There’s been a wedding in the family and the bride has lupus. Now there’s something I’d never thought about. I mean lupus, not weddings. Looks like it’s time to do just that. I’d heard the word and had my ideas as to what it meant, but let’s allow my favorite dictionary, the Merriam-Webster, define the disease for us:
“any of several diseases characterized by skin lesions”
That’s a little too general for me. Let’s see if we can get more specific. The Lupus Foundation was tremendously helpful here:
“Systemic lupus erythematosus (SLE)
This form of lupus is limited to the skin and can cause many types of rashes and lesions.
Drug-induced lupus erythematosus
This is a lupus-like disease caused by certain prescription drugs.
Of course, this is a kidney disease blog, so I wanted to know what, if anything, lupus had to do with the kidneys. By a process of elimination, we must mean SLE. We’re not interested in solely the skin, drugs, or newborns.
Notice, this is Systemic Lupus Erythematosus. You’re right; we need another definition. This time I turned to Dictionary.com for the definition of erythematosus:
“abnormally inflamed or reddened”
This is caused by the capillaries under the skin being dilated by accumulated blood.
Hmm, did you realize that the word ‘systemic’ was also a clue that this is the kind of lupus that affects the kidneys? Maybe a reminder of what the renal system is would be a good idea here. Oh, you should know that the renal system is also called the urinary system. Britannica.com offers a simple explanation of what this is:
“renal system, in humans, organ system that includes the kidneys, where urine is produced, and the ureters, bladder, and urethra for the passage, storage, and voiding of urine.”
We need another piece of information. Healthline has it:
“The immune system normally fights off dangerous infections and bacteria to keep the body healthy. An autoimmune disease occurs when the immune system attacks the body because it confuses it for something foreign. There are many autoimmune diseases, including systemic lupus erythematosus (SLE).”
Whoa! So, our bodies can attack our renal systems [among other systems]. If it does, what happens to us? The Mayo Clinic answers this question for us:
“Lupus nephritis is a frequent complication in people who have systemic lupus erythematosus — more commonly known as lupus.
Lupus is an autoimmune disease. It causes your immune system to produce proteins called autoantibodies that attack your own tissues and organs, including the kidneys.
Lupus nephritis occurs when lupus autoantibodies affect structures in your kidneys that filter out waste. This causes kidney inflammation and may lead to blood in the urine, protein in the urine, high blood pressure, impaired kidney function or even kidney failure.”
Reminder: nephritis means inflammation of the kidneys. Let’s see if we can get an explanation that draws this information together. The CDC has just the one:
“Systemic lupus erythematosus (SLE), is the most common type of lupus. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. There is no cure for lupus, but medical interventions and lifestyle changes can help control it.”
We haven’t looked at the symptoms yet:
“SLE may first appear as extreme tiredness (fatigue), a vague feeling of discomfort or illness (malaise), fever, loss of appetite, and weight loss. Most affected individuals also have joint pain, typically affecting the same joints on both sides of the body, and muscle pain and weakness. Skin problems are common in SLE. A characteristic feature is a flat red rash across the cheeks and bridge of the nose, called a “butterfly rash” because of its shape. The rash, which generally does not hurt or itch, often appears or becomes more pronounced when exposed to sunlight. Other skin problems that may occur in SLE include calcium deposits under the skin (calcinosis), damaged blood vessels (vasculitis) in the skin, and tiny red spots called petechiae. Petechiae are caused by a shortage of cells involved in clotting (platelets), which leads to bleeding under the skin. Affected individuals may also have hair loss (alopecia) and open sores (ulcerations) in the moist lining (mucosae) of the mouth, nose, or, less commonly, the genitals.”
Thank you to MedlinePlus for the above information.
How can life style changes affect lupus, I wondered. Ah, but then I found WebMD’s list of triggers for a flare [episode]:
“Common lupus triggers include:
Overwork
Lack of sleep
Stress
Sun exposure
Fluorescent or halogen lights
Infection
Injury
Stopping your lupus medicines
Other lupus drugs”
The same site has suggestions for dealing with lupus on a daily basis.
Okay, all there is to cover now is diagnosing lupus. Hah! There’s so much more information available. A new site for us, National Institute of Arthritis and Musculoskeletal and Skin Diseases, offers the following as far as diagnosing:
“Asking about your medical history and symptoms, and, if necessary, reading your previous medical records.
Asking if anyone in your family has lupus or other autoimmune diseases.
Performing a complete physical exam.
Taking samples of blood for laboratory tests, such as:
Antinuclear antibodies (ANA), a sensitive test for lupus. Almost all people with lupus with [sic] have a positive ANA. However, having a positive ANA does not mean you have lupus since totally healthy people can have a positive ANA.
Antiphospholipid antibodies, anti-smith, and anti-double-strand DNA antibodies, which doctors order when you have a positive ANA and can help determine if you have lupus.
Complete blood counts, to check for low platelet counts, low red blood cell counts, and low white blood cell levels, which can happen if you have lupus.
Metabolic panel to look for changes in kidney function.
Taking urine samples to check for abnormal levels of protein in the urine.
Performing a biopsy of the skin or kidney (when labs indicate there may be a problem with the kidney) by taking a small sample of tissue to examine under a microscope.”
Notice the mention of the kidneys.
Until next week,
Keep living your life!
SlowItDownCKD 