WHILE there are certain illnesses that automatically appeal to the public conscience and interest, inevitably there will be some less well known conditions, perhaps because they do not have a famous sufferer, that are not as publicised, and hence not understood to the same level. One of these is Systemic Lupus Erythematosus (SLE), often abbreviated to Lupus. However, with the story of the singer Selena Gomez, who successfully underwent kidney transplant, as a result of complications arising from Lupus, and her efforts to raise its profile, SLE is now very much in the minds of both the public and medical profession alike.

SLE is an autoimmune condition. This means that the body’s natural antibodies, which would normally fight infection, begin to attack the individual’s own organs, causing these to become inflamed. Typical features of Lupus include muscle and joint pains, with fatigue that is not relieved despite adequate rest.

However, as the autoimmune process can literally affect any part of the body, presentations can vary from persistent mouth ulcers to recurrent miscarriage, and it has been referred to as “the disease with a thousand faces”. Other organs affected include the skin, although the classic “butterfly rash” across the face does not affect all sufferers. The brain, eyes, heart, lungs and kidneys can also be involved to varying degrees of severity.

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We are still unsure as to the exact cause of SLE, but know that there are certain triggers. Lupus is nine to ten times more common in women and it is thought that hormonal changes such as during puberty, pregnancy and the menopause, may prompt the start of symptoms. Equally, viral infection, exposure to strong sunlight and certain medications can be the catalyst.

There is a genetic component, although only three in 100 people with SLE have a parent with the condition. The age at which the disease first presents varies widely from teenage years to middle age and beyond, and it occurs more frequently in Afro-Caribbean, Chinese and Asian people.

SLE can be notoriously difficult to diagnose, and relies on being aware of the condition as a potential cause for what can often be a multitude of symptoms, both physical and mental. Blood tests demonstrating high levels of antibodies known to be involved in SLE may help, although confusingly these are sometimes raised in perfectly healthy individuals.

The treatment for Lupus very much depends on which organs are affected and indeed to what extent. Currently there is no cure, and management commences with adequate pain relief for muscle and joint aches.

Hydroxychloroquine, a drug also involved in treating malaria, may help when simple painkillers are no longer effective, and is particularly useful in addressing the skin problems associated with SLE. Steroids are reserved for dampening flare ups, but due to their multiple side effects, courses tend to be short and at the lowest dose possible.

For a minority of people with the disease, it can be severe enough to require immunosuppressant medication, to quieten down the body’s own protective system. However as a result, such individuals are more prone to picking up infections that would not be a problem for others.

While a small number of individuals, as highlighted by the case of Miss Gomez, will be severely affected, the warming news is that most people with SLE lead active, normal lives, with mild to moderate symptoms that can be well controlled. The condition is usually managed by your GP and a rheumatologist, who will have specialist knowledge and interest in SLE.

Once the diagnosis is made, there is also much that can be done on a personal level. Recognizing your limits and pacing yourself will certainly help, while reducing your activities during flare ups may decrease the amount of frustration experienced. A healthy diet, routine cardiovascular exercise and adequate sleep is advised, and may reduce your chances of picking up infections. You should ideally avoid people while they have active infection, especially if you are on steroids or immunosuppressants. As sunlight is known to aggravate SLE, a high factor sunscreen and covering exposed skin is important, especially on hot days.

With support groups online and in person, as well as the help of trained healthcare professionals, there is usually someone who will lend an ear and address any questions you may have about your illness.

*doctorzak.co.uk; @AskDoctorZak

Useful website: www.lupusuk.org.uk