Lupus: Beware Of Fatigue, Joint Pains And Rashes

By Zulkiple Ibrahim This is the first of two articles on Systemic Lupus Erythematosus (SLE), also known as lupus. Despite being a widespread disease, the awareness of lupus in Malaysian society is still behind that of many other illnesses. According to health authorities, if there is greater lupus awareness among the society, Lupus patients would not feel so isolated and would receive the support they deserve. KUALA LUMPUR, Dec 27 (Bernama) -- AiBee's 25-year-old daughter, Siew Ping, appeared to be a healthy girl until one day her body developed persistent fatigue and weakness, coupled with sudden and persistent loss of appetite. "It happened in September last year when Siew Ping complained of aching all over her body, apart from having fever and flu. "She also had nose bleeds and skin rashes on her body and face. Her joints became painful and swollen. She even had chest pain and coughed blood," AiBee told this writer at a medical centre here recently. AiBee had her daughter admitted into a hospital centre here and doctors later diagnosed Siew Ping as having SLE, Systemic Lupus Erythematosus, which is also known as lupus. According to rheumatologists, a study held in 1990 revealed that for every 100,000 in the Malaysian population, 43 people had SLE. Health authorities estimate that there are now more than 11,000 SLE cases in this country. Statistics from the Lupus Foundation of America reveal that 1.5 million people have lupus in the United States alone, while the figure worldwide is 5 million. FEELING OF LETHARGY A medical specialist, Dr H.Tan said the presentation of lupus varies from one individual to another. "About 80 per cent of SLE patients have joint and muscle pain as well as skin rashes. They also have fatigue and a general feeling of being unwell. "During a flare-up, those with lupus will usually have flu-like symptoms with or without fever, fatigue, muscle and joint pains. For women, the symptoms can be worse before a menstrual period and that is why the symptoms are sometimes thought to be just pre-menstrual tension," he said. He also said the most common signs of SLE are arthritis pain and inflammation of the joints, including the hands, feet and knees; fatigue; and skin rashes, including on the face. IMMUNE SYSTEM According to medical experts, SLE is a disease of the immune system. "In lupus, the immune system becomes unbalanced, resulting in the body reacting against healthy tissue. This is why the symptoms of lupus can vary so much. "Sometimes the disease is caused by using certain drugs. This is known as drug-induced lupus," said Dr Tan. He said SLE is classified as a rheumatic disease and can cause inflammation in the joints and several of the body's organ systems, such as the kidneys. CAUSES OF SLE The causes of SLE are unknown, although recent research indicates a genetic influence. Dr Tan said SLE is about 10 times more common in women than in men. The initial diagnosis of SLE is most common among women of childbearing age. "Lupus can be difficult to diagnose. Sometimes lupus patients need to consult many physicians before being correctly diagnosed with lupus. "The symptoms are similar to that of other illnesses, making diagnosis difficult. There is no specific test that can tell whether a person has lupus. "It is not unusual for a person to experience symptoms for months or even years before being diagnosed with lupus," said Dr Tan. He said diagnosis of lupus is made after a careful review of a person’s entire medical history, coupled with an analysis of routine laboratory tests, and some specialised tests related to immune status. "There are 11 diagnostic criteria. Generally, a patient needs to meet at least four of the criteria, including blood tests that would point to a positive diagnosis of lupus," he said. FATAL According to rheumatologists, lupus can be fatal. The Lupus Foundation of America says thousands of individuals worldwide die from complications of lupus every year. However, early diagnosis and improved management of lupus enable most people with the disease to live a normal lifespan. Unfortunately for many who have the disease, lupus remains a debilitating and devastating illness that greatly impacts their quality of life. CURE FOR LUPUS Medical experts say there is no cure for lupus at the present time. However, treatments are available to control symptoms and keep the disease under control in most cases. Therapies vary and depend on which organs are affected and the severity of the disease. Dr Tan said individuals who have symptoms of lupus should consult the doctor immediately. "They should tell the history of their symptoms, even though the symptoms are not present at that particular time. The doctor may ask the patient to undergo additional tests or refer the patient to a rheumatologist or dermatologist," he said. More information on this disease is available at www.lupus.org. "Extra rest is an essential part of managing the disease," Dr Tan added. -- BERNAMA