Could lupus be causing your health problems?

With a broad range of symptoms, lupus is an autoimmune disease that attacks normal tissues and cells, and can be tricky to diagnose. Here’s what you need to know.

When US singer, actress and beauty guru Selena Gomez revealed she has lupus in 2015 she put the spotlight on a condition that affects more than 25,000 Aussies.

Since then Selena has continued to share details about how the disease has affected her life, including a 2017 Instagram post when she revealed she had to have a kidney transplant after lupus damaged her kidney.

What is lupus?

Lupus is one of Australia’s least recognised major diseases.

When you have lupus, your immune system – which is supposed to protect you against infection – creates antibodies that attack your tissues and organs, such as the kidneys, brain, heart and joints.

This can cause cardiovascular disease, stroke and kidney disease.

There are four major types of lupus, but systemic lupus erythematosus (SLE) is the most common.

What are the symptoms of lupus?

The most distinctive sign of lupus is a facial rash that looks like the wings of a butterfly unfolding across both cheeks.

Monash Lupus Clinic head Associate Professor Alberta Hoi explains while lupus affects people in different ways, “(it) commonly causes inflammatory joint pain (and) skin rashes and (has the) potential for internal organ inflammation”.

Kidney damage is a common problem caused by lupus.

University of Sydney rheumatology Associate Professor Sean O’Neill says lupus can cause the damage over time.

“Around one third of those with lupus will experience kidney issues,” Assoc Prof O’Neill notes.

What causes lupus?

While there is not one cause, Assoc Prof Hoi says certain factors can contribute to the disease.

“Most of the time, causes are unknown but there are factors thought to be important, such as UV light, viruses and estrogen,” she says.

“Genetic predisposition plays a major part too.”

One thing is certain – women are more likely to experience lupus.

About 90 per cent of lupus sufferers are women, with many developing the disease between the ages of 15 and 40.

Because of this, research has delved deeper into the influence of estrogen.

Assoc Prof O’Neill says things like “the oral contraceptive pill, hormone replacement therapy, pregnancy or simply being a female can influence or flare up the disease”.

How is lupus diagnosed?

Lupus is difficult to diagnose because the symptoms are broad, can come and go, and may mimic other diseases.

Assoc Prof Hoi says diagnosis begins by identifying symptoms.

“The most common symptoms of lupus are fatigue, joint pain and skin rashes,” she says.

“The diagnostic process requires a level of clinical suspicion as these symptoms can occur in many other conditions.”

Assoc Prof O’Neill says there’s not a single straightforward test for lupus.

“People might have symptoms for years before they work out what’s going on, or a healthy person might have an ANA positive blood test, then fear they have lupus when they’re actually fine,” he explains.

ANA (antinuclear antibody) is the blood test used to screen for lupus, and a positive result is only the start of diagnosis.

“While those with lupus show a positive result, plenty of healthy people can come up positive too,” Assoc Prof O’Neill says.

“Once an ANA test is positive, there are more specific blood tests to do.”

How is lupus treated?

Treatment depends on severity and symptoms, Assoc Prof Hoi says.

“The spectrum of disease is broad, as some people have relatively mild symptoms, while others require daily medications and learn to live with the disease on a daily basis,” she says.

With no clear cure, lupus is often managed by medication, Assoc Prof O’Neill says.

“If you’re at the mild end of lupus, we use medications that you might stay on for years to improve symptoms,” he says.

Lifestyle changes can also keep symptoms in check.

“Sun exposure and infections can cause flare-ups, so sun avoidance and regular vaccination is really important,” Assoc Prof O’Neill says.

With proper treatment and management, Assoc Prof Hoi says, people with lupus lead fulfilling lives.

“The key lies in proper diagnosis, regular follow-ups, learning about symptoms and self-management techniques,” she says.

For more about autoimmune diseases:

Written by Hayley Hinze.