Clinical Manifestations, Causes and Treatments for Lupus - Research Paper Example

? Clinical Manifestations, Causes and Treatments for Lupus Deidre Jones English 201 2/21/12 Lupus is an autoimmune disease that exhibits through a wide variety of symptoms, and as a consequence can be very difficult to diagnose. Many different parts of the body can be affected, including the skin, organs and joints. People often have to wait a significant amount of time for the disease to be correctly diagnosed because of this. Which systems are affected is not uniform across sufferers, and for some the disease may have only minor implications, while for others it can be severe. There are a number of variations of lupus, with the most common being systemic lupus erythematosus which affects the entire body. The causes of lupus are not fully known, although stress has been shown to play a role in the appearance of symptoms, and the presence of the disease itself is thought to be genetically linked. There is no known cure for the disease, although medication and treatment can help to alleviate some of the symptoms. Nevertheless, lupus sufferers can often lead relatively normal lives, and more than 80 percent survive the first ten years after diagnosis. Thesis statement Lupus is an autoimmune disease that affects a large number of systems and is difficult to diagnose. However, despite the fact that there is no known cure for the disease, treatments are available, and most people can live normal lives. Introduction The name lupus is from the Latin word for wolf due to the appearance of a facial rash which was thought to resemble the bite of a wolf . However, not all suffers get the rash, and it is not always severe . Lupus is an autoimmune disease, which results in the body perceiving its own tissues as invaders and raising an immune response against it. The disease can be present in several different body systems and substantially ranges in severity. Some cases of the disease are life threatening, while others can be trivial and little to no effect on daily activity. The result of this is that the disease can be extremely difficult to diagnosis . The primary means of diagnosing lupus is through the use of an anti-nuclear antibody test (ANA). However, this is not fully reliable, as many people have positive ANA results that do not have lupus, and some forms of lupus do not trigger a positive ANA result. For example, although many people are diagnosed with lupus through blood screening, only around ten percent of these actually have the disease . Consequently, a range of methods are used for diagnosis, and patients are often misdiagnosed many times before being correctly diagnosed with lupus. Lupus varies in intensity, it can flare up with stronger symptoms for a time, and it can go into remission for many years at a time. The exact causes of flares or remission are unknown, but research suggests that stress is a likely driver of the severity of the symptoms . One of the most recognizable aspects of lupus is the red rash that many patients get. In many cases when the rash heals, there is no trace of it remaining . While most lupus sufferers have systemic lupus erythematosus (SLE), there are other variations of the disease. Types of Lupus Systemic lupus erythematosus (SLE) can affect all or most of the body, including the blood, joints, skin and often kidneys . The term “systemic” refers to all over, while erythematosus means red. This can affect any part of the body . The disease acts by the presence of antibodies in the bloodstream that attack components of the hosts system. Wherever these land, they cause inflammation and often pain. Symptoms vary substantially depending on where the antibodies are present. For example, some lupus patients have general aches, severe pain in their joints, a skin rash or an unusual blood count . SLE is the most common form of the disease, and this type is most often associated with the term lupus . For a person to be officially diagnosed with lupus (SLE variant), the disease must conform to four of 11 criteria. The criteria are broken down into three sections, the first relating to the skin, the second one to specific organs and the final three are related to abnormalities that can be seen in the laboratory, such as abnormal blood cell counts . Neonatal SLE is a form of lupus that occurs as a result of the interaction between the immune systems of a mother and her unborn child. Here, if the mother possesses a certain antibody known as anti-Ro, it can cross the placenta and cause an autoimmune response in the child. However, this does not usually last more than a few months after birth, as the mother’s version of the antibody is used up in this time . However, on rare occasions, this can cause damage to the heart of the baby, resulting in it needing a pace maker . Mixed connective tissue disease (MCTD) and crossover syndrome are terms used to refer to patients that meet the requirements for SLE as well as for another autoimmune disease . For the most part, this disorder is similar to SLE. Discoid lupus erythematosus (DLE) is a variant of lupus where the autoimmune reaction is specific to the skin. This form of lupus can often lead to a negative result for an ANA test. Patients are diagnosed with DLE if no internal systems are affected by the disease. Approximately ten percent of lupus suffers fit these criteria . Drug-induced