Lupus: see the main symptoms and forms of treatment

O lupus — known scientifically as SLE (Systemic Lupus Erythematosus) — is an autoimmune inflammatory disease that can affect several organs and tissues, including the skin, joints, kidneys and brain. According to the Brazilian Society of Rheumatology, it is estimated that there are around 65 thousand people with the disease in Brazil, the majority of whom are women.

An autoimmune disease is one in which the immune system attacks the body's own healthy tissues by mistake. Although the causes for this behavior of the immune system are not yet fully understood, the main suspicion is that it is related to genetic or external factors, such as the use of certain medications.

In the case of lupus, according to the Ministry of Health, hormonal, infectious, genetic and environmental factors may be involved in the development of the disease.

“Lupus has a higher prevalence in women, probably because of estrogen, the female sex hormone”, says Marco Antônio Araújo da Rocha Loures, president of the Brazilian Society of Rheumatology, to CNN . “Estrogen can facilitate this inflammatory process, causing women to have a higher incidence of systemic lupus erythematosus.”

Main symptoms of Lupus

According to the Ministry of Health, there are more than 80 autoimmune diseases and lupus is one of the most serious. Therefore, it is important that the diagnosis is made early to initiate the most appropriate treatment. In this sense, it is essential to know how to identify the signs from the beginning.

You lupus symptoms They may appear abruptly or develop slowly. Most patients present moderate symptoms, but the disease can also be mild or severe. Among the most common signs are:

• Fatigue;
• Fever;
• Joint pain;
• Muscle rigidity;
• Redness on the face (skin rash);
• Difficulty breathing;
• Chest pain when taking a deep breath;
• Sensitivity to sunlight;
• Enlarged lymph nodes;
• Loss of hair;
• General discomfort, anxiety and malaise.

Specific symptoms may also appear depending on the region of the body affected by the disease. This is the case with cardiac arrhythmia (heart), headache, seizures and vision problems (brain), coughing up blood (lung), irregular skin color (skin) and abdominal pain, nausea and vomiting (digestive tract).

Types of lupus

There are different types of lupus, which are characterized by their manifestations and causes. Are they:

• discoid lupus : affects the patient's skin, causing reddish lesions on the face, neck and/or scalp;
• Systemic lupus : is the most common and is characterized by inflammation throughout the patient's body;
• Drug-induced lupus : it is also common and occurs due to the use of substances or medications that can cause inflammation — the symptoms are similar to those of systemic lupus;
• Neonatal lupus : It is a rare type and affects newborn children of women who have lupus. At birth, the child may have a skin rash, liver problems or low blood cell count.

How is lupus diagnosed?

Diagnosing lupus can be challenging because it is a disease that has symptoms similar to those of other health conditions. “We call lupus a mimicking disease, that is, it can mimic, simulate another disease, both autoimmune and contagious”, explains Loures.

Therefore, differential diagnosis is essential for starting appropriate treatment and, consequently, improving the quality of life of people with lupus. “The important thing is to investigate the person’s history, family history, find out how the symptoms started and, from there, request tests”, adds the specialist.

The main tests that can help diagnose lupus are:

• Physical exam;
• Antibody tests;
• Complete blood count;
• Chest x-ray;
• Kidney or skin biopsy;
• Urine analysis.

How is lupus treated?

O lupus is a disease that still has no cure and, therefore, treatment aims to control symptoms and improve the person's quality of life. As Loures explains, the treatment is individualized . “As it is a genetic disease, it varies from patient to patient, even among people in the same family. We have more severe cases and others that are milder and, logically, therapy is carried out according to these characteristics,” he says.

According to the Ministry of Health, in general, mild lupus can be treated with anti-inflammatories, topical corticosteroids for those with skin lesions and low-dose corticosteroid medications. For severe lupus, the use of high doses of corticosteroids or medications to reduce the response of the body's immune system (immunosuppressants) and cytotoxic drugs (which block cell growth) may be indicated.

However, once again, the rheumatologist emphasizes: “Even though there are guidelines, treatment is individualized, because the patient may often have other comorbidities or may come with other associated immunological diseases”, he explains.

Main complications related to lupus

If not treated correctly, lupus can develop serious health complications. “The rheumatologist’s biggest concern is the kidney,” says Loures. “Patients who have severe lupus have several autoantibodies and this inflammatory process can damage the kidneys and lead to kidney failure. Many patients have to undergo dialysis and even kidney transplantation”, he adds.

Furthermore, if the disease reaches the brain, it can cause symptoms related to the nervous system, such as stroke, hallucinations, behavioral changes, mental confusion, dizziness and seizures. Diseases such as anemia and vasculitis (inflammation of blood vessels) are also among the main possible complications resulting from lupus.

To top it off, according to the Ministry of Health, lupus can lead to pleurisy, an inflammation of the tissues lining the lungs and rib cage. Finally, it can also cause, in some cases, inflammation of the heart muscles, increasing the risk of heart attack.