures most commonly involve loss of consciousness and involuntary body movements. The person does not usually recall what happened and descriptions by relatives or friends who witnessed the seizure are most helpful. Seizures can usually be confirmed by performing an electroencephalogram (EEG) which is a reading of the electrical activity of the brain. Fortunately, several drugs are available to control seizures in SLE patients.When seizures are the first symptom experienced by the patient, SLE may not be suspected until other lupus problems appear. This can cause confusion, as physicians may wonder if the other symptoms were triggered by the anti-epileptic drugs. In other words, is this drug-induced lupus? In most cases the answer is no and the seizures will begin again if the anti-epileptic drug is stopped.Psychosis is a serious mental condition where thinking and behavior are disturbed, often including hallucinations (seeing or hearing things that aren't there) and delusions (false notions or ideas, for instance the belief that one is being poisoned). Relatives may say that the person has partly or completely lost contact with reality. Other symptoms may be present such as confusion (the person does not know where he/she is, what the time and date are and may not recognize family members or close friends). Many doctors think that SLE psychosis is best treated with prednisone or a steroid drug.



9. Disorders of the blood cells are caused by autoantibodies that attack one of the blood cells or particles, usually the red or white cells or platelets. It is important to understand that these problems may have causes other than SLE. In all cases, doctors must rule out the other possible causes before treating these problems as related to lupus. Red blood cells may be attacked, resulting in a large number of cells being destroyed and removed from the body in the spleen, a process called hemolytic anemia. This destruction may be slow and relatively mild or may be very quick and cause an emergency. Prednisone is effective in treating this anemia in most people but sometimes the spleen must be removed to bring the anemia under control.
SLE commonly causes a decrease in the white blood cells called leukopenia. In most instances this is not dangerous and by itself does not require treatment.Platelets are cell particles that control the clotting of blood. Autoantibodies to platelets may cause the platelet count to drop, a situation called thrombocytopenia. Some SLE patients continue to have, over time, lower than normal platelet counts which do not require treatment but do need to be checked regularly. In others, a severe decrease in the platelet count can cause bleeding in various parts of the body such as the digestive tract, the urinary tract, the uterus or the brain. This is a serious situation that requires treatment with prednisone and, sometimes, removal of the spleen. Easy bruising of the skin may be a sign of a decreased platelet count but it also occurs in normal individuals or can be caused by prednisone. In my experience, these explanations account for far more cases of bruising than does a low platelet count.



10. Immunologic disorders refer to four autoantibodies found in the blood which, when taken with other symptoms, point to SLE.The lupus erythematosus cell preparation (doctors say LE prep) test is positive when a particular cell (the LE cell) is found in the blood of patients with active SLE. However, the LE cell is sometimes found in disorders other than SLE and most doctors have stopped using this test simply because better tests are now available.Anti-native DNA autoantibodies are common in SLE and it would be unlikely that they would be seen in other diseases. This test is repeated often because the amount of anti-native DNA autoantibodies seems to increase when lupus is active and the test can help the physician measure the degree of disease activity.Anti-Sm autoantibodies refer to the name of the first patient in whose blood they were found (her name was Smith). These antibodies point to SLE.A false-positive test for syphilis, which happens in approximately 20% of SLE patients, suggests that patients have the venereal disease called syphilis when, in fact, they don't. This is another of SLE's sneaky thousand faces and one that has caused a lot of fright and upset. When a diagnosis of SLE is suspected, doctors simply request this blood test for syphilis (V.D.R.L.) and, if it is positive, further tests are done that can show whether or not syphilis is actually present.



11. Antinuclear antibodies, or ANA, are found in the blood in almost every patient with SLE. This test has made the diagnosis of SLE more certain, as it is very accurate, but three cautions must be kept in mind. The first is that ANA may be present as a reaction to various drugs, may be present in diseases other than SLE and may be present in healthy individuals, particularly the elderly. Therefore, a positive ANA must always be looked at in light of other symptoms of SLE. The second caution is that the improved methods of testing for ANA have found small amounts of ANA in the blood of many apparently healthy people. Therefore a positive ANA does not necessarily mean a diagnosis of SLE. The third caution is that a positive ANA test should be repeated to be absolutely sure.In rare cases, a diagnosis of SLE will be made even when the ANA test is not positive. Some patients with several specific symptoms of lupus will not develop a positive ANA until later on in their disease. Other patients may have a particular autoantibody in their bloodstream called anti-Ro (from Robert who was the first person identified with this antibody) which is poorly detected by standard ANA tests. In these cases, there is a specific test for anti-Ro that is available at University Hospitals.

