What causes lupus? How is lupus diagnosed?

Author
summerrain23 says:
What causes lupus?
The cause of systemic lupus erythematosus (SLE or lupus) is unknown. Finding the cause is the object of major research efforts.

Factors which may contribute to the cause of lupus include viruses, environmental chemicals and the person's genetic makeup.

Female hormones are believed to play a role in the development of lupus because women are affected more commonly than men. This is especially true of women during their reproductive years, a time when hormone levels are highest.

The observation that lupus may affect more than one member of the same family has raised the possibility that the tendency to develop lupus may be inherited. Having such a tendency, however, does not predict that a relative will develop lupus. About 10% of lupus patients have a close relative with lupus.

How is lupus diagnosed?
The diagnosis of lupus is best made by an experienced clinician who fully understands the disease and other diseases with similar features that can mimic lupus. The diagnosis is made when a patient has several features of the disease (including symptoms, findings on examination and blood test abnormalities). The American College of Rheumatology has devised criteria to assist clinicians in making the correct diagnosis of lupus.

Does a positive ANA test mean that I have lupus?
Not necessarily. The antinuclear antibody (ANA) test is positive in most patients with lupus, but it may also be positive in many people who do not have lupus. Therefore, a positive ANA test alone is not adequate for the diagnosis of lupus – there must be at least three additional clinical features for the diagnosis to be made.

How is lupus treated?
The type of treatment prescribed will depend on several factors, including the person's age, type of medications he or she is taking, overall health, medical history and location and severity of disease.

Because lupus is a condition that can change over time and is not always predictable, a critical part of good care includes periodic visits with a knowledgeable, available physician.

Some patients with mild features of the disease do not require treatment, while patients with serious involvement (such as kidney complications) may require the use of powerful medications. Medications used to treat lupus include:

• Steroids or prednisone and related derivatives of cortisone. Steroid creams can be directly applied to rashes. The use of creams is usually safe and effective, especially for mild rashes. The use of steroid creams or tablets in low doses can be effective for mild or moderate features of lupus. Steroids can also be used in higher doses when internal organs are threatened. Unfortunately, high doses are also most likely to produce side effects.

• Hydroxychloroquine (Plaquenil) is commonly used to help keep mild lupus-related problems, such as skin and joint disease, under control.

• Cyclophosphamide (Cytoxan) is a chemotherapy drug which has very powerful effects on reducing the activity of the immune system. It is used to treat severe forms of lupus.

• Azathioprine (Imuran) is a medication originally used to prevent rejection of transplanted organs. It is commonly used to treat the more serious features of lupus.

• Methotrexate (Rheumatrex) is another chemotherapy medication used to suppress the immune system. Its use is becoming increasingly popular for skin disease, arthritis, and other non-life threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.


Feb 28, 2008
 
 
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