Lupus can affect any part of the body and can be difficult to diagnose as the symptoms are wide-ranging, meaning it is often mistaken for other conditions. The most common type is systemic lupus erythematosus (SLE), which can affect almost any part of the body, while discoid lupus mainly affects the skin.
Experts believe the cause of the abnormal autoimmune reaction which causes lupus symptoms is probably a mixture of genetic, hormonal and environmental factors.
If you have lupus, there’s about a one in 100 chance your child will develop it later in life. There's also a high probability that you will have relatives with other autoimmune conditions, such as diabetes and thyroid problems.
Possible environmental triggers include viral infections, exposure to sunlight (ultraviolet light), smoking, emotional stress, or prolonged use of medication. Lupus symptoms tend to occur when there are hormonal changes, such as puberty, pregnancy and the menopause.
Symptoms of SLE are unpredictable and can vary from person to person, and they can flare up and then die down again. The main symptoms are extreme tiredness, swelling and joint pain, and rashes on the face, wrists and hands. Recurrent miscarriages can also be a symptom.
Other symptoms may include fever, swollen lymph glands, weight loss or gain, recurring mouth ulcers, anaemia and mood changes. If lupus affects the internal organs, such as the heart, lungs, brain and kidneys, the outcome can be more serious.
Most people will only have one or two of the possible symptoms and many will find that they come and go.
Several blood tests can be used for a diagnosis. These include: an anti-nuclear antibody test, which looks for the antibody ANA; an anti-DNA antibody test, which checks for specific antibodies; and a complement level test, which measures the activity of certain proteins in the blood that decrease during a flare up. Another tests the erythrocyte sedimentation rate (ESR), which assesses inflammation in your body.
If your organs have been affected, most typically the kidneys, further tests will be carried out including, urine testing, an ultrasound scan, X-ray and CT scanning.
Who gets lupus?
More women than men have lupus, with nine out of 10 cases affecting women. It’s more common in Afro-Caribbean, Asian and Chinese women and is more likely to develop between the ages of 15 and 45 years.
There’s currently no cure for lupus, but with careful monitoring and treatments to control symptoms, most people can live virtually normal lives. The treatments available aim to minimise symptoms and reduce the chances of organ damage.
Drugs used to treat lupus include: non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids, which reduce inflammation in the body; anti-malarials (hydroxychloroquine), to control symptoms of lupus and prevent flare-ups; and immunosuppressant drugs, which suppress the immune system.
Two newer biologics, rituximab and belimumab, may be used in people with severe lupus who aren’t responding to other drugs.
Lifestyle changes that can help include staying out of the sun and using a sunscreen that blocks both UVA and UVB rays. It’s important to take a vitamin D supplement if you’re avoiding sun exposure and to include good sources of vitamin D such as eggs, salmon and sardines, in your diet.
Arthritis Research UK says there's some evidence that a diet low in saturated fat and high in omega 3 oils, which is found in oily fish, may be helpful, and that lupus patients could try taking fish oil supplements (not cod liver oil, though).
Learning how to relax should also be a priority. Talk to your doctor as soon as possible if you have any new symptoms.