What causes Lupus?

It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown.

Some potential triggers include:

• Sunlight: Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people.
• Infections: Having an infection can initiate lupus or cause a relapse in some people.
• Medications: Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. Rarely symptoms may persist even after the drug is stopped.

Factors that may increase the risk of developing lupus include:

• Lupus is more common in women
• Although lupus affects people of all ages, it’s most often diagnosed between the ages of 15 and 45
• More common in African, Asian or Hispanic people

What are the most common symptoms of Lupus?

Signs and symptoms may come on suddenly or develop slowly, may be mild or severe and may be temporary or permanent. 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.

The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease.

The most common signs and symptoms include:

• Fatigue
• Fever
• Joint pain, stiffness and swelling
• Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
• Skin lesions that appear or worsen with sun exposure
• Fingers and toes that turn white or blue when exposed to cold or during stressful periods
• Shortness of breath
• Chest pain
• Dry eyes
• Headaches, confusion and memory loss

How is Lupus diagnosed?

There is no one test to diagnose Lupus. A GP will generally perform a physical exam, take a medical history, order blood tests and any relevant imaging then refer you to a Rheumatologist who specialises in diagnosing and treating autoimmune diseases, arthritis and other diseases of the bones, joints, and muscles.

Physical exam: looking at joints and skin, listening to the lungs, feeling the abdomen, examining the eyes.

Medical history: asking about symptoms, what makes them worse or better, when they started and any family history.

Blood tests: inflammatory markers, full blood count, antibody screening, kidney and liver function

How is Lupus managed?

Medicines: The drugs used to treat lupus will depend on how serious it is and which parts of your body are affected. Your treatments will probably be changed or adjusted as your symptoms flare up or improve. Many drugs used to treat lupus were originally developed for other conditions but were later found to be useful in lupus.

Team Based Care: Your care is likely to involve many different healthcare professionals, although how this will work will vary from person to person. If you attend a clinic in a public hospital, most of your team-based care will be organised through the clinic.

For people who see a private rheumatologist, your GP may coordinate most of your care. They will communicate with your rheumatologist and arrange many of your tests and prescriptions. They may also refer you to allied health workers, such as a physiotherapist or occupational therapist (OT), for support in the home or community.

Counselling: Many people find that counselling can help when dealing with the emotional aspects of Lupus. A psychologist or social worker may also be an important person in your healthcare team.

Exercise, healthy eating and lifestyle: One of the best things you can do for yourself is get some exercise every day. You can also play an active role by not smoking, reducing stress and eating a healthy diet.

Limiting Sun Exposure: Keep out of the midday sun and wear a hat. Keep your skin covered or use sun cream of factor 50 or greater – which is available on prescription for people with lupus. You can also buy high-factor sun creams that include a tint and can be used as foundation make-up. Be careful when sitting under sun umbrellas on a paved area as the sunlight will be reflected onto your face.

What are flares?

Lupus is a condition that naturally improves and worsens at different times. Learning how to manage a flare-up of your symptoms helps you to be more in control of your condition.

The reasons for a flare-up can vary from person to person, but exposure to sunlight, too little rest time, infections and stress can all play a part. It can be useful to try to spot the things that lead to a flare-up and find ways of managing or avoiding them.

Keep in touch with your rheumatology team.