What
is
Lupus
*
Lupus
(pronounced
loo-pus)
is
the
name
of
a
group
of
diseases.
*
The
most
common
and
serious
type
of
lupus
is
called
systemic
lupus
erythematosus
(pronounced er-reeth-a-ma-toe-sus). Many people just call this type
by
the
name
lupus.
It
can
also
be
shortened
to
SLE.
*
With
SLE,
the
body’s
immune
system
stops
working
properly.
The
immune
system’s
job
is
to
fight
off
germs
and
disease. However, with SLE, the immune system attacks healthy tissues.
*
This
attack
on
healthy
tissues
causes
them
to
become
swollen
and
painful.
This
is
called
inflammation.
*
Inflammation
can
happen
in
the
skin,
muscles
or
joints.
The
heart,
lungs,
kidneys,
blood
vessels
or
the
nervous
system can also be attacked by the immune system.
*
With
SLE,
there
may
be
periods
of
inflammation,
called
flare-ups,
and
then
periods
where
there
is
little
or
no
inflammation, called remissions.
Lupus
is
the
name
given
to
a
group
of
chronic
autoimmune
diseases.
Systemic
lupus
erythematosus
(SLE)
is
the
most
common
and
serious
type
of
lupus.
With
SLE,
the
immune
system
that
normally
protects
the
body
from
germs,
viruses,
and
bacteria
begins
to
malfunction.
It
generates
antibodies
that
attack
healthy
tissue
in
different
parts
of
the
body.
These
tissues
become
inflamed
as
a
result.
Inflammation
can
occur
in
the
skin,
muscles,
joints,
heart,
lungs,
kidneys,
blood
vessels
and
the
nervous
system.
SLE
can
fluctuate
between
active
periods
(flare-ups
or
exacerbation),
and
times
of
minimal
symptoms
or
no
symptoms
(remission).
Other
types
of
lupus
are
discoid
lupus
erythematosus
(DLE)
and
subacute
cutaneous
lupus
(SCLE).
With
these
types
of
lupus,
skin
rashes
and
sun
sensitivity
are
the
main
symptoms,
and
the
internal
organs
are
not
attacked.
However,
approximately
10%
of
people
diagnosed
with
these
more
limited
forms
of
lupus
will
go
on
to
develop
symptoms
of
SLE.
How
common
is
lupus?
*
It
affects
15,000
(1
in
2,000)
Canadians.
*
Women
develop
lupus
up
to
10
times
more
often
than
men.
*
It
usually
occurs
in
women
between
the
ages
of
15
and
45.
Lupus
can
affect
men,
women,
and
children
of
any
age,
but
it
occurs
most
often
in
women
of
childbearing
age
(ages
15
to
45).
Systemic
lupus
erythematosus
(SLE)
is
eight
to
10
times
more
common
in
women
than
men.
What
are
the
warning
signs
of
lupus?
*
Pain
in
the
muscles
and
joints
of
the
hands,
arms,
shoulders,
feet,
knees,
hips
or
jaw.
The
pain
may
move
from
area
to
area
and
may
cause
the
skin
to
feel
hot,
be
red
or
swell.
*
Fever
and
loss
of
appetite.
*
Low
energy
and
fatigue.
*
Skin
rashes,
often
on
the
face.
Sometimes
the
rash
is
across
the
cheeks
and
bridge
of
the
nose.
This
is
called
a
butterfly
rash.
Sometimes
the
rash
is
red
and
scaly
and
appears
on
the
face,
scalp,
ears,
arms
or
chest.
A
milder
form
of
lupus
called
discoid
lupus
causes
this
type
of
rash.
*
Small,
usually
painless
sores
in
the
moist
lining
of
the
mouth
or
nose.
These
are
called
mucosal
ulcers
*
Feeling
of
being
very
sensitive
to
sunlight.
*
Changes
in
the
colour
of
the
fingers
when
they
are
cold.