lupus erythematosus (DILE) is a form of lupus that arises as a result of the use of a prescription drug. This type of lupus is generally stops if the patient stops taking the medication, although this is not always the case. Symptoms of the drug-induced form of the disease also tend to be lower than the other variations. Like DLE, it is estimated that around ten percent of lupus patients fall into this category . Causes The disease is not contagious and cannot be transmitted from one person to another, more from pets to owners or vice versa . The age of onset for lupus varies substantially, and it has been diagnosed in patients from birth to 89 years of age. Lupus can affect people of any race, age or social class. However, most patients are women between 15 and 45 years of age . The causes of lupus are difficult to determine, and there is substantial research into finding out what drives the disease. There are some differences in the prevalence of lupus among different races. For example, in the Caribbean, England and the United States, white women get the disease much less than any other racial group. This has led to the conjecture that there is a genetic aspect to the disease . Genetic research has suggested that there may be a gene on chromosome one that is related to lupus, but the exact casual role has not been determined . Another proposal is that the environment may have an influence on the prevalence of the disease, as research suggests that SLE is rare in central Africa . Stress has been connected to worsening the symptoms of lupus as well as causing an onset of symptoms in sufferers who have not yet shown any symptoms of the disease. However, stress is not thought to be the primary driver of the disease . Research continues to try and elucidate the causes of lupus, and it is hoped that we will have a better idea of what drives the disease in the future. Prognosis One of the most difficult factors about lupus is the wide range of symptoms that is associated with it. This means that even when the disease is diagnosed, each new symptom must be carefully examined to determine whether it is caused by lupus or by something else. For example, a symptom that appears to be related to lupus may in fact be a side effect from a drug that the patient has been taking . It is important that any symptom of the disease or anything else is treated appropriately, rather than simply assuming that it is the result of lupus. For lupus sufferers, the disease can be confusing, as it is difficult to know what symptoms will arise and when. Furthermore, many symptoms can in themselves be difficult to manage, and patients greatly benefit from having people around them who can encourage them on the good days, and help them on the bad days . The disease can go into remission for long periods and emerge, apparently without warning. Lupus can have many mental effects, for example, psychosis, cognitive problems and depression are common in lupus patients . One example of this is that lupus patients often need more rest than other people, and many battle chronic fatigue on a daily basis. Also, common across lupus suffers is intense pain and loss of concentration . Many lupus patients are capable of living fully normal lives; for some the disease has no effect, for others it must be managed daily. Between 80 and 90 percent of people who have lupus survive the ten years immediately following the diagnosis, and most go on to lead relatively normal lives. However, while medicine has improved significantly since lupus was first discovered, there is still no cure for the disease. Treatments include nonsteroidal anti-inflammatory (NSAIDS) and chemotherapy. While these may decrease some of the symptoms, they do not remove them . Death from lupus does still occur, primarily from organ damage caused by the disease, active SLE, atherosclerotic disease or infections . However, research continues on the disease and it is likely that as more is found about its mechanism and causes, there will be a greater ability to treat, and perhaps even one day cure, lupus. Conclusion Lupus is a famously confounding disease where the immune system fights the body resulting in a wide range of symptoms and severity. While for some people, lupus is barely noticeable, others have to manage chronic fatigue and pain, and for others, the disease is life threatening. Although research continues on the disease, there is currently no cure for lupus, and sufferers must manage their symptoms as best as is possible with the assistance of medications and other methods. Living with lupus may be difficult but is possible, and the support of friends and family makes it easier for suffers to manage the disease and the associated symptoms. References Aladjem, H. (1999). The challenges of lupus, insights & hope. Garden City Park, New York: Avery Publishing Group, 3-15. Foy DiGeronimo, T. (2002). New hope for people with lupus. New York City, New York: Three Rivers Press, 1-15. Hanger, N. C. (2003). The first year, lupus. New York: Marlowe & Company, 1-10. Health Research Today (2007). Freedom from lupus. London: Sayshell Ltd., 29-35. Trager, J., & Ward, M. M. (2001). Mortality and causes of death in systemic lupus erythematosus. Current Opinion in Rheumatology, 13, 345-351. Wallace MD, D. J. (2009). The lupus book, a guide for patients and their families. New York: Oxford Press, 1-20. Read More