This week  Dr Ciarán  Roarty of Scally McDaid Roarty Medical Practice takes a look at an interesting condition called Lupus  (Systemic Lupus Erythematosus).

Lupus or Systemic Lupus Erythematosus (SLE) to give the full title, is a chronic disease that causes inflammation in different parts of the body and can cause a variety of symptoms depending on what part is affected.

These range from tiredness (due to anaemia) depression, anxiety,  right through to joint pains, headaches, chest pain and even mouth ulcers. It tends to affect women more than men and about 1 in 1000 people are affected. The typical patient is female in her 20s, 30s or 40s. 

It is caused by the body’s own immune system attacking the body’s own cells. It is not fully understood what causes it and while there seems to be some hereditary factor, there are other factors involved also. Sunlight, infections and even certain medicines may have a role. 

How does it affect the patient?

Joint and muscle pain are very common in SLE, particularly in the small joints of the hands and feet. The pain can “hop” from one joint to another and stiffness is more common in the morning. Rashes may develop, particularly a very specific type of “butterfly” pattern rash on the face, but rashes elsewhere are common also. Mouth ulcers are common in people with SLE as well as hair thinning. Anaemia is common, though usually mild and lymph nodes may swell. Pleurisy (inflammation of the lining of the lungs and inner chest wall) and chest pain may occur as well as problems with the kidneys. Depression and anxiety are not uncommon as well as headaches. Tiredness is also a common feature. Symptoms tend to flare up from time to time and then settle again. 

How will I know if I have it?

If your doctor suspects Lupus they will send certain blood tests.  Once diagnosed, regular monitoring of blood tests are required. Other scans and x-rays may be required depending on the part of the body affected. 

Can it be treated?

We cannon cure Lupus but we can usually help ease the symptoms. Specialists will oversee treatment but usually medications such as anti-inflammatory drugs and even steroids are used. More severe cases may require medicines to settle the immune system. 

Will I get better? 

The outlook for patients with Lupus is very good and active normal life is usually possible. Treatments are good and while joint pain and skin symptoms are annoying they can usually be managed well with medicines. Serious complications tend to occur within the first 10 years so after that, they are unlikely to occur. Severe disease where the kidneys or brain are affected can be life-threatening but modern immunosuppressive treatments have greatly improved outcomes even in these rarer cases. 

Lupus can cause an increased risk of miscarriage but in the case of mild or well-controlled Lupus, pregnancy tends to uneventful.  Kidney involvement may cause blood pressure problems, however. 

The above information is intended as advice only and should you have any concerns please contact your own Doctor. 

Dr Ciarán Roarty MB, BCh BAO MICGP DRCOG Grad. Cert. Obst. Ultrasound is a full-time GP  at Scally McDaid Roarty Medical Practice, Scally Place, Letterkenny,  Tel 0749164111

scallys.ie


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