What is lupus?
There are two main forms of this autoimmune disease - Systemic lupus erythematosus and Discoid lupus erythematosus.
Systematic lupus erythematosus (SLE) is the most common and debilitating form which can cause inflammation of the joints, tendons, connective tissue and major organs such as the kidneys and heart. However, the most obvious symptom is a butterfly-shaped rash which occurs across the cheeks and nose.
Discoid lupus erythematosus (DLE) is the second most common form affecting the skin only. It produces a red, scaly rash which can appear all over the body and leave scars.
Lupus is characterised by the presence of large numbers of circulating autoantibodies against DNA, platelets, erythrocytes, nucleic acids and other nuclear materials (antinuclear antibodies - ANA). Immune complexes, especially those with anti - DNA antibody are deposited in connective tissue anywhere in the body, causing inflammation and degeneration of the tissue.
Inflammation of the blood vessels, known as vasculitis, can develop in many organs impairing blood supply to the tissue. This inadequate oxygen supply to the cells can lead to further inflammation and destruction of the tissue. This process can take place in several areas of the body simultaneously. Common sites include the joints, heart, skin, kidneys, lungs, brain and digestive tract. Diagnosis is based on the presence of multi system involvement and positive laboratory test results.
What causes it ?
The condition mainly affects women between the ages of 15 - 45 and is more frequent in African Americans and those people of Chinese or Japanese descent. Inherited genes, viruses, ultraviolet light and certain prescription drugs may all play a part. Immune thyroid disease and rhuematoid arthritis are more common among relatives of patients with lupus than the general population.
Some researchers believe that the immune system in lupus is more easily stimulated by external factors such as viruses and ultra violet light . They have also found that the prevalence of the disease in premenopausal women may be due to the female sex hormones, in particular oestrogen levels. Some prescription drugs have been reported to produce lupus symptoms but drug induced SLE is rare and ususally resolves when the medication is discontinued.
How can it be treated ?
There is no absolute cure for lupus but it can be controlled with careful monitoring and lifestyle changes. In conventional treatment there are 4 main types of drug which control the condition by reducing the over activity of the immune system - antimalarials and steroids (for both DLE and SLE ) and immunosuppressives and anti - inflammatories (SLE only).
Diet may help alleviate the symptoms. As with other inflammatory disorders, the type of fats consumed is crucial. As a general rule one should avoid animal fats and omega 6 type polyunsaturated oils e.g. safflower, corn and sunflower seed oils which promote inflammation in the body. The intake of omega 3 fats in the form of oily fish (salmon, mackeral and sardines), flaxseed or a good quality supplement should be increased. Many sufferers have intolerances to certain foods and it is important that these are identified and eliminated from the diet. It is important to drink plenty of water (1 1/2 - 2 litres daily ) to flush toxins from the body, particularly if the kidneys are involved.Alfalfa should be avoided in this condition as it contains L-canavanine which can trigger an autoimmune response in susceptible individuals.
For further information and advice contact Lupus UK at or the American Lupus Society.