*
Sudden
and
unexplained
weight
loss
or
gain.
*
Increase
in
the
number
and
severity
of
headaches.
*
Increase
in
loss
of
hair
over
the
whole
scalp.
*
Chest
pain
when
lying
down
or
taking
deep
breaths
*
Ongoing
high
blood
pressure.
*
Swelling
of
the
feet
and
legs.
SLE
is
a
different
disease
for
each
person
it
affects
because
it
can
target
any
of
the
body's
tissues.
Each
person
has
his
or
her
own
combination
of
symptoms
and
these
symptoms
range
from
mild
to
severe.
If
you
have
recently
experienced
three
or
more
of
the
warning
signs
of
SLE
you
may
want
to
discuss
this
with
your
doctor.
What
causes
lupus?
*
The
exact
cause
of
lupus
is
unknown.
*
Some
people
with
lupus
have
other
family
members
with
it.
*
Since
it
often
affects
women
during
their
childbearing
years,
there
may
be
a
link
between
lupus
and
hormones.
Hormones
are
substances
produced
by
the
body
that
help
different
organs
in
the
body
run
normally.
Certain
hormones
allow
women
to
be
able
to
get
pregnant.
Estrogen
is
an
example
of
a
hormone.
The
relationship
between
hormones
and
the
disease's
preference
for
women
of
childbearing
age
is
not
understood.
Certain
external
factors,
such
as
particular
medications,
viruses,
sun
exposure,
and
prolonged
and
severe
stress,
are
also
thought
to
trigger
the
onset
of
SLE.
This
is
also
not
fully
understood,
and
therefore
the
cause
of
lupus
will
be
unknown
until
scientists
gain
more
knowledge
about
the
functioning
of
the
immune
system.
What
can
you
do
about
lupus?
*
If
your
doctor
thinks
you
have
SLE,
he
or
she
will
usually
refer
you
to
a
rheumatologist
(pronounced
room-a-tol-o-jist).
A
rheumatologist
is
a
doctor
who
has
received
special
training
in
the
diagnosis
and
treatment
of
problems
involving
inflammation
of
the
joints,
muscles
and
other
parts
of
the
body.
*
If
your
doctor
thinks
you
might
have
SLE
or
another
form
of
lupus,
he
or
she
may
perform
a
physical
examination
and
order
laboratory
tests,
such
as
blood
tests.
There
is
not
just
one
single
symptom,
sign
or
test
that
will
give
a
diagnosis
of
SLE.
*
There
is
no
cure
for
SLE
but
there
are
things
you
can
do
to
manage
the
disease.
*
Learn
as
much
as
you
can
about
lupus.
Speaking
with
people
who
are
specialists
in
arthritis
care
can
provide
you
with
the
information
you
need.
At
this
time
there
is
no
cure
for
SLE.
Therefore
treatment
is
designed
to
control
the
symptoms
and
reduce
the
number
of
flare-ups.
Establishing
the
correct
diagnosis
is
important
because
something
can
be
done
to
manage
most
forms
of
arthritis
and
most
therapies
work
best
when
started
early
in
the
disease.
Diagnosis
of
SLE
can
be
difficult
because
the
symptoms
vary
from
person
to
person.
The
symptoms
can
also
mimic
those
of
other
medical
conditions.
If
your
doctor
thinks
you
might
have
SLE
or
another
form
of
lupus,
he
or
she
may
review
your
medical
history
and
symptoms,
and
may
perform
a
physical
examination
and
order
laboratory
tests,
such
as
blood
tests.
It
might
take
a
period
of
time
before
a
diagnosis
is
made.
Usually
a
diagnosis
can
be
made
when
there
is
evidence
of
a
number
of
the
main
warning
signs
of
SLE,
and
other
conditions
that
can
also
indicate
the
presence
of
SLE:
*
Pleuritis,
an
inflammation
of
the
lining
of
the
lungs,
or
pericarditis,
an
inflammation
of
the
lining
of
the
heart.
