Peripheral Neuropathies: Lupus

Peripheral Neuropathies: Lupus Overview

Peripheral Neuropathies, Lupus, is often associated with a “butterfly rash” on the face. Its affects, however, are far from being as harmless as its namesake.

Lupus, or lupus erythematosus, is an autoimmune disease which causes the body’s immune system to mistakenly attack its own healthy tissue. Nearly any tissue including that of the muscles, skin, organs, blood and blood vessels, peripheral nerves, or the central nervous system can be affected. In 1 out of 10 Lupus-afflicted patients, only the skin is attacked, causing red, bumpy rashes (discoid/cutaneous lupus). The majority of cases, however, involve autoimmune complications with one or more major organs, which may or may not include the skin (systemic lupus). Lupus may also be called mixed connective tissue disease by physicians, due to multiple, “overlapping” disorders (such as scleroderma and polymyositis). Carriers additionally experience photosensitivity, where light may worsen rashes or discomfort.

The precise cause of Lupus is unknown, but it sometimes will occur more frequently in certain family lines (though scientists have not yet discovered any inherited genes associated with it).

Contributing factors such as stress, smoking, UV rays, infections, and even pregnancy or menstruation, can trigger flare-ups. There are also certain medications that have a tendency to cause drug-induced lupus, but this form of the disorder is rare (<10% of cases) and usually goes away within a few months after discontinuing use of the medication in question. Tetracycline, sulfa, diuretic, and antibiotic drugs are usually the causes of drug-induced lupus, but thorough diagnostics from your doctor should be performed before ceasing any of these medications.

Ethnicity, gender, & age seem to play a role in likelihood of developing symptomatic Lupus.

• Lupus may appear in anyone, anywhere in the world. However, the disorder has a statistical tendency toward appearing in people of African or Asian descent. It also commonly affects people of the Hispanic/Latino, Pacific Islander, or Native American races.
• Lupus occurs much more frequently in women than men according to the Lupus Foundation of America, approximately 90% of individuals diagnosed with the disorder are female.
• While Lupus can affect anyone at any stage of their lives, its symptoms usually appear between the ages of 15 and 45.

Lupus is an enigmatic disorder that takes many forms, and is sometimes difficult to diagnose.

Currently, it is estimated that around 1.4 million Americans, and more than 5 million people worldwide, suffer from Lupus. There are no “perfect”, definitive tests for pinpointing the disorder, as symptoms have a tendency to change over time. The most common tests involve immunofluorescence, a type of ANA screening, where a sample is taken from a patient’s tissue or blood, is infused with fluorescent dyes, and is studied under a special type of microscope, to identify the distribution of antibody molecules. Before performing this test, however, most doctors base their diagnoses on certain criteria, including visual identification, or kidney/blood tests. As a result, some patients may not be properly diagnosed if their symptoms were less apparent prior to testing. According to a survey done by the Lupus Foundation of America, the most common doctors to reach Lupus diagnoses were Rheumatologists, who are generally more familiar with the finer details of the criteria, or who likely see its non-visual identifiers more frequently among their patients.

The disease is not believed to be contagious and does not seem to be genetically transferred, although it is possible to pass affected antibodies onto an unborn child. While the disease is considered harmful, there are many things that are not out of the question for its patients. Women with Lupus can become pregnant and usually carry a healthy baby to full term, assuming her kidneys and heart are not affected by the disease and she is receiving the proper care (however, there is an increased risk for complications).

Possible Symptoms of Lupus

• Painful or swollen joints, arthritis, or fibromyalgia
• Chest pain, breathing problems, and pleurisy
• Fever
• Hair loss
• Swelling or itching of the hands and feet due to kidney problems
• Feeling constantly listless, fatigued, and ill
• Mouth sores and ulcers, as well as ulcers on other parts of the body
• Rash, most commonly across the face and nose in a butterfly pattern, and sometimes on other parts of the skin
• Sensitivity to sun
• Swollen glands
• Dry eyes
• Headaches, confusion, or memory loss
• Seizures
• Psychological and emotional disorders
• Hypertension

Other symptoms may also occur, depending on where the Lupus affects the body. If the disease affects the heart, brain, lungs, or kidneys, there could be serious complications. The function of these organs could be compromised and could potentially lead to organ failure if left untreated (this is most common in Lupus patients aged 40+). The symptoms throughout specific areas of the body vary greatly and should be discussed at length with a doctor to understand the risks associated with one’s specific case.

Treatment of Peripheral Neuropathies (Lupus)

Treatments for Lupus treat both the symptoms and the immune system. While there is no cure for Lupus, current medications are usually effective at controlling the disease and suppressing immune response. Common treatments for pain and inflammation include NSAIDs, COX-2 inhibitors, and corticosteroids. Antimalarial and immunosuppressive medications are also in attempting to restore peak immune system function. In rare circumstances, doctors may use cytotoxic drugs to block cell growth if other methods of treatment aren’t working, but these medications are saved as a last resort due to the intense side effects. It is also recommended for Lupus patients to wear protective clothing, hats, eyewear, and sunscreen outside to prevent sun exposure. UV light can amplify symptoms of Lupus, and should be limited.

Scientific research is currently underway to obtain a better understanding of the disease, how it works, what causes it, and what can be done to treat it. It is hoped that at some point in the foreseeable future, there will be a way to cure the disease. At the moment, research is still in discovery stages, and there have been no news releases about the development of any revolutionary methods or medications to cure the disease.