EXPERT INFORMATION ABOUT LUPUS TREATMENT

Nine out of ten people with lupus are women, and it strikes most often when they're 15-44 years old. All of us produce beneficial antibodies that fight against harmful viruses and bacteria. But that's not the case when a woman has lupus. With lupus, her immune system goes haywire, producing antibodies that attack not invading germs, but the body's own healthy cells. In the process, it systematically damages many different tissues and organs, such as the skin, kidneys, lungs and heart. It is a lifelong disease, but most women live fairly normal lives even when they have it. Although there is no cure for lupus, treatments have improved dramatically in the last decade.

WHAT CAUSES LUPUS? It is partly genetic. If a twin has lupus, her identical twin, with the same genes, has a 20-30% chance of developing it too. Family history increases your risk, but 80% of those who get it have no family members with lupus. So, the environment matters, too. If a woman is exposed to silica dust (for example), that seems to increase her risk for lupus. Smoking and getting either too little Vitamin D or too much sun exposure can also trigger lupus. One form of lupus is induced by taking certain medications. We don't really know what causes this switch in the immune system.

WHAT MEDICATIONS CAN CAUSE LUPUS? There is a blood pressure drug, Hydralazine, and another for heart arrhythmia called Procainamide. They are not used a lot by women. There is one for rheumatoid arthritis called Infliximab, and that's used more often by women. Drug-induced lupus is rare and reversible. You are just switched to other medicines.

WHY IS LUPUS MORE PREVALENT IN WOMEN? Female hormones may help explain the sex disparity. Boys are about at likely as girls to get lupus before puberty. The shift happens when horomones kick in. On the other hand, women who take birth control pills or hormone replacement after menopause are not at higher risk for lupus. Women are advised to avoid high doses of estrogen as a precaution, because research suggests this might contribute to developing lupus.

IS THERE ANYTHING WOMEN CAN DO TO PREVENT THE DISEASE? There is no proven way of preventing lupus. Based on what raises the risk, we advise women not to smoke and to wear goggles or a mask if you're exposed to silica dust, to make sure your Vitamin D levels are normal and not to get too much sun.

WHAT ARE THE COMMON LUPUS SYMPTOMS IN WOMEN? Joint pain is what sends most women to the doctor. Fatigue is another huge problem - lots of women have had it for months, even years, and it feels like having the flu all the time. Loss of appetite, weight loss, low-grade fever and swelling in the legs are other typical symptoms of lupus. There may also be hair loss. More than half of people with lupus have rashes that worsen with sun exposure. It is called the butterfly rash, because it goes across on cheek, over the bridge of the nose and then across the other cheek.

IT IS HARD FOR DOCTORS TO GET A LUPUS DIAGNOSIS? It can be difficult for primary-care doctors to diagnose because you have to be able to see the pattern. If you're not thinking about lupus, you could easily conclude that the woman just has the flu or arthritis. Sometimes it takes women years to get an accurate lupus diagnosis.

IF A WOMAN SUSPECTS THEY HAVE LUPUS, WHAT ARE TESTS DOCTORS SHOULD GIVE TO DIAGNOSE IT OR RULE IT OUT? A good screening test is the antinuclear antibody blood test (ANA), and 99% of people with lupus will screen positive on it. You also should get a complete blood count test because it will usually show low white blood cells with lupus. Doctors also should test to see if you have protein in the urine, since that is an early tipoff that you might have lupus and that it's starting to harm your kidneys.

IF YOU SCREEN POSITIVE ON THE ANA, WHAT IS THE NEXT STEP TO AN ACCURATE DIAGNOSIS? At this point, it would be wise to ask for a referral to a rheumatologist. You will need a battery of more sophisticated tests to confirm lupus, and a specialist will know how to do them.

WHAT ARE THE DIFFERENT TREATMENTS IF YOU DO HAVE LUPUS? For many years the gold standard has been Cytoxan, which suppresses the immune system and helps keep symptoms of lupus manageable. But, it can put into early menopause and lead to dangerously low white blood counts or bleeding from the bladder. Some women take arthritis drugs, aspirin or steroids, depending on their symptoms of lupus. There is a new drug called Benlysta. It works well for 60-70% of patients, and that is a big response rate.

WHAT IS THE PROGNOSIS FOR WOMEN WITH LUPUS? Although there isn't a cure, the chances of living a pretty normal life are goo. Less than 10% of people with lupus die from it, and almost all of them are African-American. That's because they'r not just at higher risk to get the disease, they often have more severe cases.

Roughly 1.5 million Americans are afflicted with lupus. A diagnosis can be difficult, because the symptoms are sometimes intermittent and changing. Recent improvements in lupus treatment have made the condition somewhat easier to control.

source: www.lifescript.com