Skin . Skin problems are a common feature of lupus. Some people with lupus have a red rash over their cheeks and the bridge of their nose -- called a "butterfly" or malar rash. Hair loss and mouth sores are also common. One particular type of lupus that generally affects only the skin is called "discoid lupus." With this type of lupus, the skin problems consist of large red, circular rashes that may scar. Skin rashes are usually aggravated by sunlight. A common lupus rash called subacute cutaneous lupus erythematosus is often worse after exposure to the sun. This type of rash can affect the arms, legs, and torso. An uncommon but serious form of lupus rash results in the development of large blisters and is called a "bullous" lupus rash.
A substance (generally a protein, polypeptide, or peptide) that stimulates the differentiation, division, development, and maintenance of cells and the tissues they make up. Growth factors are signaling molecules released by certain groups of cells, e.g., lymphocytes, to influence the activities of other cells. Growth factors can be divided into families, e.g., platelet-derived GFs, transforming GFs, and angiogenic GFs. They are released normally during fetal and embryonic development, wound healing, and tissue maturation. Massive releases of GFs are characteristic of some types of cancer cells. Artificial GFs, e.g., granulocyte colony-stimulating factor, are used in health care to restore depressed levels of cells to normal values, e.g., in patients who have received chemotherapy.
A genetic disorder is a disease caused in whole or in part by a change in the DNA sequence away from the normal sequence. Genetic disorders can be caused by a mutation in one gene (monogenic disorder), by mutations in multiple genes (multifactorial inheritance disorder), by a combination of gene mutations and environmental factors, or by damage to chromosomes (changes in the number or structure of entire chromosomes, the structures that carry genes).
Any of a diverse group of plasma polypeptides that bind antigenic proteins and serve as one of the body’s primary defenses against disease. Two different forms exist. The first group of immunoglobulins lies on the surface of mature B cells, enabling them to bind to thousands of antigens. When the antigens are bound, the B plasma cells secrete the second type of immunoglobulins, antigen-specific antibodies, which circulate in the blood and accumulate in lymphoid tissue, esp. the spleen and lymph nodes, binding and destroying specific foreign antigens and stimulating other immune activity. Antibodies also activate the complement cascade, neutralize bacterial toxins and viruses, and function as opsonins, stimulating phagocytosis.
In recent years, mycophenolate mofetil (CellCept) has been used as an effective medication for lupus, particularly when it is associated with kidney disease. CellCept has been helpful in reversing active lupus kidney disease (lupus renal disease) and in maintaining remission after it is established. Its lower side-effect profile has advantage over traditional immune-suppression medications.
Numerous studies suggest that moderate intake of alcohol may decrease the risks of developing cardiovascular disease problems, increase HDL good cholesterol levels, and may even decrease the risk for certain cancers. However, the sugar it contains will increase your calorie consumption (potentially contributing to weight gain) and regular alcohol consumption may increase the risk for breast cancer.
Some people with lupus experience occasional heartburn, acid reflux, or other gastrointestinal problems. Mild symptoms can be treated with OTC antacids. If you have frequent bouts of acid reflux or heartburn, try cutting down on the size of your meals, and avoid beverages containing caffeine. Also, don’t lie down right after a meal. If symptoms continue, see your doctor to rule out other conditions.
Lupus is an inflammatory autoimmune disease that can affect multiple parts of the body including the various organ systems. Doctors prescribe traditional pharmaceutical medications to manage symptoms and prevent flare ups of the disease that can cause more serious problems and complications. Many patients choose to supplement their pharmaceutical care with alternative treatments and lifestyle adjustments like using diet and exercise to minimize lupus symptoms. We discuss this further in our blog, Lupus/Chronic Illness: The Mind/Body Connection. There exists two major diets widely discussed in the autoimmune world. One is the anti-inflammatory diet and one is called the Paleo Diet.
Below you will find that list, accompanied by questions created by the LFA to help individuals determine whether they should contact a healthcare professional to discuss the potential for having lupus. The LFA suggests discussing the possibility with a doctor if you answer “yes” to more than three of the questions, from your present and past health history.
The panel judged the effect of extended AC as a large benefit, reducing VTD with increase in bleeding risk as a moderate harm. For the comparisons of different AC intensities, the panel decided to use the evidence from observational studies because it judged that it probably better reflects reality given that the randomised controlled trials (RCT) are severely flawed (indirectness of intervention as most patients did not reach the INR >3 goal). They judged the reduction in VTD as a large benefit and the bleeding increase as a large harm. Hence, the panel considered that the balance could favour the intervention only when the risk of VTD recurrence is particularly high.
A chronic inflammation of large arteries, usually the temporal, occipital, or ophthalmic arteries, identified on pathological specimens by the presence of giant cells. It causes thickening of the intima, with narrowing and eventual occlusion of the lumen. It typically occurs after age 50. Symptoms include headache, tenderness over the affected artery, loss of vision, and facial pain. The cause is unknown, but there may be a genetic predisposition in some families. Corticosteroids are usually administered.
