Selena Gomez calls lupus a daily struggle: From joint pain to skin rash—early symptoms, causes, and treatment

Lupus is a Latin word meaning “wolf”. The term was coined because the rash in a lupus patient resembles wolf bites! Lupus is a chronic auto-immune disease where the body’s autoimmune system, instead of performing its normal protective function, produces antibodies that start attacking healthy tissues and cause inflammation.

Paula Abdul, Lady Gaga and Selena Gomez are just a few of the many celebrities who have been diagnosed with lupus and use their platforms to educate followers about the autoimmune disease.

In a 2019 interview with People, Selena Gomez said, “I’ve found that anxiety, panic attacks and depression can be side effects of lupus, which can present their own challenges. It’s a daily struggle.”

Knowing the early warning signs is important for patients to begin treatment for the disease as soon as possible, much like other life-threatening conditions.

What is lupus?

An autoimmune condition known as lupus develops when the body’s immune system attacks its own cells and organs.

Dr Kaushik Bhojani, Head of Rheumatology Services, Fortis Hospitals, shares more about Lupus, the secretive wolf of autoimmune disease.

“Normally these antibodies are meant to fight off external infections such as bacteria and viruses. However, in lupus, the body loses the ability to distinguish between these foreign invaders (antigens) and our normal healthy tissue. So the body’s immunity The system starts fighting against it.” It has its own ‘self’,” says Dr Kaushik.

The antibodies then combine with the self-antigens to form immune complexes within the tissues that cause inflammation within the organs. It can sometimes cause major health problems and can even be fatal!

“Often, in our country, the disease is diagnosed late because the patient approaches the rheumatologist late. By this time, the inflammation has affected multiple organs and then the disease becomes life-threatening. Young lives are often lost by it when the disease is diagnosed,” comments Dr Kaushik.

Lupus: Causes

The causes of lupus are many, and sometimes quite vague. Lupus occurs in a genetically predisposed individual who is exposed to a trigger; Some well-known triggers are:

Sun and ultraviolet exposure

– bacterial or viral infection

Hormonal treatments containing estrogen can trigger a flare-up.

Some medications can also cause flare-ups

– Known to provoke extreme exertion, stress and emotional upheaval, in diagnosed cases

– Pregnancy can trigger a flare of lupus and therefore patients with lupus should plan their pregnancy only when the disease is well controlled and consult their rheumatologist who will do a detailed workup before the couple plans a pregnancy .

However, often, one is not able to identify the cause of the trigger.

Lupus: Symptoms

A major symptom is a skin rash on the face, particularly the cheek bones – known as a ‘malar rash’. It is usually shaped like a butterfly’s wings and hence is also called ‘butterfly rash’. Other symptoms include:

Sun sensitivity

– painful swollen joints

Frequent mouth ulcers

– excessive hair loss

– persistent anemia

– Prolonged fever with no clear evidence of infection anywhere

Fingers turn white or blue when exposed to cold

– Excessive fatigue

– Kidney failure in youth for no apparent reason – such as swollen feet, foamy urine

Chest pain and shortness of breath on exertion

When a combination of more than one symptom is present, it is easy to suspect the disease.

Lupus: When to See a Doctor?

Generally, it is common practice for the patient to consult his family physician in case of fever, general body ache etc. And if the onset of the disease is accompanied by joint pain, usually a patient first consults a nearby orthopedic surgeon. However, if the patient has ‘plus syndrome’, which means that the symptoms are affecting different aspects of the patient’s body, then the patient should not lose time.

“If the patient has joint pain and hair loss or the patient has low-grade fever and joint pain or a skin rash along with hair loss and joint pain, it is important to realize that this is a It is not a common disease and a specialist consultation is needed,” highlighted Dr Kaushik.

What are the treatment options for lupus?

The management of lupus involves three major aspects:

a) Arriving at the diagnosis correctly and quickly. Some autoimmune diseases can look similar and a correct diagnosis is essential. A detailed history is not negotiable with a thorough medical evaluation. Laboratory tests are then performed to confirm the diagnosis. Tests range from routine hematology tests to immunologic tests such as the antinuclear antibody test (ANA). This ANA is followed by a thorough immunological test for clinical signs based on internal organ resection.

b) Assessment of degree of involvement: A detailed clinical assessment from head to toe is important as lupus may involve one or several organs. Treatment will depend on the extent of lupus and the intensity of the organ inflammation.

c) Monitoring of disease control: At each visit, answering a detailed questionnaire, and conducting laboratory tests to assess internal organ function, as well as evaluation is necessary to keep the disease under good control.

Based on the above three parameters, the treatment and intensity of treatment are to be determined. However, it is very important to remember that there is no permanent cure for lupus, and the treatment will need to be continued indefinitely even after the patient feels that he is well.

lupus prevention

Measures include:

a) The patient should avoid sun exposure between 9.00 am to 5.30 pm

b) If unavoidable, it is essential to cover up well using long-sleeved clothing and use of a hat and sunglasses. In addition, the use of a sunscreen with an SPF greater than 40 is essential.

c) Avoid going for picnics on beaches or river banks as sunlight reflected from the water is an even more dangerous trigger. There is no question of swimming in the sunlight

d) It is necessary to avoid hormonal pills containing estrogen, so even for contraception, only progesterone pills are safe.

e) While consulting other doctors, they should be informed that you have lupus and you should consult your rheumatologist to make sure that there is no risk from the treatment prescribed by him

f) Before any planned surgery, you should consult with your rheumatologist and preferably have your surgeon talk to your rheumatologist.

g) Importantly, planning pregnancy in active disease should be avoided.