Lupus, One of The Most Difficult Diseases To Diagnose


Lupus is an autoimmune disease that affects mostly women between 15 and 40 years. Depression and psychiatric disorders are the most common symptoms; Nevertheless, they are not the only ones. The wide spectrum of lupus symptoms makes diagnosis difficult.

In Latin it means “wolf” because the skin lesions that occur in patients who have this disease are similar to the bites of this wild animal. We speak of Lupus, an autoimmune disease that in recent months has starred many headlines due to cases such as Selena Gomez . The artist was forced to cancel her tour of Europe to take a break and recover from the lupus she suffered.

Lee : Keys for pregnancy to stop being a utopia for women with lupus

But he has not been the only character with public projection that has acknowledged suffering from the disease that was already commissioned to make fashionable the television Doctor House. The American singer Toni Braxton was hospitalized for lupus. The winner of seven Grammy Awards was diagnosed with lupus after 40 years. The same disease recognized Nick Cannon, Mariah Carey’s ex-husband and one of the best-known faces of America’s Got Talent . Some media have come to link Michael Jackson and Lady Gaga with lupus; however, they have never recognized it .

The cases of these artists were excellent opportunities to talk about the disease. But, with everything and with it, lupus remains a great unknown. And not only among the population, but also among the specialists themselves.

What is Lupus and why does it appear?

Lupus is an autoimmune disease, that is, the immune system that should protect the body against diseases and infections attacks healthy cells by mistake. Of all the subgroups of the disease, Systemic Lupus Erythematosus (SLE) is the most common. It can appear at any age but, it usually debuts between 15 and 40 years, affecting more women than men. Although the cause of this difference between sexes is unknown, it is believed that it may be due to hormonal causes. In addition, in ethnic groups with African or Asian origins the disease is more aggressive. The global incidence of the disease is 1 to 10 cases per 100,000 inhabitants each year. In Spain, lupus has a prevalence of 91 cases per 100,000 inhabitants.

” Despite the advances that have occurred in recent decades, the cause of Lupus continues without being fully clarified . As it happens in other autoimmune diseases, it seems clear that some environmental factor (probably more than one) that acting on genetically predisposed individuals is capable of triggering the disease. There has been speculation that this triggering agent is a microorganism, especially a virus, although it is not known exactly, “explains Dr. Manuel Romero, rheumatologist at the Rheumatology Clinic and Doctoralia doctor. As to whether it is hereditary, the expert argues that some studies have shown that in lupus there is a relevant genetic predisposition. However, it also recognizes that it is complex to determine due to the large number of genes involved.

Because SLE is a disease that can affect any organ and the symptoms are sometimes nonspecific, the diagnosis must be differential and be conducted by a specialist, which in this case is the Rheumatologist.

The most frequent symptoms of lupus: cutaneous manifestations and depression

“The spectrum of symptoms of Lupus is very broad. There is usually a syndrome that combines fatigue, fever, weight loss, arthralgias and / or arthritis, skin lesions in the form of photosensitivity or malar erythema (what is known as “erythema on the wings of a butterfly”, leaving the cheeks and nose red), and alopecia, “explains the rheumatologist. Cutaneous manifestations are the most common, especially in the case of systemic lupus erythematosus , since approximately 75% of patients suffer from them. In more extreme cases where the disease is combined with other pathologies, arteriovenous thrombosis and spontaneous abortions may occur.

Along with physical manifestations, which affect various organs of the body, Lupus often also has neuropsychiatric symptoms, such as depression and mood disorders . These symptoms affect between 17% and 75% of patients. “The main factors that trigger this picture are the pathophysiology of the disease, the use of steroids and the various psychosocial stressors related to the chronicity of SLE,” says the expert.

“Although the relationship of mood disorders with SLE is not well studied, the fact is that up to 43% of patients can suffer major depressive episodes, combined with alterations in the ability to concentrate, psychomotricity, appetite and sleep. Anxiety is also usually present, whether due to neurological involvement or because of the difficulty involved in the diagnosis and treatment of this disease, “concludes Dr. Romero.

How to live with Lupus?

” Although systemic lupus erythematosus is considered a chronic disease, the activity of this and its symptoms are not always present, ” says Dr. Romero. The disease manifests itself through outbreaks, which combine with periods of apparent inactivity, although the chronic damage that the disease leaves is still present. These outbreaks can be controlled with medication. The expert stresses: “Generally, patients can lead a normal life, although they must follow a series of precautions such as avoiding contact with infectious diseases, avoiding tobacco and alcoholic beverages, reducing salt intake, avoiding direct exposure to sunlight and use appropriate clothing and protective creams to take care of your skin. “

It is also important to avoid stress, both physical and mental, and not perform intense physical exercise in the outbreak periods of the disease. Respect the rest periods, as Selena Gómez did in her day , is vital in the treatment of any type of Lupus . Women, in addition, have to avoid oral contraceptives and, if they want to become pregnant, they must consult with their rheumatologist beforehand to plan it so that their health is not put at risk.