One main type of lupus, cutaneous lupus erythematosus, is limited to skin symptoms, including a rash and lesions. That means people with cutaneous lupus, which does not progress and become systemic lupus erythematosus, only experience skin symptoms. People with cutaneous lupus most commonly develop a discoid rash. It appears as round, raised, red patches and can cause scarring, Dr. Caricchio explains. “It’s often confined to small areas above the neck, such as the ears and scalp,” he says. The rash usually does not itch or cause discomfort.
Lupus in children tends to be more aggressive than in adults, says Dr. Pascual. The exact reasons for this are not understood. One theory is that people are born with genetic susceptibility to the disease that may be triggered by environmental factors such as a virus. “Children with the condition may have inherited a more complex set of predisposing genes,” she says. But this theory has yet to be proved.
Elevation of the antinuclear antibody (ANA) titer to 1:40 or higher is the most sensitive of the ACR diagnostic criteria. More than 99 percent of patients with systemic lupus erythematosus have an elevated ANA titer at some point,21,41 although a significant proportion of patients may have a negative ANA titer early in the disease.2 However, the ANA test is not specific for systemic lupus erythematosus. A study41 involving 15 international laboratories found that ANA tests in the general population were positive in 32 percent of persons at a 1:40 dilution and in 5 percent of persons at a 1:160 dilution. Rates of positive ANA tests were not affected by age up to 60 years (the upper age limit of the study).41
Soy products. Soy products are high in a type of estrogen called phytoestrogen, and estrogen is known to be a risk factor for lupus. In animal studies, researchers noted that a diet high in soy seemed to make lupus symptoms worse. Although there is no definitive evidence that soy products cause lupus symptoms, you should be cautious about including large amounts of soy in your diet.
If you are a young woman with lupus and wish to have a baby, carefully plan your pregnancy. With your doctor’s guidance, time your pregnancy for when your lupus activity is low. While pregnant, avoid medications that can harm your baby. These include cyclophosphamide, cyclosporine, and mycophenolate mofetil. If you must take any of these medicines, or your disease is very active, use birth control. For more information, see Pregnancy and Rheumatic Disease.
Libman-Sacks endocarditis is the most characteristic cardiac manifestation of lupus. It is characterized by clusters of verrucae on the ventricular surface of the mitral valve. These lesions consist of accumulation of immune complexes, platelets, and mononuclear cells. This can lead to heart failure, valvular dysfunction, emboli, and secondary infective endocarditis. Diagnosis is best made via echocardiography, which may reveal the characteristic valvular masses (arrows). IVS = interventricular septum; LA = left atrium; LV = left ventricle.
Not all fats are unhealthy. Polyunsaturated fats and monounsaturated fats are the healthier fats compared to saturated fats. Some of these fats are high in anti-inflammatory properties and have a rich source of Vitamin E. Foods that contain unsaturated fats include; nuts, seeds, avocados, olive oil, soybean oil, and canola oil. It is important to understand that these fats are still high in calories - therefore, portions should be monitored. These fats, however, are preferred over saturated fats.
Autoreactive B cells can accidentally emerge during somatic hypermutation and migrate into the germinal center light zone. Autoreactive B cells, maturated coincidentally, normally do not receive survival signals by antigen planted on follicular dendritic cells and perish by apoptosis. In the case of clearance deficiency, apoptotic nuclear debris accumulates in the light zone of GC and gets attached to FDC. This serves as a germinal centre survival signal for autoreactive B-cells. After migration into the mantle zone, autoreactive B cells require further survival signals from autoreactive helper T cells, which promote the maturation of autoantibody-producing plasma cells and B memory cells. In the presence of autoreactive T cells, a chronic autoimmune disease may be the consequence.
There is no single diagnostic test for systemic lupus. The test you will hear most about is called the antinuclear antibody (ANA) test. This is not a specific test for lupus, however. In fact, a variety of laboratory tests are used to detect physical changes or conditions in your body that can occur with lupus. Each test result adds more information to the picture your doctor is forming of your illness.
In patients with systemic lupus erythematosus (SLE), the presence of antiphospholipid antibodies is common; depending on the assay, these antibodies have been reported in up to 30-50% of SLE patients.  Therefore, it is important to evaluate these patients for risk factors for thrombosis, such as use of estrogen-containing drugs, being a smoker, immobility, previous surgery, and the presence of severe infection or sepsis.  The European League Against Rheumatism (EULAR) has noted that low-dose aspirin in individuals with SLE and antiphospholipid antibodies is potentially useful for primary prevention of thrombosis and pregnancy loss. 
Although it is known that chronically low complement levels and functional asplenia may result in a low level of susceptibility to infection, it is not known to what degree. [128, 129] Overall, it is likely that the primary reason patients with SLE die of infections is immunosuppressive medications.Stress-dose steroid protocols should be used in patients who are receiving maintenance corticosteroids when they are admitted with infectious or perioperative stress.