These
will
cause
chest
pain
when
lying
down
or
taking
deep
breaths.
*
Decreased
kidney
function,
which
may
be
mild
or
severe.
Weight
gain
or
swelling
of
the
feet
and
legs
may
indicate
kidney
involvement.
*
Central
nervous
system
involvement.
This
may
be
exhibited
by
seizures
or
psychosis
(acute
disturbance
in
mental
functioning).
*
Decreased
blood
cell
count
(lower
than
normal
amounts
of
circulating
red
blood
cells,
white
blood
cells
or
platelets)
*
Autoantibodies
present
in
the
blood.
These
point
to
an
abnormality
in
the
immune
system
response.
*
Antinuclear
antibodies
present
in
the
blood.
Your
doctor
may
reach
a
diagnosis
of
SLE
after
thoroughly
examining
the
combination
of
symptoms,
conditions,
and
test
results,
and
after
ruling
out
other
illnesses.
There
is
no
single
symptom,
sign
or
test
that
will
give
a
diagnosis
of
SLE.
If
you
are
diagnosed
as
having
SLE,
the
goal
of
your
treatment
plan
will
be
to
bring
the
symptoms
and
disease
under
control.
Some
people
with
SLE
may
require
no
treatment
if
their
symptoms
are
not
severe
and
the
disease
is
mild.
Treatment
plans
are
based
on
the
type
and
severity
of
symptoms,
and
are
individualized
to
meet
each
person's
needs.
Your
active
involvement
in
developing
your
prescribed
treatment
plan
is
essential.
If
you
are
a
woman
with
SLE
be
sure
to
discuss
birth
control
methods
with
your
doctor,
as
well
as
the
best
time
to
become
pregnant.
Birth
control
methods
and
pregnancy
can
change
the
level
of
hormones
in
your
body,
and
in
turn
can
have
an
impact
on
your
SLE.
Because
your
immune
system
will
not
be
working
properly
if
you
have
SLE
you
should
also
get
regular
immunizations
against
infectious
diseases.
Steps
should
also
be
taken
to
avoid
flare-ups.
Each
person's
pattern
of
lupus
flares
tends
to
be
unique.
A
person
with
lupus
may
be
able
to
detect
early
warning
signs
of
flares.
Early
detection
can
lead
to
more
effective
treatment
while
symptoms
are
in
the
beginning
stages
of
a
flare.
Medicine
Medications
are
often
prescribed
for
people
with
SLE.
This
approach
is
to
control
symptoms
and
help
bring
the
disease
into
remission.
The
variety
of
medications
commonly
used
depends
on
the
organ(s)
involved
and
the
degree
of
involvement.
*
Acetaminophen
is
often
given
to
manage
the
pain
of
SLE.
A
common
form
of
acetaminophen
is
Tylenol®.
It
can
relieve
pain
but
does
not
reduce
inflammation.
For
mild
to
moderate
SLE
doctors
often
recommend
acetaminophen
(Tylenol®,
Panadol®,
Exdol®,
etc.).
Acetaminophen
is
a
pain
reliever,
but
has
no
anti-inflammatory
properties.
For
this
reason
it
can
usually
be
safely
taken
along
with
most
prescription
medications,
should
these
also
be
needed.
However,
there
are
daily
limits
of
acetaminophen
that
can
be
taken,
so
caution
should
be
exercised,
particularly
if
other
medications
that
contain
acetaminophen
(for
example,
it's
found
in
many
cold
remedies)
are
being
used.
A
serious
overdose
of
acetaminophen
can
cause
liver
damage.
*
Nonsteroidal
anti-inflammatory
drugs
(NSAIDs
-
pronounced
en-seds)
are
a
type
of
medication
that
helps
reduce
inflammation.
NSAIDs
are
often
used
when
acetaminophen
does
not
control
the
pain
of
SLE.
NSAIDs
reduce
pain
when
taken
at
a
low
dose,
and
relieve
inflammation
when
taken
at
a
higher
dose.
