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MINI MED
SCHOOL: LUPUS 2 CLASS
HOURS
Objectives: At
the end of this class, you will be able to
1. List the 4 types of lupus.
2. Discuss the signs and symptoms of
lupus.
3. Relate how to care for the person with
lupus.
Introduction Lupus is a rare disease. It occurs when the body’s own
immune system attacks the body, its tissues and its
organs. The immune system protects the body from infection when it is normal.
With lupus, this system attacks and hurts the body rather than helping it.
Lupus can attack the blood, the heart, the lungs, the skin, and the joints.
Women get it more than men. No one knows why but women are at a greater risk
than men. Types of Lupus There are four types of lupus. Each type is different. Each type has a
different set of signs. These four types are: ·
systemic lupus (the
most common form) ·
discoid lupus ·
drug-induced lupus ·
neonatal lupus. The systemic type is the most common type. This
type can attack the skin, joints, lungs, kidneys and blood. The discoid
type affects only the skin. A circle rash is seen on the neck, face or head.
Some of these patients may also get the sytemic type. Some medications cause
the drug-induced type of lupus for some people. Other people may take
the same drugs and not get it. This type can affect a number of body parts but
it usually goes away when the person stops taking the drug.
The neonatal form is rare. It affects some new
born babies. These babies get it from the mother even when the mother may not
even have it. The new baby may have a rash that goes away in a couple of months.
Other new babies may end up with a heart problem because of it. Causes
We do not really know why people get it. It seems that it
may result from a combination of environment and genes. Many people think that
you inherit a tendency to get lupus from your parents, but not the disease
itself. It will only come out later in life when you contact something like a
virus. The Signs
Every case of this disease is different. No two patients will have the same
signs. Some people have signs that come on very fast and without any signs.
Other people get signs that develop slowly over time. Some people get very
serious and severe signs. Others may get only very minor and mild signs. Most
people have signs that go away over time and then come back later. Others have
signs that do not go away. These signs are always there. Some of the signs and symptoms of lupus are listed below. ·
Fatigue ·
Fever ·
Weight gain ·
Joint pain and swelling ·
A butterfly-shaped rash on the face that covers the
cheeks and the top of the nose ·
Skin changes that appear or get worse when the person is
in the sun ·
Mouth sores ·
Hair loss ·
Blue or white fingers and toes when
the person is cold or under stress ·
Shortness of breath ·
Anxiety ·
Chest pain ·
Dry eyes ·
Easy bruising ·
Anxiety ·
Depression ·
Memory loss Risk Factors
Some people are more apt to get lupus than others.
Some of the risk factors are:
·
Age. It is most
often diagnosed in people beteen 15 and 40 years of age. ·
Sex. It is most
common in women. ·
Race. It is most
often seen among Asians, hispanics and African Americans ·
Sunlight. People that are in the sun a lot get it more than other
people who do not spend a lot of time in the sun. ·
Some drugs. Some drugs lead to lupus. For example, some heart
drugs, TB drugs, and antipsychotic drugs put the person at risk especially when
they are taken for a long time. ·
Some infections. People who get infected with the Epstein-Barr virus are
more at risk than other people who never got this infection. ·
Some chemicals. Peoole that are exposed to chemicals, like mercury
cigarettes and silica, are at greater risk than those who are not exposed to
these things. What Damage Does It Cause?
Lupus affects many parts of the body. The damage and the
system affected are desribed below. Kidneys. Kidney
failure is one of the most common causes of death as a result of lupus. About ¾
of the people with lupus have this kind of damage within 2 years after they get
this disease. As a result, they may have pain, itching, nausea, vomiting, leg
swelling and weight gain. This problem is usually
treated with drugs. Brain. The person
may be dizzy and confused. They may have headaches, seizures, changes in
behavior, memory problems and trouble telling people what they need or
think. Blood . Some people
may have anemia, bleeding, blood clotting
problems and/or a serious problem with their veins.
Lungs. Many may have
trouble breathing because they have a problem with their lungs or a pneumonia. Heart. Lupus can
cause inflammation of all parts of the heart. This can lead to high blood
pressure, heart attacks and hard arteries. Infection. Some people
will get infections easily. They occur because the person may be taking certain
drugs that lower the person’s ability to fight off germs and some may get them
because of the disease itself. These patients may get urine or lung infections,
like pneumonia and food related infections. We must protect these people from
all germs so that they do not get these serious things. Handwashing and
infection control are very important. Cancer. People with
lupus often get cancer, like lung cancer, more than other people. Bones. The bones may
become weaker and weaker over time. This can lead to bone breaks or fractures.
Again, we have to protect our patients from injury to their bones. These bones
are not as strong as they should be. These bones may break very easily. Pregnancy problems. Many people
with lupus, who get pregnant, may lose the baby before it is born. Others may
have their baby sooner than they should. These babies will be very, very tiny.
They will need lots of care after they are born. Some of these tiny babies
live. Others die because they were born too soon. The mother may also get very
high blood pressure while they are carrying the baby before it is born. These
mothers need good care from their doctor. How Do People
Find Out That They Have Lupus? It is often
very hard for the doctor to diagnose lupus. This is because the signs vary from
person to person. They also vary over time. Some signs may come and others may
go. Also, the signs are very often like those of other diseases and disorders
like arthritis. So, it is hard find out what is wrong with the person. Some
doctors will decide that the person has it after the person has at least four
of the following signs:
·
Face rash with a butterfly shape
across the nose and the person’s cheeks ·
Raised, scaly patches on the person’s
skin ·
A rash that appears after the person
has been in the sun ·
Mouth sores that do not cause the
person any pain ·
Pain and swelling of two or more bone
joints ·
A swollen lining around the heart or
the lungs ·
A kidney disorder ·
Seizures or a mental health disorder
that can happen when lupus affects the nervous system ·
A low blood count (low red blood
cells, white blood cells, etc.) ·
A positive autoimmune disease lab test ·
The results of other lab tests How Is It
Treated?
The treatment of this disease depends on the signs
and symptoms that the person is having. Drugs and other treatments are often
used. All drugs have side effects. For example, NSAIDs may lead to a bleed in
the stomach or heart problems.
The person may get one or more of the following kinds
of drugs:
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