A lot of people have heard about lupus, but few people really know about the disease. Proof of this is that there are many myths and doubts surrounding the subject. For example, is this a disease that only affects women? Is it contagious? What symptoms do you have? Is there a cure? All of these and other questions will be clarified below.
What is lupus?
Evandro Mendes Klumb, coordinator of the Lupus Commission of the Brazilian Society of Rheumatology (SBR) and president of the Society of Rheumatology of Rio de Janeiro, points out that systemic lupus erythematosus (SLE), or simply lupus, is an inflammatory, autoimmune and chronic disease.
Below you know better the main facts about this disease:
1. The main characteristic of the disease is the intermittence (intercalation) of its clinical manifestations.
Klumb explains that the person with lupus usually has stages in which he has symptoms, called by doctors "periods of activity". and, other times, in which it is without manifestations of the disease, called period of "remission".
Precisely because of this, "even if the person does not have any symptoms, it is not possible to say that the disease is" cured ", because the immune changes remain present and can determine the return of symptoms again," says the doctor.
"It is necessary to maintain medical control continuously with the use of one or more medications, for most people with lupus, who help keep the disease under control," adds the expert.
2. Lupus is an inflammatory and autoimmune disease.
Evandro Klumb explains that lupus can have symptoms in various organs, which are due to inflammation, caused by an imbalance in the immune system of the person, causing it to produce an increased amount of antibodies.
"It is precisely these antibodies that have the ability to react against proteins in our own body that establish the concept of autoimmune disease," explains the expert of the Brazilian Society of Rheumatology.
3. Lupus depends on genetic inheritance but is related to environmental factors.
It is noteworthy that the immune system is designed to protect the human body from bacteria, viruses and other pathogens. In the case of autoimmune diseases, it generally identifies parts of the body as pathogens and attacks them.
But it is not possible to define a single cause for this? Mistake? immune system. Do you believe in combining genetic trends with environmental factors? among them, not only ultraviolet irradiation, but also tobacco, as pointed out by expert Klumb.
4. There are two types of lupus: systemic and cutaneous.
Evandro Klumb points out that there are two types of lupus: one is the systemic, characterized by presenting symptoms in various organs, such as skin, lungs, heart, kidneys, joints and others, may have a severe or not. "In this systemic form, are also common general symptoms with tiredness, discouragement, anemia, low fever and weight loss," he says.
The second type, according to the doctor, is a disease that only has symptoms on the skin, ie there is no manifestation in other organs and is called cutaneous lupus.
5. Lupus can have very varied symptoms.
Evandro Klumb reinforces that systemic lupus erythematosus (SLE) triggers symptoms that may appear in various organs, slowly and progressively (months) or faster (in weeks) and vary with phases of activity and remission.
The rheumatologist points out that in the early stages of SLE, especially, the symptoms that bother you most are:
- Discouragement;
- Tiredness;
- Loss of appetite.
Also according to Klumb, most people with SLE may also have, at some point:
- Joint pain, sometimes also with swelling (arthritis).
In addition, in general, as rheumatologist Klumb points out, at least 50% of lupus sufferers will have, at some point in the disease:
- Inflammation in the pleura (membrane covering the lungs) or in the pericardium (membrane covering the heart);
- Kidney inflammation, which does not necessarily determine pain, but protein loss in the urine, swelling in the legs and face, high blood pressure and, in more severe cases, kidney failure requiring hemodialysis.
In the case of cutaneous lupus, the symptoms occur only in the skin. It can generally occur:
- Hypersensitivity to light (redness / inflammation of the skin on light-exposed parts such as the face and lap);
- Stains;
- Hair loss.
Expert Klumb points out that any organ or tissue may be involved in the inflammation that occurs in lupus, but some are particularly worrying. "In the skin of the face, for example, the person may have marks and, therefore, stigmatized, which determines decreased self-esteem, especially for women," he says.
6. Lupus is more prevalent among women than among men.
Evandro Klumb explains that the disease can occur in people of any age, race and gender, but women are much more affected, especially in the age group between 20 and 45 years.
Also according to the doctor, it is estimated that 120,000 to 250,000 people have systemic lupus erythematosus (SLE) in Brazil. ? 1 out of every 1,000 women in Brazil have systemic lupus erythematosus (SLE). In Rio de Janeiro, it is estimated that the disease affects between 8 and 14 thousand people. In São Paulo, experts estimate the existence of 12 to 18 thousand SLE carriers ?, adds Klumb.
7. Treatment of lupus varies with the severity of the disease.
The diagnosis of SLE is made by a rheumatologist who recognizes the characteristic symptoms of the disease, associated with tests that include blood count, kidney evaluation and research of the disease's own immunological disorders.
The treatment of lupus patients, according to Evandro Klumb, depends on the type of manifestation presented and should be individualized. The goal is to rebalance the immune system as well as control pain and inflammation. And the treatment begins by raising awareness of the patient ?, explains.
The intensity with which this rebalancing (of the immune system) is sought and the amount of drugs needed for this control depends fundamentally on the severity and extent of the disease, according to the doctor:
Initial and lighter cases: only chloroquine or hydroxychloroquine (which are immunomodulators) and analgesics may be used.
More advanced or more severe cases: It may be necessary to use corticosteroids (cortisone), immunosuppressants and, more modernly, also some medicines called biological agents as? missile? therapy. or "target" therapy.
The expert adds that some measures are fundamental for the immune balance of lupus patients:
- Protective measures against sunlight or irradiation (using photoprotectors),
- Smoking cessation,
- Away from stressful conditions,
- Balanced diet,
- Adequate rest,
- Regular physical activity.
8. It is not yet possible to talk about healing lupus, but about controlling the disease.
Currently, it is not possible to talk about cure of lupus, but control of the disease, says Klumb. "There are countless people with SLE who only use chloroquine (medicine) and general measures with good disease control," he says.
However, the doctor points out, most will need regular follow-up every three to six months with a rheumatologist. "Because in case of a reactivation of the symptoms of the disease, these should be controlled early on, allowing the person to quickly rebalance their immune system and restore their health," he explains.
9. Most people with lupus lead a normal life.
"Today, we can say that most people with lupus lead a relatively normal life, although this normality fluctuates and depends on regular follow-up with the rheumatologist," says expert Klumb.
10. Lupus is not a contagious or hereditary disease.
Although many people have doubts about this, it is myth to say that lupus is a contagious disease. She is an inflammatory, autoimmune and chronic disease.
As far as heredity is concerned, this is another myth. Do experts believe in genetic predisposition, but not in heredity? that is, it is not because a person's mother has the disease, for example, that she too will have.
Another myth is that a lupus patient can never have children. Although pregnancy is not indicated while the disease is active, the woman may become pregnant, provided it is planned and authorized by the doctor.
Finally, it is noteworthy that it is a consensus among the specialists of the Brazilian Society of Rheumatology (SBR) that new knowledge about the mechanisms involved in the development of systemic lupus erythematosus (SLE) is increasingly emerging. This also gives rise to new drugs that are more effective and have fewer adverse effects.
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