Looking at Lupus: An Attack from Within

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Lupus  is a complex and mysterious disorder. It arises when the cells that are  supposed to protect your body from disease mistakenly assault your own healthy  cells and tissues. This attack from within can damage your joints, skin and  most other parts of your body. NIH-funded scientists are working to uncover the  causes of lupus and find better ways to diagnose and treat the disease.

"Just about anyone can get lupus, but it mostly affects young  women. It can rob them of the prime years of their lives," says NIH's Dr. Mark  Gourley, an expert on lupus and related disorders. The disease often strikes  between the ages of 15 and 44. Lupus afflicts about 9 times more women than  men. For unknown reasons, African American women are at especially high risk.

No one knows what causes lupus. But researchers suspect that a  combination of genes and the environment is to blame.

Lupus comes in different forms. The most common and serious type  is called systemic lupus erythematosus. It can cause severe problems throughout  the body. Other types can cause temporary skin sores after sun exposure or  long-term rashes that may lead to scarring.

Lupus can be difficult to diagnose because its symptoms vary so  widely. People with mild lupus may have just a few symptoms, such as skin  rashes or achy joints. In other cases, lupus can harm essential organs,  including the kidneys and brain.

"Diagnosis is one of the biggest challenges patients can face,"  says Gourley. "The most frequent and common symptom is overwhelming fatigue."  But extreme tiredness could be mistaken for many other disorders, including  sleep problems. Because of the variable symptoms, some patients can go for  months or years without an accurate diagnosis.

No single test can identify lupus, either. Your doctor might  perform some tests to rule out other possible causes of your symptoms. Blood  tests can also determine if you have certain immune system proteins called antibodies that might be a sign of  lupus. These tests also detect inflammation, an internal irritation and  swelling that can be caused by your immune system mistakenly attacking your own  healthy cells.

Lupus has no cure. But medicines and lifestyle changes can help  control it. Patients with joint or chest pain might use anti-inflammation  drugs, such as ibuprofen or naproxen. Corticosteroids are stronger drugs that  can suppress inflammation, but long-term use may lead to severe side effects.  Other drugs can block production or stop the function of immune cells.

In March 2011, a new medication called belimumab was approved by  the U.S. Food and Drug Administration. "It's the first new therapy to be  approved for lupus in over 50 years," says Gourley. The drug is expensive, and  it doesn't work for everyone. Still, it's led the way for several promising new  therapies now being tested in clinical trials.

You can take other steps to lessen or prevent lupus  symptoms. "Follow your typical mom's advice," says Gourley. "Get plenty of  sleep. Eat right. Take good care of your body and exercise. Wear sunscreen. And  if you're on medications, take them as your doctor recommends. That's the best  thing you can do for lupus."

Recognizing Lupus

Lupus symptoms can vary widely, but here are some common ones:

Pain or swelling in joints

Muscle pain

Fever with no known cause

Red  rashes, often on the face

Chest pain when taking a deep breath

Hair loss

Pale or purple fingers or toes

Sensitivity to the sun

Swelling in legs or around eyes

Mouth ulcers

Swollen glands

Feeling very tired

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