NSAIDs
such
as
ASA
(Aspirin,
Anacin,
etc.)
and
ibuprofen
(Motrin
IB,
Advil,
etc.)
can
be
purchased
without
a
prescription.
Examples
of
NSAIDs
that
require
a
prescription
include
Naprosyn,
Relafen,
Indocid,
Voltaren,
Feldene,
and
Clinoril.
The
various
NSAIDs
and
Aspirin®,
if
taken
in
full
doses,
usually
have
the
same
levels
of
anti-inflammatory
effect.
However,
different
individuals
may
experience
greater
relief
from
one
medication
than
another.
Taking
more
than
one
NSAID
at
a
time
increases
the
possibility
of
side
effects,
particularly
stomach
problems
such
as
heartburn,
ulcers
and
bleeding.
People
taking
these
medications
should
consider
taking
something
to
protect
the
stomach,
such
as
misoprostol
(Cytotec).
There
are
also
several
side
effects
of
some
NSAIDs
that
can
either
imitate
symptoms
of
SLE
or
complicate
it
further.
*
Oral
cortisone
could
also
be
prescribed.
Cortisone
is
a
steroid
that
reduces
inflammation
and
can
control
your
immune
system.
Cortisone
is
a
steroid
that
reduces
inflammation
and
swelling
and
that
can
influence
regulation
of
the
immune
system.
It
is
a
hormone
naturally
produced
by
the
body.
Corticosteroids
are
man-made
drugs
that
closely
resemble
cortisone.
The
most
common
form
of
corticosteroid
is
called
prednisone,
taken
in
pill
form.
Prednisone
is
usually
considered
when
SLE
symptoms
are
not
being
controlled
by
other
treatments,
and
there
is
concern
about
an
imminent
flare-up,
or
the
disease
is
severe
and
perhaps
life
threatening.
For
some,
prednisone
is
a
life-saving
medication.
Prednisone
use
needs
to
be
carefully
monitored
because
of
its
many
side
effects,
and
the
drug
must
never
be
stopped
abruptly.
Some
of
the
side
effects
from
long-term
use
include
cataracts,
high
blood
pressure,
sleep
problems,
muscle
loss,
bruising,
thinning
of
the
bones
(osteoporosis),
weight
gain
and
increased
risk
of
infections.
The
goal
with
this
and
most
drugs
is
to
find
the
lowest
effective
dose
that
will
avoid
as
many
of
the
side
effects
as
possible.
*
Antimalarial
medications
help
in
managing
fatigue,
skin
rashes
and
joint
pain.
Antimalarials
were
originally
designed
to
treat
malaria,
but
have
been
found
to
be
also
effective
in
managing
some
of
the
symptoms
of
SLE,
such
as
fatigue,
skin
rashes
and
joint
pain.
Aralen
(chloroquine)
and
Plaquenil
(hydroxychloroquine)
are
examples
of
antimalarial
medications.
If
you
have
SLE
and
are
given
antimalarials,
keep
in
mind
that
it
may
take
several
months
before
you
feel
any
benefits
from
these
drugs.
The
most
common
side
effect
is
stomach
upset.
A
more
rare
but
serious
side
effect
affecting
the
eyes
can
occur
with
the
use
of
some
anti-malarials
that
are
taken
in
high
doses
for
a
long
period
of
time.
Loss
of
vision
can
occur
if
the
medication
accumulates
in
the
back
of
the
eyes.
This
side
effect
rarely
occurs,
but
for
this
reason
if
you
are
prescribed
an
antimalarial,
it
will
be
necessary
that
you
have
an
eye
examination
before
starting
the
medication,
and
get
regular
follow-up
eye
examinations.
*
Cytotoxic
drugs
can
be
used
to
control
inflammation
and
the
immune
system.
These
are
also
called
immunosuppressive
drugs.
