Myositis Overlap Diseases: Lupus
May is Lupus Awareness Month calling attention to another chronic autoimmune disease, which frequently overlaps with Myositis. An estimated 1.5 million Americans currently have Lupus as compared to 50,000 to 75,000 Americans living with Myositis.
While there are four types of Lupus, two are the most common: Systemic Lupus Erythematosus, referred to as SLE and Discoid, also referred to as Cutaneous.
- SLE is typically the most common form of Lupus and is generally considered more serious than the other forms. SLE can affect many parts of a person’s body including kidneys, heart, lungs, brain, blood and skin. Symptoms tend to vary among patients and can change often and suddenly. SLE can follow an unpredictable pattern of remissions and flares.
- Discoid is a form of Lupus that only affects the skin and causes rashes, which may occur anywhere on the body but are usually found on the face, neck and scalp. This type of Lupus does not affect any of the internal body organs although 1 in 10 people who have Discoid Lupus will develop SLE.
Symptoms of Lupus often include fatigue, a butterfly-shaped rash across checks and nose, fever, headaches, painful or swollen joints, anemia, edema, mouth or nose ulcers, light or sun sensitivity, hair loss, chest pain when breathing, Raynaud’s Phenomenon and abnormal blood clotting.
Lupus is sometimes called “the great imitator” because its symptoms often mimic those of other diseases such as Rheumatoid Arthritis, blood disorders, Fibromyalgia, Diabetes, thyroid problems, Lyme disease and a number of heart, lung, muscle and bone diseases.
No single lab test can diagnose Lupus. Tests that are commonly given could yield a positive result but may be due to another illness. Further, a test that is positive one time can be negative at another time. In addition, laboratories differ, so test results may vary.
A healthcare professional may detect red, painful, hot or inflamed parts of the body, facial rash and loss of function in certain body parts, which may indicate Lupus.
A variety of laboratory tests are used to detect physical changes or conditions in your body. Each test result adds more information to the picture your doctor is forming of your illness, however, laboratory tests alone cannot give a definitive answer.
Initial blood lab work may include a Complete Blood Count (CBC), CPK and SED Rate/ESR and C-reactive proteins (CRP), all of which are used to measure inflammation. An Antinuclear Antibody Panel (ANA) is often used and a positive ANA occurs in about 97% of those with Lupus. A Lupus Specific Panel may indicate specific antibodies which primarily occur with the disease. Tissue biopsies are also used to help pin down the diagnosis.
Many scientists believe that Lupus develops in response to a combination of factors, including hormonal, genetic and environmental.
Because 90% of people with Lupus are women, it is believed that there is a hormonal connection. Lupus appears to run in families, but no specific gene has been found.
While no gene or group of genes has been proven to cause Lupus. Lupus does appear in certain families. Lupus can develop in people with no family history of the disease, but some family members are likely to have another autoimmune disease.
As in Myositis, any number of environmental factors could play a part in triggering the disease including viruses, medicines, injuries, emotional stress, trauma such as surgery or childbirth and UV rays from the sun or fluorescent light bulbs.
Rheumatologists, doctors who specializes in diseases of the joints and muscles, generally treat people with Lupus. If Lupus has caused damage to a particular organ, the patient may be referred to a specialist such as a dermatologist for Discoid Lupus, a cardiologist for heart disease, a nephrologist for kidney disease, a neurologist for brain and nervous system disease or a gastroenterologist for gastrointestinal tract disease.
Patients are treated with a wide variety of medicines and may be changed over the history of the disease and prescribed medications will usually change during a person’s lifetime with Lupus. The right combination of medicines and dosages may be a trial-and-error process to keep Lupus symptoms under control.
As with Myositis, there are many categories of drugs used to treat Lupus, and the U.S. Food and Drug Administration has approved only a few specifically for Lupus, which include corticosteroids, antimalarials, and a few other drugs depending upon the type of Lupus.
For more information about Lupus, visit www.lupus.org.