Get Well Wednesday: The Truth About Lupus

My little sister was diagnosed and passed away from symptoms of lupus in 2008 at the age of 24. She was diagnosed with mental illness prior to her lupus diagnosis at 16. Would the mental issues and lupus be correlated?

Unfortunately, it is doubtful that the mental illness is due to lupus, but – lupus CAN cause mental issues in many forms, from depression to seizures, so if there is a concern for others and the appropriate testing for “central nervous system disease” due to lupus, or “neuropsychiatric” lupus, were never performed, then you or your loved one should see a neurologist or a rheumatologist to have those tests performed..

Is it true that if you have one auto-immune illness you are likely to develop another one, because I have Hashimoto’s and it can be triggered by pregnancy and lupus is triggered the same way in 4 other women I know.

Having one autoimmune condition does not mean you will necessarily develop another, but it does mean that your immune system is “overactive” and some autoimmune conditions do overlap. Hashimoto’s is commonly seen in patients with lupus and whenever we see patients with Hashimoto’s we generally will look for signs or symptoms of lupus. Many autoimmune illnesses will occur around the time of pregnancy and just following delivery. Lupus is at the top of that list.

I have been diagnosed with systemic scleroderma and it is the same symptoms as lupus.

Good Question! Scleroderma, also called Progressive Systemic Sclerosis (PSS) can overlap with lupus or be a separate entity. Some of the symptoms are similar but the PSS can be more aggressive in areas such as the lung, blood vessels and GI tract. This can be a tough disease, so make certain that you stay “glued” to your doctor to anticipate and prevent irreversible damage.

What is the difference between lupus and fibromyalgia?

Lupus is an inflammatory illness and fibromyalgia is a neurologic illness characterized by diffuse soft tissue pain and tenderness. There is no internal organ damage in fibromyalgia and steroids or other immune suppressing drugs are NOT indicated in fibromyalgia.

If I’m already diagnosed with RA, can that also mean I’ll get lupus?

About 10% of patients with lupus have an arthritis that looks almost identical to the arthritis of rheumatoid but fortunately most patients with the arthritis of lupus have a milder form of arthritis. One does not lead to the other, but many patients with lupus may initially present only with joint pain and are incorrectly diagnosed with RA only to find, after continued observation, that they really had SLE to begin with!

My sister died in 2010 after having lupus for 20 years. She was only 37 years, though. Is there some type of test that I can take to screen me for this disease? My mother also has it too.

A: I am terribly sorry about the loss of your sister. If you are not having symptoms of lupus, then I WOULD NOT SCREEN FOR THE DISEASE. There is a 25% chance that you will have a positive lupus test – but – there is only about a 3-5% chance that you will develop a disease called lupus.

Not everyone who has a positive ANA (lupus test) gets lupus and having the positive test will only worry you and your family. If you develop symptoms of an autoimmune condition (arthritis, sun-sensitive facial rashes, chest pain with inspiration (inhalation) then proceed with the testing. Screening in asymptomatic patients is full of pitfalls!

Are lupus and sarcoidosis related? The symptom are similar.

Both are inflammatory conditions, can have similar symptoms and both are prevalent in the African-American population. They can occur together.

I’m being tested for lupus on the 11th of June because of the lesions I’ve been suffering with since las August and I still have the itching though I was prescribed ointment. Is this normal with lupus?

A: Some lupus rashes are more difficult to treat than others. Creams and ointments are generally tried first and if not effective there are a number of oral meds which are more powerful and effective. There are also meds for the itching.

What are some of the early symptoms of lupus?

Often the symptoms are subtle, such as increased fatigue, low grade fever, hair shedding and occasional facial rashes with sun exposure. Morning stiffness may become an issue and pain and swelling in the small joints of the hands and wrist.

My mother died from lupus leaving my brother and I in the foster care system. Does the disease make one have seizures?

I am so very sorry for the loss of your mother. It is often a hole in your soul that is difficult to fill. Stay encouraged as time heals many wounds. I am proud of the strength that you and your brother have demonstrated. Yes, lupus can cause central nervous system (brain) conditions, including seizures. Rest assured, if it is due to lupus it is treatable.

My daughter has several unexplained symptoms. She has seen several different specialists that seem to look at her symptoms in isolation. What type of physician should she go to that would look at her symptoms as a whole and review the whole record. Her symptoms: idiopathic angioedema of hands, wrists and feet; anemia, occasional chest pain and now (new) small white spots on torso and face.

This certainly sounds like a multisystem disease. Angioedema is diagnosed and treated by rheumatologist but if the other skin lesions (white spots) are not consistent with a rheumatological illness a dermatologist may be consulted as well. Consider seeing either or both.

Is lupus related to gout?

Both are inflammatory forms of arthritis but other than that, they are not related.

Is lupus contagious?

Not at all! You can feel free to hug someone with lupus today!!

What are the first signs of lupus – is it hereditary?

A: Patients can present with a variety of symptoms from mild arthritis and rashes, to full blown kidney disease and lung infiltrates! Most patients present with joint aches, sun sensitive skin rashes, fatigue and mild hair shedding. The disease is not hereditary but one does inherit the genes which place them at risk for the development of the illness and then one requires some stimulus to cause the disease to become active. There can be a number of stimuli including pregnancy, infections, traumatic accidents, viral illnesses and stress.

What are your thoughts on BENLYSTA, the only treatment in 50 years?

Great drug for moderately severe disease. For severe internal organ problems, it is not very potent.

In order for a lupus diagnosis to be made does the patient have to display symptoms of a flare up? I have displayed many symptoms from extreme hair loss, extreme fatigue, heart palpitations, swelling, facial rashes, I’ve had blood work that showed ANA speckled patterns in one test and nothing when re-tested.

I have seen just about every doctor with an -ologist behind their names both civilian and military and the VA came up with depression. I can agree with that diagnosis, however my symptoms which display physically, aren’t in my mind. Sometimes I just want to give up!

Not always. If the blood tests are rock solid positive that may be enough for a diagnosis to be confirmed. Most patients SHOULD have clinical findings for a diagnosis to be confirmed. It can be a diagnosis that is difficult to pin down so remain diligent.

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