Cytotoxic,
or
immunosuppressive,
drugs
are
a
group
of
powerful
medications
that
suppress
inflammation
and
the
immune
system.
You
may
be
prescribed
these
if
your
SLE
symptoms
are
difficult
to
control
with
prednisone
alone
or
if
you
are
experiencing
side
effects
from
prednisone.
Cytoxan
(cyclophosphamide),
Procytox
(cyclophosphamide)
and
Imuran
(azathioprine)
are
commonly
prescribed
cytotoxic
drugs.
Serious
side
effects
include
decreased
blood
cell
counts,
increased
risk
of
infection,
and
a
risk
of
developing
certain
types
of
cancer.
People
with
SLE
on
these
medications
must
have
regular
blood
tests
and
be
monitored
very
closely
by
their
doctor.
All
the
regularly
prescribed
medications
are
aimed
at
bringing
lupus
symptoms
under
control
and
bringing
about
a
remission
of
the
disease.
Early
treatment
can
reduce
the
chance
of
permanent
tissue
damage,
and
may
reduce
the
amount
of
time
a
person
with
SLE
needs
to
stay
on
high
doses
of
a
medication.
Diet
*
Maintain
a
well-balanced
diet.
If
you
have
SLE,
a
poor
diet
can
contribute
to
flare-ups.
*
Avoid
drinking
too
much
alcohol,
as
this
can
also
cause
flare-ups.
Once
your
SLE
is
brought
under
control
by
medication,
there
are
a
number
of
changes
you
may
have
to
make
to
your
lifestyle
to
minimize
the
possibility
of
future
flare-ups.
Certain
activities,
like
having
a
poor
diet,
can
contribute
to
lupus
flares.
Excessive
use
of
alcohol
and
smoking
can
also
trigger
inflammation
and
increase
symptoms.
Exercise
*
Regular
exercise
can
help
prevent
future
flare-ups.
It
can
help
you
manage
stress,
reduce
pain
and
keep
your
body
strong.
*
If
you
exercise
outdoors
be
sure
to
wear
sunscreen.
People
with
lupus
are
often
sensitive
to
sunlight,
and
too
much
exposure
to
it
can
cause
flare-ups.
Exercise
can
help
prevent
flare-ups
of
the
symptoms
of
SLE
and
can
help
you
feel
better
overall.
Stress
is
often
a
contributing
factor
in
flare-ups,
and
regular
exercise
reduces
stress.
There
are
three
main
types
of
exercises:
*
Range
of
motion
exercises
reduce
stiffness
and
help
keep
your
joints
moving.
A
range
of
motion
exercise
for
your
shoulder
would
be
to
move
your
arm
in
a
large
circle.
*
Strengthening
exercises
maintain
or
increase
muscle
strength
*
Endurance
exercises
strengthen
your
heart,
give
you
energy
and
control
your
weight.
These
exercises
include
walking,
swimming
and
cycling.
Always
consult
a
doctor
before
beginning
an
exercise
program.
Protect
Your
Joints
*
If
you
have
SLE,
your
joints
may
be
affected.
Protecting
your
joints
can
reduce
pain
and
fatigue.
*
Be
kind
to
your
body.
After
doing
heavy
work,
or
doing
the
same
task
over
and
over,
stop.
Slow
down
by
doing
an
easy
task,
or
by
taking
a
rest.
*
Use
your
back,
arms
and
legs
in
safe
ways
to
avoid
putting
stress
on
joints.
For
example,
carry
a
heavy
load
close
to
your
body.
*
Use
helpful
devices
such
as
a
cart
to
carry
your
grocery
bags,
or
an
enlarged
handle
that
fits
over
a
knife
handle
so
you
can
hold
it
easily.
If
you
have
SLE
your
joints
may
be
affected.
Protecting
your
joints
means
using
them
in
ways
that
avoid
excess
stress.
Benefits
include
less
pain
and
greater
ease
in
doing
tasks.
The
activities
to
protect
your
joint
can
also
help
you
reduce
fatigue.
