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When Cynthia Nichols-Jackson woke up one day and could barely get out of bed because her joints hurt so badly she obviously knew something was wrong. But what she didn't realize was how serious it was.
"At about age 26, right after I graduated from nursing school, I woke up one morning and was unable to get out of bed," says Nichols-Jackson. "I rested all day and the following day I went to my doctor. He felt it was just a flu-like symptom, but I just never recovered."
Cynthia was later diagnosed with lupus, an autoimmune disease that causes the immune system to attack the body's own tissue and organs. As in Cynthia's case, lupus often is difficult to diagnose because its symptoms mimic other illnesses. However, according to Joseph McCune, M.D., Director of the Rheumatology Clinic at the University of Michigan Health System, diagnosing lupus has greatly improved over the past 30 years.
"In the past, because there were limited tests available to diagnose lupus, many patients were not diagnosed until they had already gravely damaged their organs," says McCune. "The ability to diagnose lupus, and the awareness of lupus among physicians, is much better than it used to be."
What is lupus?
Systemic lupus erythematosus (SLE) is an autoimmune disease. This means that your body's defenses against infection are attacking your own tissue, which causes inflammation. Areas of the skin or joints become painful, red, and swollen. Other parts of the body can also become inflamed, including the muscles, kidneys, nervous system, blood, lungs, and heart. Kidney disease affects 50 percent of lupus patients.
According to the Lupus Foundation of America, it is estimated that approximately 1.4 million Americans have a form of lupus. McCune says more women than men suffer with this disease.
"Lupus usually affects women who are of child bearing age," McCune says. "Women are 10 times more likely than men to be affected. And, in non-white Americans, the rate of lupus is two to three times more prevalent."
The exact cause of lupus is not known. There may be an inherited tendency to develop the disease. In some people, lupus becomes active after exposure to sunlight, infections, or certain medications. However, lupus is not contagious. You can't give it to someone else.
What are the symptoms of lupus and how is it diagnosed?
Lupus can take many forms and does not affect everyone in the same way. Some of the more common symptoms are:
-Fatigue and weakness-Joint pain and swollen joints-Rashes-Baldness-Sensitivity to sunlight
"Patients with the new onset of lupus typically see their doctor because of a rash in sun-exposed areas, arthritis, chest discomfort, or fatigue," McCune notes. "When a physician suspects lupus, an antinuclear antibody test, or ANA, is performed to help determine if the patient's immune system is affected by lupus."
How is lupus treated?
There is no cure for lupus, but treatment is steadily improving. A variety of medications ranging from anti-inflammatory drugs (such as ibuprofen) to potent immune suppressive drugs may be needed at different times. Treatment will vary depending on the patient and can change as the disease changes within the patient. At the present time, there are highly effective therapies for lupus, but many of them also have severe side effects. An important focus of the lupus research being done at UMHS is focusing on reducing treatment side effects without compromising effectiveness.
"Another consequence of lupus can be heart disease," McCune notes. "The rate of heart disease in people who suffer from lupus is eight times that of someone who does not have the disease. In young women, it's 50 times as likely. Learning to prevent heart disease in lupus patients is also a major research endeavor here at the University of Michigan."
Living with lupus
"Many patients with lupus can achieve satisfactory control of most aspects of their illness and lead relatively normal lives," says McCune. "We tell our patients to eat right and exercise and keep their weight down, control their blood pressure, and not to smoke. So right from the beginning, we plan for the patient to live to the healthiest possible old age by improving their lifestyle."
Cynthia has learned to live with lupus. She manages her disease with medication and a healthy lifestyle. "I'm learning to eat not so much high fat foods and trying to exercise and increase my level of activity. This along with my medication is helping me remain healthy."
Facts about lupus
-Systemic lupus erythematosus (SLE) or lupus is an autoimmune disease.-Lupus is a chronic disease that rarely goes away completely.-The exact cause of lupus is not known.-Lupus can be managed with medications and maintaining a healthy lifestyle. There is no cure for lupus.-The Lupus Foundation of America estimates that approximately 1.4 million Americans have a form of lupus.-Ninety percent of individuals with the disease are women.-Lupus is two to three times more prevalent among non-white Americans.
For more information, visit the following websites:
U-M Health Topics A to Z: Lupus Erythematosushttp://www.med.umich.edu/1libr/aha/aha_lupus_crs.htm
UMHS -- Antinuclear Antibodies Test (ANA)http://www.med.umich.edu/1libr/aha/aha_antinucl_crs.htm
National Institutes of Health (NIAMS) -- Systemic Lupus Erythematosushttp://www.niams.nih.gov
Lupus Foundation of America, Inc.http://www.lupus.org
National Kidney Foundationhttp://www.kidney.org
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