The authors reviewed the influence of nutritional factors on systemic lupus erythematosus (SLE) and discussed an alternative treatment option. The autoimmunity and inflammatory process of SLE are related to the presence of dyslipidemia, obesity, systemic arterial hypertension, and metabolic syndrome, which should be properly considered to decrease cardiovascular risk. A diet with moderate protein and energy content, but rich in vitamins, minerals (especially antioxidants), and mono/polyunsaturated fatty acids can promote a beneficial protective effect against tissue damage and suppression of inflammatory activity, in addition to helping the treatment of those comorbidities. Diet therapy is a promising approach and some recommendations may offer a better quality of life to patients with SLE.
In the absence of systemic lupus erythematosus, the most common reason for a positive ANA test is the presence of another connective tissue disease. Diseases that often are associated with a positive ANA test include Sjögren's syndrome (68 percent of affected patients), scleroderma (40 to 75 percent), rheumatoid arthritis (25 to 50 percent), and juvenile rheumatoid arthritis (16 percent).20 An ANA test also can be positive in patients with fibromyalgia. In patients with diseases other than systemic lupus erythematosus, ANA titers usually are lower, and the immunofluorescent pattern is different.20
There is a wide range of diets advertised to help you lose weight quickly or control various chronic diseases, such as lupus. Many people claim to be experts in nutrition yet have limited knowledge and offer no protection to the public. You should be wary of unqualified practitioners who may be offering unproven techniques to diagnose and treat nutritional problems.
“NHS dieticians seem to specialise in those struggling to lose (rather than gain) weight in my experience. On my initial consultation I was given a booklet with advice based on eating a full English breakfast, then snacks like doughnuts and pork pies. My sons would be thrilled to get medical advice to eat like that! The nutritional supplements they offer taste extremely artificial to me. I can only eat a little and very slowly, so get to ‘savour’ every sip of it. I’m trying protein shakes I buy myself, which taste better, but just one of those is very filling.”
The severity of lupus varies from mild to life threatening. Kidney problems and neurologic complications are more dangerous than the rashes, arthritis or other symptoms. After many years of having lupus, patients may develop hypertension (high blood pressure), accelerated atherosclerosis (plaque and fat build-up in the arteries), heart and lung diseases, kidney failure or osteoporosis. With proper treatment, the majority of people diagnosed with lupus have a normal life expectancy, but many will experience disabilities. Each patient will likely have his or her own specific pattern of symptoms and flares, but the disease can change over time.
In 2009, an American College of Rheumatology (ACR) Task Force generated a quality indicator set.  In 2012, the ACR published “ Guidelines for the Screening, Diagnosis, Treatment and Monitoring of Lupus Nephritis in Adults,” as well as an evidence report for lupus nephritis. These and other guidelines are available at the ACR's Clinical Practice Guidelines Web site.
Infections and diseases of the cardiovascular, renal, pulmonary, and central nervous systems are the most frequent causes of death in patients with systemic lupus erythematosus.8,23,32–37 Since the 1950s, the five-year survival rate for patients with systemic lupus erythematosus has increased from 50 percent to a range of 91 to 97 percent.8,23,32–34,38,39 It is not known how much of this increase in survival is due to improved management versus diagnosis of earlier and milder disease. Higher mortality rates are associated with seizures, lupus nephritis, and azotemia.36,37,40
Immunoglobulins are formed by light and heavy (depending on molecular weight) chains of polypeptides made up of about 100 amino acids. These chains determine the structure of antigen-binding sites and, therefore, the specificity of the antibody to one antigen. The five types of immunoglobulins (IgA, IgD, IgE, IgG, IgM) account for approximately 30% of all plasma proteins. Antibodies are one of the three classes of globulins (plasma proteins) in the blood that contribute to maintaining colloidal oncotic pressure.
In more severe cases, medications that modulate the immune system (primarily corticosteroids and immunosuppressants) are used to control the disease and prevent recurrence of symptoms (known as flares). Depending on the dosage, people who require steroids may develop Cushing's syndrome, symptoms of which may include obesity, puffy round face, diabetes mellitus, increased appetite, difficulty sleeping and osteoporosis. These may subside if and when the large initial dosage is reduced, but long-term use of even low doses can cause elevated blood pressure and cataracts.
Immunosuppressive agents/chemotherapy. In advanced cases of lupus, drugs like azathioprine, methotrexate and cyclophosphamide might be used to suppress the immune system. These types of therapies can help prevent organ damage; however, they do cause severe side effects as well as infertility in women. People on immunosuppressive therapies must be closely monitored by a doctor.
Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus. High doses of steroids such as methylprednisolone (A-Methapred, Medrol) are often used to control serious disease that involves the kidneys and brain. Side effects include weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection. The risk of side effects increases with higher doses and longer term therapy.
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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.
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