Sunday 20 October 2019

Better outlook for lupus sufferers

Dr Michelle Cooper

SYSTEMIC Lupus Erythematosus - or SLE - can cause various symptoms, the most common being joint pains, skin rashes and tiredness while problems with the kidneys and other organs can occur in severe cases. Treatment includes anti-inflammatory painkillers which ease joint pains. Steroids and/or other medications are sometimes required.

SLE is a persistent, chronic disease that causes inflammation in various parts of the body. It is commonly just called 'lupus'. The severity of SLE ranges from mild to severe and there are two mains forms of the condition. Discoid lupus only affects the skin whereas the other form, which I will focus on in this article, involves the skin and joints and may also involve internal organs such as the heart or kidneys as well.


SLE affects about 5 in 10,000 people in the UK. It is ten times more common in women than in men and most typically develops in women between 20 and 40 years of age. It is more common in people from Afro-Caribbean, Asian or Chinese origin. Although SLE can run in families, only 3 in 100 children of patients with SLE will actually develop the disease.


SLE is an autoimmune disease. This means that the immune system which normally protects the body from infections mistakenly attacks healthy cells, causing damage to the affected parts of the body. It is not known why SLE occurs. However, possible triggers include infections, certain medications, or sunlight. Hormonal changes may also play a role in SLE, which could explain why it is much more common in women.


The symptoms and severity of SLE vary tremendously between people. Many patients suffer with tiredness, weight loss and a mild raised temperature. In addition, one or more of the following may develop:

l Joint and Muscle Pains: Most people with SLE develop joint and muscle aches and pains, which may fleet from joint to joint and which are commonly associated with joint stiffness - usually worst first thing in the morning.

l Skin, mouth and hair: A red rash which develops over the cheeks and nose is common. Other areas of sun-exposed skin may also be affected and about 6 in 10 people with SLE find that their skin is very sensitive to sunlight. Mouth ulcers are more common in people with SLE and hair 'thinning' may also occur.

l Blood and lymph nodes: A mild anaemia is common in SLE sufferers and reduced numbers of white cells or platelets may also occur. A tendency to form blood clots, although uncommon, may develop and some lymph glands may also swell.

l Heart and lungs: The tissues that cover the heart and lung may become inflamed and can cause pains in the side of the chest (pleurisy) or central chest pains (pericarditis).

l Kidneys: Around 1 in 3 people with SLE may develop inflammation of the kidneys, which can lead to the kidneys leaking protein and blood into the urine.

l Brain and nervous system: Mental health problems such as anxiety and depression are common in SLE. Although mild depression can be part of the disease itself, it can also be due to the reaction to having a serious illness. Occasionally, inflammation of the brain can lead to epilepsy, headaches, migraines and other conditions.


In some cases, the symptoms develop quite slowly and may be confused with other conditions. Symptoms range from mild to severe and, typically, there are times when the disease flares up and other times when symptoms settle.


If you have symptoms suggestive of SLE, your doctor will usually order some blood tests. Most patients with SLE have an antibody in their blood known as antinuclear antibody (ANA). Another antibody called anti-double stranded DNA (anti-dsDNA) is often present in patients with severe SLE. Once SLE is diagnosed, patients normally have regular blood tests as well as tests to check for anaemia and urine tests to check for kidney problems. A blood test to measure a chemical in the blood known as 'complement' can assess the activity of the disease and is usually frequently monitored. Other tests, including scans and X-rays, may be advised to check on the function of the heart, kidneys and other organs if the disease is thought to be affecting these areas of the body.


Although there is no cure for SLE, this condition can usually be controlled and symptoms eased. Most people with SLE are seen regularly by a specialist who advises on treatments which may vary from time to time depending on the severity of the disease and the part of the body affected.


Most people with SLE lead active, normal lives. The outlook for people with SLE is much better than it was in the past due to the efficacy of modern treatments. For many people with SLE, symptoms are mild or moderate, with little risk to life.

Support and information may be obtained from

Wexford People

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