What is Lupus?
Lupus is an autoimmune disease where the body produces antibodies, normally used to fend off infections and diseases, that actually work against the body's own healthy cells. It is a chronic condition that affects every patient differently. It is known as the disease of many faces because so many of the symptoms can resemble other minor conditions (such as the flu or a cold), and it can often be misdiagnosed. It is estimated that the average patient sees three doctors and can suffer symptoms for as long as four years before a diagnosis is reached (www.lupus.org).
Once the disease is diagnosed, however, treatment can only focus on alleviating the symptoms, as there is no cure for lupus or treatment that will keep the body from producing antibodies.
It is estimated that approximately 1.5 million Americans are affected by lupus and one of its manifestations (www.lupus.org): systemic lupus erythematosus, discoid lupus erythematous, drug-induced lupus erythematosus, and neonatal lupus. Lupus can occur at any age, usually in women between the ages of 18 and 24, and may present for the first time during pregnancy or shortly after giving birth. It is unclear why the disease occurs more in women than in men, or why "African Americans are three to four times more likely than Caucasians to develop the disease" (www.csmc.edu).
Commonly reported symptoms include:
- extreme fatigue
- painful or swollen joints
- unexplained fever
- anemia (low levels of red blood cells or low total blood volume)
- swelling (edema) in feet, legs, hands, and/or around eyes
- pain in chest on deep breathing (pleurisy)
- butterfly-shaped rash across cheeks and nose
- sensitivity to light or sunlight
- hair loss
- abnormal blood clotting
- fingers turn white and/or blue when cold
- ulcers in the mouth and nose
None of these symptoms either on their own or in combination are any guarantee or indication that a person has lupus.
The Effects of Lupus on the Lungs
The effects of lupus are usually most noticeable in the joints, skin, kidneys, heart, lungs, blood, or brain. The cardiopulmonary system is responsible for pumping oxygenated blood throughout the body, and pumping low-oxygenated blood back to the lungs where the carbon dioxide is processed out. Anything that happens to compromise the function of any major or minor muscles or tissues can affect a person's overall health.
One of the most common side effects of lupus is inflammation of the lung tissue (acute lupus pneumonitis) and the linings of the chest cavity so that breathing is painful, and there is the increased risk of pneumonia (www.csmc.edu). Many people with lupus experience pain when they breathe, but it doesn't necessarily mean there is something "wrong" with the lungs (such as pleurisy or pneumonia). The pain may be an indication of inflammation of the chest muscles, cartilage, ligaments, or costochondral joints (the joints that connect the ribs to the breastbone)--in these conditions the lungs aren't affected at all.
Those for whom lupus causes blood to clot too easily are at higher risk of developing blood clots (pulmonary emboli). There is also the chance of pulmonary edema (build up of fluid in the lungs) from heart or kidney problems, but this is extremely rare.
Lung conditions that can be associated with lupus include:
Pleuritis - This happens when the pleura (the lining that covers the outside of the lungs) becomes inflamed. Symptoms include a severe, sharp, stabbing pain in a certain area or areas of the chest, which worsens on deep breathing, coughing, sneezing, or laughing. This pain is called "pleurisy." Many patients experience shortness of breath associated with this condition, as well. "Sometimes an abnormal amount of fluid will build up in the space between your lungs and your chest wall; when it leaks out it is called pleural effusion. Pain from pleurisy, with our without effusions, is found in 40 to 60 percent of people with lupus" (www.lupus.org).
Pneumonitis - This is the inflammation of lung tissue. Symptoms include: fever, chest pain, shortness of breath, and cough. The inflammation is usually caused by bacteria, viruses, or fungi.
Chronic Diffuse Interstitial Lung Disease - Chronic inflammation of the lungs can lead to scarring and this scarring in turn prevents the effective swap of oxygen for carbon dioxide in the blood. Symptoms include: a chronic dry cough, chest pain, and difficulty breathing during physical exertion.
Pulmonary Emboli - This was mentioned a little earlier. Pulmonary emboli are blood clots that block the arteries leading to the lungs, and can cause chest pain and shortness of breath.
General Stay Healthy Pointers for Lupus Patients
- get enough sleep
- exercise regularly
- stop smoking (smoking increases the risk of cardiovascular disease and makes the effects of lupus worse on the heart and blood vessels)
- limit alcohol use to limit its effects on the liver, kidneys, hearts and muscles
- eat a healthy, balanced diet
- seek medical counseling if considering becoming pregnant to find out protocols for ensuring a safe pregnancy, and to reduce risks to yourself and the baby
- reduce stress and find ways to relax
- build a support system of family, friends or an organized lupus support group (www.csmc.edu)
Sources: www.lupus.org; www.cnn.com; www.csmc.edu (Cedars-Sinai); http://lupus.webmd.com