Lupus Symptoms, Causes, and Diagnosed

Systemic lupus erythematosus (SLE) or lupus is a condition of chronic inflammation caused by an autoimmune disease. Autoimmune diseases are illnesses that occur when the body's tissues are attacked by its own immune system. One of the mechanisms that the immune system uses to fight infections is the production of antibodies. 

Patients with lupus produce abnormal antibodies in their blood that target tissues within their own body rather than foreign infectious agents. Because the antibodies and accompanying cells of inflammation can involve tissues anywhere in the body, lupus has the potential to affect a variety of areas of the body. Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints, and/or nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).

Its cause:

The precise reason for the abnormal autoimmunity that causes lupus is not known. Inherited genes, viruses, ultraviolet light, and drugs may all play some role. Genetic factors increase the tendency of developing autoimmune diseases. Its cause is unknown. It is likely that a combination of genetic, environmental, and possibly hormonal factors work together to cause the disease.

Its sign and symptoms

Patients with SLE can develop different combinations of symptoms and organ involvement. Common complaints and symptoms include fatigue, low-grade fever, loss of appetite, muscle aches, arthritis, ulcers of the mouth and nose, facial rash ("butterfly rash"), unusual sensitivity to sunlight (photosensitivity), inflammation of the lining that surrounds the lung (pleuritis) and the heart (pericarditis), and poor circulation to the fingers and toes with cold exposure (Raynaud's phenomenon). More serious organ involvement with inflammation occurs in the brain, liver, and kidney. White blood cells and blood clotting factors also can be decreased in SLE, thereby increasing the risk of infection and bleeding.

What are the symptoms of Lupus?

Symptoms of Lupus vary widely depending on the individual case and the form of Lupus present. Most people with Lupus do not experience all of these symptoms. This list only serves to alert people to clues that might indicate the presence of Lupus in an undiagnosed person.

• Achy or swollen joints
• Persistent fever over 100 degrees
• Prolonged, extreme fatigue
• Skin rashes, including a butterfly-shaped rash across cheeks and nose
• Pain in the chest on deep breathing
• Anemia
• Excessive protein in the urine
• Sensitivity to sun or ultraviolet light
• Hair loss
• Abnormal blood clotting problems
• Fingers turning white and/or blue in the cold
• Seizures
• Mouth or nose ulcers lasting longer than two weeks       

How is systemic Lupus diagnosed?

Physicians have to gather information from a variety of sources: past medical history, lab tests and current symptoms. They use a list of 11 criteria to help diagnose SLE. A person needs to satisfy at least 4 out of the 11 criteria before the diagnosis can be pinpointed. Some criteria, such as a biopsy diagnosis of kidney Lupus, can carry more weight.

Of the 11 criteria, 7 relate to symptoms and 4 have to do with lab tests. The ANA test is used as a screening test for systemic Lupus. We know that 95% of people with SLE have a positive ANA. Therefore, if a person has many symptoms of systemic Lupus and their ANA test is negative, that's generally regarded as pretty good evidence against Lupus being the explanation for the symptoms they are having.

If on the other hand, the ANA comes back positive, that IS NOT proof of Lupus. The positive ANA is only an indicator; it is not diagnostic. A positive ANA can be found in a number of illnesses and conditions including rheumatoid arthritis; Sjögren's syndrome; and scleroderma; infectious diseases such as mononucleosis; malaria; and subacute bacterial endocarditis (SBE); and other autoimmune diseases including autoimmune thyroid disease and autoimmune liver disease.

Certain medications can also cause a positive ANA. About 20% of the general population when tested will have a positive ANA and not have any of the above mentioned illnesses. The ANA is only a test and like a high cholesterol value, a positive ANA doesn't necessarily equate with having a disease.

So, a positive ANA, by itself, is not diagnostic of any one particular disease and may be present in people who have no illness. Although it is often referred to as "a Lupus test," it is not like a pregnancy test where a positive result can mean only one thing. The ANA is only an indicator, which points in several possible directions. A positive ANA satisfies only one criterion. A person would need to satisfy at least 3 additional criteria. 

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