Lupus (SLE)

Author: DAVID P JOHNSON MB ChB FRCS FRCS. MD
Consultant Orthopaedic Surgeon

Summary
This booklet is written for people with lupus and their families and friends. It explains how lupus develops, how it affects different parts of the body, how it can affect people in different ways, and how doctors diagnose it. It then explains how it can be treated and offers tips and advice on living with it more easily.

Introduction
Lupus is an illness that mainly affects women during their child-bearing years. It is caused by a fault in the body’s immune system. The immune system normally protects us by fighting infections. In people with autoimmune diseases (of which lupus is one example), the immune system starts to attack body tissues (‘auto’ means ‘self’). This causes inflammation in those tissues. The effect this will have depends on which part of the body has been attacked by the immune system. This means that different people with lupus have different symptoms, depending on which part of the body is being attacked. For example, where the skin is attacked the main symptom is a rash, but if the joints are attacked the main symptom is joint pain.

The effect of lupus therefore varies greatly from person to person. For many people lupus represents little more than a nuisance condition, but for some the disease is very troublesome, even life-threatening. This uncertainty is a challenge for both the individual and the doctors who are trying to help. There are two main forms of lupus. One form is called discoid lupus. This form affects only the skin. The other form, systemic lupus (full name – systemic lupus erythematosus) involves the skin and joints and may involve internal organs such as the heart or kidney as well. This booklet deals only with systemic lupus erythematosus (sometimes shortened to SLE). Wherever the word lupus appears in this booklet, it means SLE, not discoid lupus.

Who gets lupus?
Lupus affects mainly young women. It is about nine times as common in women as in men and it is more common in Africans and Caribbeans than Asians, and more common in Asians than in white people. Only about 1 in 15 cases begin after the age of 50 and it very rarely develops after the age of 60. Around 1 in 250–500 women of Afro-Caribbean origin develop lupus, compared to 1 in 1000 Chinese women and 1 in 4000 white women.

Link: http://www.arc.org.uk/arthinfo/patpubs/6023/6023.asp
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