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Odishatv Bureau

By Prof Dr Jyoti Ranjan Parida

Due to overexposure to sunlight or the UV rays, often we tend to develop red butterfly-like rashes on our cheeks and others part of our body. It is a usual perception that it is just a seasonal rash, which keeps occurring at regular intervals. Beware. It could be one of the major symptoms of an auto-immune disease called 'Systematic Lupus Erythematosus'. The manifestation of this disease may vary from simple skin rash to grave complications affecting kidney, brain and heart. 

Today, with necessary treatment, a Lupus patient can lead a normal life. Due to lack of awareness or early diagnosis and proper treatment, these patients are suffering from long-term complications and organ damage. May 10th is observed as “World Lupus Day” to create awareness on this incurable yet potentially treatable disease. The theme for lupus day this year is "Make Lupus Visible" with the use of social media and other platforms for more awareness on this disease so that help is offered to these patients in getting early treatment.

What Is Lupus?

Sometimes our immune system goes awry and wild. It misreads signals. As a result, our defenses do not recognize our body at work and "begin" attacking our own cells. This leads to illnesses called autoimmune (self-immune) diseases and one such disease is “Systemic Lupus Erythematosus” commonly known as Lupus. It is very difficult to diagnose as different patients may have different presentations. It can affect one’s skin, joints, blood, heart, kidney, brain etc. 

What are the warning signs and symptoms?

Appearance of reddish malar rash, flat or raised over the cheek bones also known as "butterfly rash" (due to its shape) is a very classical symptom of Lupus. Rashes over sun-exposed areas, painless oral or Nasopharyngeal ulceration or excessive hair loss may be other features. Any young patient losing protein or blood in urine; unusual decrease in Haemoglobin, prolonged fever, joint pain etc may be the warning signs.

Is early detection possible?

Lupus is called the "great imitator" because its symptoms mimic many other diseases. It is very difficult to diagnose unless one specifically looks for it. So a trained and alert physician can help. No single test or symptom can diagnose Lupus. Considering its multisystemic nature, usually Lupus is suspected when a young patient is presented with complaints of two or more systems. For example, if a person develops joint pain, renal failure and decrease in hemoglobin, along with fever, then Lupus is suspected.

Is there any specific gender and age group which is more prone to the ailment?

It mainly affects females in the age group of 15–45 years. However, men, children and teenagers, all can develop the same. Out of 10 patients, usually one is male and rest females.

Is there any test to screen Lupus?

Anti Nuclear Antibodies (ANA) test is done to screen Lupus if somebody presents with symptoms suggestive of the disease. The sensitivity and simplicity of an ANA test makes it extremely popular to determine the intensity of the disease. But this is not a specific test and can be present even in normal people. Once ANA test results are positive, anti-dsDNA and compliment tests are done to confirm Lupus. 

Is it contagious?

No, it is not contagious; not even through sexual contact. So people should not have any social stigma to live with Lupus patients. In fact it is advisable to give them emotional and moral support as they need it most.

What precautions should Lupus patients take?

Out of all the environmental factors, sunlight is known to aggravate Lupus. A person suffering from Lupus should use sunscreen lotion and avoid UV lights. Besides, avoiding stress and fatigue and quitting smoking always helps.

What exercises help Lupus patients?

Regular Aerobics and deep breathing exercises help in the long run for mental and physical healing. But they should be practiced along with prescribed medicines. 

What is the mainstay therapy for Lupus?

As the overactive immune system is at fault causing harm to different organs, immunosupressive drugs are the mainstay of treatment. Corticosteroid is life-saving but its unnecessary prolonged use may have side effects. When treatment is required for a prolonged period, other drugs like hydroxycholoroquine, cyclophosphamide, azathioprine, mycophenolate etc are used, which help in decreasing corticosteroid dose. Because all these drugs may have side effects, so treatment of Lupus should be done under a trained rheumatologist or clinical immunologist. 

What are the long-term complications of Lupus?

Complications may be related to the disease itself or related to its treatment. If not treated well, it can cause kidney failure, bone destruction (avscular necrosis), atherosclerosis and heart disease etc. These patients are also at risk of infections and osteoporosis as a side-effect of its treatment.

Can Lupus patients take COVID vaccine?

Lupus patients can take Covid vaccines just like normal patients, and both vaccines available in India (Covaxin and Covishield) are safe to use. Those patients who are on high dose steroid (more than 10 mg prednisolone) or advised immunosuppression medicines may show little less response to vaccine. These patients should consult with the rheumatologists and time their vaccination.

A final word for these patients

Although there is no permanent cure, if treated at the right time, majority of Lupus patients can lead a normal life. Acceptance of the disease and compliance with medications are determinants of better outcome. Recent advance in molecular understanding of the disease has provided enough hope for breakthrough treatment in near future.

The author Prof Dr Jyoti Ranjan Parida, is an immunologist, rheumatologist; and also the Medical Director of Odisha arthritis and Rheumatology center.

(DISCLAIMER: The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same.)

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