Lupus Erythematosus.
Last updated Thursday, December 23, 2004
Prognosis and impactsHow serious is lupus erythematosus? Is lupus erythematosus chronic? Lupus may be a mild disorder in some people, but for others it can
lead to serious problems. Each person is different, and what is true
about someone else's disease may not apply to you.
Lupus is a chronic, systemic, inflammatory disease. Chronic means it
lasts a long time, probably for the rest of your life. However, nearly
all people with lupus have fluctuations in disease activity known as
flares and remissions. At times there may be no signs or symptoms of
lupus at all (remissions). Some people have complete and long-lasting
remissions. A systemic disease is one in which many different parts of
the body may be affected. Inflammatory refers to a reaction of the body
resulting in pain, heat, redness and swelling.
Although lupus is a chronic disease, this doesn't mean you can't
live a full life. Chronic diseases can't be cured but they can be
controlled through proper treatment.
Special concerns for people with lupus
People with lupus are more likely to develop infections. This is true
partly because of the illness itself, and partly because of the side
effects of medications, especially corticosteroids and
immunosuppressive drugs. In some people with lupus, infections can
trigger disease flares.
Exposure to the sun and fluorescent lighting is known to make
the skin rashes associated with lupus worse in most people. Sun
exposure may also cause generalized flares of lupus, resulting in
fevers, joint pains, or even inflammation involving the heart, lungs,
kidneys or nervous system. Of course, what is too much sun for one
person may be fine for someone else. However, it's best to take simple
precautions. These include regularly using a sunscreen lotion or sun
block on your skin and avoiding outdoor activities during peak sunlight
hours (usually 10 am to 4 pm). Sunscreens may be bought without a
prescription, and are available in many different forms, some of which
also include skin lubricants. Those with a sun protection factor of 15
or more are the best. Some chemicals in sunscreens may cause skin
irritation or rashes, so it is important to try a different type of
preparation if this occurs. During unavoidable times of sun exposure,
it is important to wear a hat to shade you from direct sun and clothing
to cover the arms, legs and chest.
Because of possible problems from sun exposure, you may
wonder if it is safe to move to a warmer climate. As long as you
protect yourself when you go out in the sun, your illness should not
affect where you live.
Will lupus erythematosus change the patient?s ability to have children or get pregnant?
Pregnancy
may mean special problems for women with lupus. Fertility, or the
ability to conceive, may be decreased during periods of disease flares.
This may be the result of hormonal changes caused by lupus or from side
effects of medications used to treat lupus. Women may experience lupus
for the first time or a worsening of their symptoms during pregnancy or
several weeks to months after delivery.
Women with lupus have an increased chance of having a
miscarriage. This can occur either early or late in the pregnancy.
Certain abnormal antibodies present in the blood of some women with
lupus may contribute to the chance of a miscarriage. Therefore it is
important that you discuss your plan to become pregnant with your
doctor, and that you are seen regularly by your doctor during the
pregnancy. Blood tests to detect the presence of the abnormal
antibodies and to measure other signs of lupus activity should be done
regularly. With these precautions, many women with lupus can have
normal pregnancies.
Occasionally, newborn babies of mothers with lupus have a
mild illness caused by transfer of the mother's antibodies through the
placenta to the baby. This illness may include a rash, low blood
counts, or an enlarged liver. These features go away, generally by six
months after birth. Rarely, babies may have a permanent problem called
congenital heart block, which causes a slow heart beat. This may
require treatment with a pacemaker.
If your doctor advises against pregnancy, or if you do not
wish to have children, the safest method of contraception for women
with lupus is the diaphragm used with contraceptive jelly. Some women
with lupus are able to use birth control pills safely, either
combination pills with low dose estrogen and progesterone or
progesterone only (minipill) preparations. Intrauterine devices (IUD's)
are not advisable because of the risk of infections connected with
their use.
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