What are the Symptoms of SLE (Systemic Lupus Erythematosus)

Non-specific Symptons

The word non-specific is used by doctors to describe symptoms that can occur in many illnesses other than Lupus. They include fatigue, weight changes, fever, and swollen glands. Because these symptoms can arise from other illnesses, they can be connected to Lupus only after some of the specific symptoms begin to develop.

Fatigue: is the most frequent symptom that affects patients with Lupus. The degree of tiredness is far greater than the activities of the patient would indicate. Lupus fatigue leaves the person feeling extremely drained and without energy. With experience, most patients can learn the difference between normal tiredness and Lupus fatigue which is very helpful to their doctor in determining how active their Lupus has become.

Unexplained and continuing Weigh loss:of more than 5 pounds can be caused by SLE. Weight loss may occur slowly (20 pounds over a one year period) or very quickly (20 pounds in 2 months). Weight gain that occurs, even though the diet remains the same, may be caused by swelling, particularly in the feet and legs. This swelling may be related to Kidney, heart, blood vesselr or other organ involvement in Lupus. If the swelling continues, it requires prompt medical attention.

Fever:is another non-specific symptom that may occur in many illnesses such as the common cold or the flu. However, low-grade fever that lasts a long time or sudden, high fevers may indicate the SLE is becoming active or that a serious infection may be present. Fever is therefore always taken seriously by physicians who treat Lupus patients.

Swollen glands: If many swollen glands suddenly appear this may be a sign of SLE, particularly if they occur along with

Symptoms Specific to Lupus

Specific symptoms are caused by involvement of one or several organs of the body. SLE can affect the organs in any combination imaginable and a complete list of all SLE symptoms would fill many booklets. To help distinguish SLE from other diseases, doctors of the American Rheumatism Association have established a list of 11 abnormalities which, when combined point to SLE. These abnormalities include symptoms (What you can feel, such as pain), signs (what your physician can see during an examination) and changes in laboratory tests.

To make a diagnosis of SLE, the patient must have had at least 4 of these 11 abnormalities at any time since the beginning of the disease. Some of the items on the list have as many as 4 possible abnormalities but only 1 of them needs to be present for a particular condition to be met.

To make a diagnosis of Lupus at least 4 of these 11 criteria must be present:

1.The butterfly rash: is a red rash that occurs over the cheeks and often over the bridge of the nose. This rash eventually happens to 50% of all SLE patients. It may be flat or raised and should not be confused with simple blushing or the redness that comes with fever. Some people notice a feeling of warmth in the area of the rash while others do not. The rash can be so faint that only the physician will notice it or it can be obvious to the point of being commented on by relatives or friends.

2. Photosensitivity: an excessive skin reaction to sunlight (causing rash) that occurs in at least 50% of patients. Usually, only the exposed skin is involved while skin that is covered by clothing is spared. Your physician will decide that photosensitivity is present only if there is a sudden change in your usual reation to sunlight . Some Lupus patients experience photosensitivity indoors, especially when exposed to fluorescent lights.

Stay tuned for the other symptoms

Types of Lupus

There are four types of lupus: discoid, systemic, drug-induced and neonatal lupus.

• Discoid (cutaneous) lupus is always limited to the skin. It is identified by a rash that may appear on the face, neck, and scalp. Discoid lupus is diagnosed by examining a biopsy of the rash. In discoid lupus the biopsy will show abnormalities that are not found in skin without the rash. Discoid lupus does not generally involve the body's internal organs. Therefore, the ANA test may be negative in patients with discoid lupus. However, in a large number of patients with discoid lupus, the ANA test is positive, but at a low level or "titer." In approximately 10 percent of patients, discoid lupus can evolve into the systemic form of the disease, which can affect almost any organ or system of the body. This cannot be predicted or prevented. Treatment of discoid lupus will not prevent its progression to the systemic form. Individuals who progress to the systemic form probably had systemic lupus at the outset, with the discoid rash as their main symptom.
  
• Systemic lupus is usually more severe than discoid lupus, and can affect almost any organ or organ system of the body. For some people, only the skin and joints will be involved. In others, the joints, lungs, kidneys, blood, or other organs and/or tissues may be affected. Generally, no two people with systemic lupus will have identical symptoms. Systemic lupus may include periods in which few, if any, symptoms are evident ("remission") and other times when the disease becomes more active ("flare"). Most often when people mention "lupus," they are referring to the systemic form of the disease.
  