Excessive
fatigue
has
been
shown
to
be
a
factor
in
flare-ups.
Three
main
techniques
to
protect
your
joints
are:
Pacing,
by
alternating
heavy
or
repeated
tasks
with
easier
tasks
or
breaks,
reduces
the
stress
on
painful
joints
and
allows
weakened
muscles
to
rest.
Positioning
joints
wisely
helps
you
use
them
in
ways
that
avoid
extra
stress.
Use
larger,
stronger
joints
to
carry
loads.
For
example,
use
a
shoulder
bag
instead
of
a
hand-held
one.
Also,
avoid
keeping
the
same
position
for
a
long
period
of
time.
Using
helpful
devices,
such
as
canes,
luggage
carts,
grocery
carts
and
reaching
aids,
can
help
make
daily
tasks
easier.
Small
appliances
such
as
microwaves,
food
processors
and
bread
makers
can
be
useful
in
the
kitchen.
Using
grab
bars
and
shower
seats
in
the
bathroom
can
help
you
to
conserve
energy
and
avoid
falls.
Relaxation
*
Relaxing
the
muscles
around
an
area
of
inflammation
reduces
pain.
*
Relaxation
can
also
help
you
manage
stress
and
fatigue.
*
There
are
many
ways
to
relax.
Try
deep
breathing
exercises.
Listen
to
music
or
relaxation
tapes.
Meditate
or
pray.
Another
way
to
relax
is
to
imagine
or
visualize
a
pleasant
activity
such
as
lying
on
a
beach,
or
sitting
in
front
of
a
fireplace.
Excessive
fatigue
and
uncontrolled
stress
can
contribute
to
the
risk
of
future
flare-ups
of
SLE.
Developing
good
relaxation
and
coping
skills
can
give
you
a
greater
feeling
of
control
over
your
arthritis
and
a
more
positive
outlook.
Support
and
counselling
is
available
to
help
you
deal
with
stress.
Outcomes
Persons
living
with
SLE
can
expect
to
live
a
relatively
normal
life
with
intervals
of
remissions
and
flare-ups.
By
following
the
advice
of
their
doctor,
taking
medication
as
prescribed,
and
seeking
help
for
side-effects
of
medications
or
new
symptoms,
most
people
with
an
early
diagnosis
of
SLE
can
look
forward
to
a
normal
life
span.
Some
people
have
severe
flares
requiring
hospitalization
and
intensive
treatment,
but
the
majority
are
never
hospitalized.
Additional
Tips
for
Living
Well
*
The
Arthritis
Society
offers
a
variety
of
programs
and
services
that
can
be
helpful.
*
You
can
reach
the
Society
at
1-800-321-1433
from
anywhere
in
Canada.
*
You
can
also
reach
us
through
our
Web
site
at
www.arthritis.ca
Along
with
the
physical
symptoms
of
arthritis,
many
people
experience
feelings
of
helplessness
and
depression.
Learning
daily
living
strategies
to
manage
your
arthritis
gives
you
a
greater
feeling
of
control
and
a
more
positive
outlook.
To
get
the
best
results,
people
affected
by
arthritis
need
to
form
close
ties
with
their
doctors
and
therapists,
and
become
full
partners
in
their
treatment.
From
our
perspective,
it's
all
part
of
'living
well
with
arthritis.'
There
are
several
resources
you
can
use
in
finding
out
how
best
to
manage
your
own
arthritis.
Here
are
a
few:
*
The
Arthritis
Self-Management
Program
(ASMP)
is
a
unique
self-help
program
offered
by
The
Arthritis
Society
to
help
you
better
control
and
manage
your
arthritis.
*
The
Open
Forum
within
this
Web
site
is
an
opportunity
to
discuss
and
share
information
with
other
visitors
-
people
who,
through
their
own
experiences,
may
be
able
to
offer
some
useful
insights.
special
stool
tests
are
needed
to
detect
it.
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