Lupus is named after a wolf because of its facial rash
Medieval physicians thought the facial rash of this disease looked like a wolf's bite, so in the 13th century they called it lupus. Today it is known as a great imitator: an autoimmune illness that flares and fades, attacks almost any organ, and can take years to pin down.
Systemic lupus erythematosus happens when the immune system produces autoantibodies, most often anti-nuclear antibodies, that turn on the body's own tissues and inflame them. Its cause is unclear, blending genes and environment: if one identical twin has it, the other has a 24 percent chance. Female hormones, sunlight, smoking, low vitamin D and some infections are thought to raise risk. Rates range from 20 to 70 per 100,000 depending on the country, women of childbearing age are hit about nine times as often as men, and people of African, Caribbean and Chinese descent face higher risk than those of European descent.
Symptoms vary so widely that diagnosis relies on a combination of signs and lab tests. More than 90 percent of patients have joint or muscle pain at some point, usually in the hands and wrists, though unlike rheumatoid arthritis it rarely wrecks the joints. Up to 70 percent have skin problems, and the butterfly-shaped rash across the cheeks appears in 30 to 60 percent. Women tend toward more relapses, arthritis and Raynaud syndrome, while men more often develop seizures, kidney disease and inflammation of the linings around the heart and lungs.
The disease reaches deep. It can inflame every layer of the heart, speed up atherosclerosis and damage the kidneys, although prompt treatment keeps end-stage kidney failure below 5 percent of cases except among Black patients, whose risk is many times higher. The American College of Rheumatology recognises 19 neuropsychiatric syndromes linked to it, and in some regions depression affects up to 60 percent of women with lupus. Up to a third of patients report eye problems.
There is no cure. Anti-inflammatories, corticosteroids, immunosuppressants, hydroxychloroquine and methotrexate manage it, but long-term steroids bring side effects, including greater heart risk. Cardiovascular disease is the leading cause of death, and men die of it at higher rates. Pregnancies carry more risk, with an estimated live-birth rate of 72 percent, yet most succeed.
Source: Lupus
