The cause of lupus is unknown. However, research into the disease has provided
evidence implicating hormones and infection (including viruses). There is some
evidence that some people may have a genetic predisposition.
Who is at risk?
Lupus affects 8-10 times as many women as men, and it is usually seen in women
of childbearing years. While it occurs more often in women of Afro-Caribbean
and Asian origin (affecting 1 in 250 compared with 1 in 1,000 European women),
it is becoming more common throughout Europe and the Americas. Only 10% of all
lupus patients are male, and the reason for this is not known.
Lupus can lie dormant in the body for many years until some external trigger
activates the disease.
What can trigger Lupus?
Lupus can be activated by a number of events, including
- exposure to sunlight.
- medication: this form of lupus is known as 'drug-induced lupus' and it is
usually reversed when the medication is stopped.
- major trauma.
- the menopause.
- viral infection.
There is no typical pattern of presentation with lupus. The tissues that are
affected will determine the symptoms.
The skin: About half of all lupus patients will suffer from a facial
rash. It usually takes the form of a distinctive butterfly-shaped rash, which
spreads over the cheeks and across the bridge of the nose. Other areas of the
body, which are exposed to the sun on a regular basis, such as the arms, wrists
and hands, may also develop a rash.
It is also common for lupus patients to develop a pinkish, spotty rash on the
elbows and around the fingers and toes. This is caused by inflammation in small
blood vessels under the skin.
A condition known as 'Raynaud's Phenomenon' is also another feature of lupus.
This is caused by poor circulation and manifests itself in the hands where the
skin will turn white and then blue again when exposed to cold.
The hair: Some degree of hair loss will be noticed in most lupus patients.
This can be very alarming and upsetting, but the hair will grow back when the
attack subsides. It may take several months for the hair to re-grow.
The joints: Almost all lupus patients will have problems with their
musculoskeletal system, and some will go on to develop arthritis. Among the
most commonly affected joints are those in the fingers, hands, wrists and knees.
During a severe flare-up of lupus there will usually be pain and swelling all
over the body, affecting muscles, ligaments and joints.
The kidneys: Roughly one-third of all lupus patients will develop inflammation
of the kidneys. It must be pointed out that lupus does not usually cause kidney
problems unless the disease is very severe. Filtration of the kidneys by means
of dialysis, or a kidney transplant, may be considered where there is severe
The heart and lungs: While lupus may affect the heart and lungs directly
in a small number of patients, it is more common for the tissues lining these
vital organs to become inflamed. These tissues are known as pericardium (lining
the heart) and pleura (lining the lungs) and inflammation of these tissues is
known as pericarditis and pleurisy respectively. The inflammation results in
the accumulation of fluid in these tissues leading to chest pains and shortness
The tendons: During an active flare-up of lupus there may be inflammation
in the tendons. This may cause the patient to be unable to fully extend their
fingers. It may also cause walking difficulties if the tendons in the toes are
The brain and nervous system: In very severe forms of lupus, the lining
tissue of the brain and nervous system may become affected. However, this is
very rare indeed. It is true to say that many patients suffering from lupus
experience depression and anxiety from time to time. In some cases, counselling
for the lupus patient and his or her family may be considered appropriate.
Blood: Most lupus patients (over 85%) will develop blood disorders at
some point. Anaemia is the commonest disorder they experience. In rare cases
clotting disorders may occur.
How is lupus diagnosed?
Given the diverse pattern of presentation lupus may remain undetected for years.
There is a specific antibody blood test, which is present in the majority of
In addition to blood and urine tests, your GP will probably refer you for a
number of specific laboratory tests to establish the extent of the disease.
These tests will usually focus on the kidneys, the heart and lungs.
What is the treatment?
There is no known cure for lupus, but with modern medical advances, the disease
can be kept under control.
Your GP will probably prescribe non-steroidal anti-inflammatory drugs (commonly
known as NSAIDS) for inflammation in the joints and tendons. Anti-malarial drugs
are occasionally used since they have been noted to have a beneficial effect
in modifying the course of the disease.
Where there is damage to the lungs or heart as a result of lupus, your GP will
prescribe a course of steroids. These drugs have a very powerful effect on inflammation.
The strength and duration of treatment are determined by the severity of the
Hospitilisation may be required to control more severe manifestations of lupus.