• Drug-induced lupus occurs after the use of certain prescribed drugs. The symptoms of drug-induced lupus are similar to those of systemic lupus. The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or hypertension) and procainamide (used to treat irregular heart rhythms). Drug induced lupus is more common in men who are given these drugs more often. However, not everyone who takes these drugs will develop drug-induced lupus. Only about 4 percent of the people who take these drugs will develop the antibodies suggestive of lupus. Of those 4 percent, only an extremely small number will develop overt drug-induced lupus. The symptoms usually fade when the medications are discontinued.
  
• Neonatal lupus is a rare condition acquired from the passage of maternal autoantibodies, specifically anti-Ro/SSA or anti-La/SSB, which can affect the skin, heart and blood of the fetus and newborn. It is associated with a rash that appears within the first several weeks of life and may persist for about six months before disappearing. Congenital heart block is much less common than the skin rash. Neonatal lupus is not systemic lupus.

Lupus on Global News

I have hypersensitive hearing when it comes to Lupus and last night, I heard Global News mention Lupus, so of course I watched and found out that three genese were found so far that cause Lupus. Here is the article posted on Global TVs website.

Studies home in on lupus cause
JASMIN LEGATOS, The Gazette

After two strokes and seven years, Miriam Gaudelli was finally diagnosed with lupus at 21.

Now 25, Gaudelli, president of Lupus Canada for Quebec, often hears similar stories of sufferers misdiagnosed for years.

That's because the illness, dubbed the disease with a thousand faces, can affect the joints, kidneys, heart, skin and brain and requires three or four symptoms to occur simultaneously in order to be diagnosed, she said.

But now an international team of researchers, which includes a group from the Montreal Heart Institute, have discovered three genes that cause the illness.

"We can now study these genes to find out what they are doing in the normal state and what they are doing in the disease," said John Rioux, an associate professor of medicine at the Université de Montréal and a researcher at the Montreal Heart Institute.

In people affected by lupus, the immune system produces antibodies that attack their own tissues, resulting in inflammation of the specific tissue or the body's organs.

Lupus Canada estimates that anywhere between 15,000 and 50,000 Canadians have lupus and women are nine times more likely to develop the disease than men.

The new studies are also important because it's the first time scientists were able to scan all 30,000 genes in the human genome, Rioux said.

"(Before) you had to pick your favourite gene that you thought, in the scientific sense, had a role to play in the disease and do a genetic test," he said.

However technology developed in recent years leaves the guesswork behind, he added.

Although researchers know little about the three genes discovered in the study, they are the first pieces of a complex puzzle, Rioux said.
"If we can start building up a knowledge of these different pieces, we can figure out which genes go with which type of symptom. Then you can figure out how to better treat these patients."

Lupus on Good Morning America

The Definition of Lupus

"Lupus is an autoimmune disease that can affect various parts of the body, including the skin, joints, heart, lungs, blood, kidneys and brain. Normally the body's immune system makes proteins called antibodies, to protect the body against viruses, bacteria, and other foreign materials. These foreign materials are called antigens.

In an autoimmune disorder like lupus, the immune system cannot tell the difference between foreign substances and its own cells and tissues. The immune system then makes antibodies directed against itself. These antibodies -- called "auto-antibodies" (auto means 'self') -- cause inflammation, pain and damage in various parts of the body."

The Disease with a Thousand Faces

Systemic Lupus Erythmatosus (SLE or Lupus), is a chronic disease with a variety of symptoms caused by inflammation in one or more parts of the body. It belongs to the family of diseases that includes rheumatoid arthritis, scleroderma and other conditions. SLE can target any of the body's tissues, and it manifests itself in many ways. Because everyone's Lupus experience is different, it is often referred to as the disease of a thousand faces.

How common is lupus?

• It affects 15,000 (1 in 2,000) Canadians.
  
• Women develop lupus up to 10 times more often than men.
  
• It usually occurs in women between the ages of 15 and 45.

Lupus can affect men, women, and children of any age, but it occurs most often in women of childbearing age (ages 15 to 45). Systemic lupus erythematosus (SLE) is eight to 10 times more common in women than men.

• The Lupus Foundation of America estimates that approximately 1.5-million Americans have a form of lupus.

• Although lupus can strike men and women of all ages, 90% of individuals diagnosed with the disease are women, and 80% of those afflicted with systemic lupus develop it between the ages of 15 and 45.

• While lupus is a widespread disease, awareness of the disease lags behind many other illnesses.

• A survey of Lupus Foundation of America members suggests that more than half of those afflicted with lupus suffered at least four years, and saw three or more doctors before obtaining a correct diagnosis of lupus.

This is why I am doing this blog; this disease needs way more attention than it is getting right now. More people must be educated about what Lupus is and its affect on people.