Also called: SLE, systemic lupus erythematosus

An illness that occurs when the immune system attacks healthy tissues and organs.

Systemic lupus erythematosus is a long-lasting, known as chronic, illness that can affect many parts of the body. These can include joints, skin, kidneys, blood cells, brain, heart and lungs.

Common

More than 200,000 US cases per year

Treatment can help, but this condition can't be cured

Requires a medical diagnosis

Lab tests or imaging always required

Chronic: can last for years or be lifelong

Symptoms

Requires a medical diagnosis

Symptoms can come on quickly or slowly. They can get worse for a while, then get better, which is called a flare. A common sign is a rash over the cheeks and nose in the shape of a butterfly. But not everyone gets the rash.

What causes lupus?

Many (but not all) scientists believe that lupus develops in response to a combination of factors both inside and outside the body, including hormones, genetics, and environment.

Hormones

Hormones are the body’s messengers. They regulate many of the body’s functions. Because nine of every 10 occurrences of lupus are in females, researchers have looked at the relationship between estrogen and lupus.

While men and women both produce estrogen, its production is much greater in females. Many women have more lupus symptoms before menstrual periods and/or during pregnancy when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus. However, no causal effect has been proven between estrogen, or any other hormone, and lupus. And, studies of women with lupus taking estrogen in either birth control pills or as postmenopausal therapy have shown no increase in significant disease activity. Researchers are now focusing on differences between men and women, beyond hormone levels, which may account for why women are more prone to lupus and other autoimmune diseases.

Genetics

Researchers have now identified more than 50 genes which they associate with lupus. These genes are more commonly seen in people with lupus than in those without the disease, and while most of these genes have not been shown to directly cause lupus, they are believed to contribute to it.

In most cases, genes are not enough.  This is especially evident with twins who are raised in the same environment and have the same inherited features yet only one develops lupus. Although, when one of two identical twins has lupus, there is an increased chance that the other twin will also develop the disease (30% chance for identical twins; 5-10% chance for fraternal twins).

Lupus can develop in people with no family history of it, but there are likely to be other autoimmune diseases in some family members.

Certain ethnic groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent) have a greater risk of developing lupus, which may be related to genes they have in common.

Environment

Most researchers today think that an environmental agent, such as a virus or possibly a chemical, randomly encountered by a genetically susceptible individual, acts to trigger the disease. Researchers have not identified a specific environmental agent as yet but the hypothesis remains likely.

While the environmental elements that can trigger lupus and cause flares aren’t fully known, the most commonly cited are ultraviolet light (UVA and UVB); infections (including the effects of the Epstein-Barr virus), and exposure to silica dust in agricultural or industrial settings.

Other examples of potential environmental triggers include:

• Ultraviolet rays from the sun and/or fluorescent light bulbs
• Sulfa drugs, which make a person more sensitive to the sun, such as: Bactrim® and Septra® (trimethoprim-sulfamethoxazole); sulfisoxazole (Gantrisin®); tolbutamide (Orinase®); sulfasalazine (Azulfidine®); diuretics
• Sun-sensitizing tetracycline drugs such as minocycline (Minocin®)
• Penicillin or other antibiotic drugs such as: amoxicillin (Amoxil®); ampicillin (Ampicillin Sodium ADD-Vantage®); cloxacillin (Cloxapen®)
• Infection, colds or viral illnesses
• Exhaustion
• Emotional stress, such as divorce, illness, death in the family, or other life complications
• Anything else that causes stress to the body such as surgery, physical harm, injury, pregnancy, or giving birth

Can anything be done to slow or prevent the development of lupus?

Early diagnosis, as well as avoiding triggers for the disease, such as excessive exposure to the sun, can aid in the management of lupus. A rheumatologist -- a specialist in conditions of the muscles, joints, and bones -- can treat lupus with a number of medications that can effectively slow the progress of disease. However, therapy is often tailored to lessen the individual's particular 

Lupus symptoms include:

• Muscle and joint pain. You may experience pain and stiffness, with or without swelling. This affects most people with lupus. Common areas for muscle pain and swelling include the neck, thighs, shoulders, and upper arms.
• Fever. A fever higher than 100 degrees Fahrenheit affects many people with lupus. The fever is often caused by inflammation or infection. Lupus medicine can help manage and prevent fever.
• Rashes. You may get rashes on any part of your body that is exposed to the sun, such as your face, arms, and hands. One common sign of lupus is a red, butterfly-shaped rash across the nose and cheeks.
• Chest pain. Lupus can trigger inflammation in the lining of the lungs. This causes chest pain when breathing deeply.
• Hair loss. Patchy or bald spots are common. Hair loss could also be caused by some medicines or infection.
• Sun or light sensitivity. Most people with lupus are sensitive to light, a condition called photosensitivity. Exposure to light can cause rashes, fever, fatigue, or joint pain in some people with lupus.
• Kidney problems. Half of people with lupus also have kidney problems, called lupus nephritis.3 Symptoms include weight gain, swollen ankles, high blood pressure, and decreased kidney function.
• Mouth sores. Also called ulcers, these sores usually appear on the roof of the mouth, but can also appear in the gums, inside the cheeks, and on the lips. They may be painless, or you may have soreness or dry mouth.
• Prolonged or extreme fatigue. You may feel tired or exhausted even when you get enough sleep. Fatigue can also be a warning sign of a lupus flare.
• Anemia. Fatigue could be a sign of anemia, a condition that happens when your body does not have red blood cells to carry oxygen throughout your body.
• Memory problems. Some people with lupus report problems with forgetfulness or confusion.
• Blood clotting. You may have a higher risk of blood clotting. This can cause blood clots in the legs or lungs, stroke, heart attack, or repeated miscarriages.
• Eye disease. You may get dry eyes, eye inflammation, and eyelid rashes.