What Are The Complications Of Sle
SLE can have both short- and long-term effects on a persons life. Early diagnosis and effective treatments can help reduce the damaging effects of SLE and improve the chance to have better function and quality of life. Poor access to care, late diagnosis, less effective treatments, and poor adherence to therapeutic regimens may increase the damaging effects of SLE, causing more complications and an increased risk of death.1
SLE can limit a persons physical, mental, and social functioning. These limitations experienced by people with SLE can impact their quality of life, especially if they experience fatigue. Fatigue is the most common symptom negatively affecting the quality of life of people with SLE.2,3
Many studies use employment as a measure to determine the quality of life of people with SLE, as employment is central to a persons life.3 Some studies have shown that the longer a person has had SLE, the less likely they are to be a part of the workforce. On average, only 46% of people with SLE of working age report being employed.3
Adherence to treatment regimens is often a problem, especially among young women of childbearing age . Because SLE treatment may require the use of strong immunosuppressive medications that can have serious side effects, female patients must stop taking the medication before and during pregnancy to protect unborn children from harm.
Can I Have Rheumatoid Arthritis And Lupus
by Patient Advocate
Is there an association between rheumatoid arthritis and systemic lupus erythematosus ? Can someone have both diseases or must he or she be diagnosed with only one? What are the challenges in addressing these questions and more?
From a recent article published in the journal Arthritis Research & Therapy, the average RA patient has 1.6 comorbidities and that number increases with the patient’s age. There is increasing interest in the field of comorbidity and rheumatic diseases.
“The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions.”
How are RA and Lupus diagnosed?
The American College of Rheumatology has defined criteria for the diagnosis of rheumatic diseases, including rheumatoid arthritis and lupus. The following lists of criteria were developed in 1987 and 1982 .
Rheumatoid Arthritis – At least four of seven criteria must be met for diagnosis:
Lupus – At least four of eleven criteria must be met for diagnosis:
Symptoms Of Psoriatic Arthritis
Like lupus, your symptoms sometimes get better and sometimes flare up. You may get tired and have pain, swelling, and warmth in your joints.
If you have psoriatic arthritis you may get problems like:
- Severe swelling in your fingers or toes
- Foot pain, often at the bottom or the heel
- Pain in your lower back
- Scaly patches on your skin that flake
- Pitted or discolored nails
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Treatment Plans For Lupus And Ra
Something interesting to know about lupus and RA is that there is a genetic connection between the two conditions. People with a STAT4 gene that is mutated are more susceptible to developing both of these conditions. A study published in The New England Journal of Medicine revealed that people who carry this mutated gene have double the normal risk of developing lupus and a 60 percent heightened the risk of developing RA.10
Therefore, some of the same treatment strategies for one autoimmune condition may work well for the other one as well. It is also possible for an individual to have both lupus and RA at the same time. This is called comorbidity, which is the existence of multiple diseases that are independent of one another.11 Certain treatment plans can help reduce joint pain and organ damage for both conditions and also in the early stages of one disease in which the diagnosis is not yet clear.
Although there is no definitive cure for lupus, it is possible to manage the symptoms by taking medications to control joint pain and inflammation.3 Cortisone shots may help control inflammation as well. Individuals joint pain caused by both lupus and RA can benefit from using topical pain relieving creams, like JointFlex, to deliver onsite treatment where joints hurt the most. There are significant benefits to treating comorbidity conditions like lupus and RA simultaneously to reduce drug interactions and potential side effects.
Menopause And Increased Risk Of Disability
Menopause appears to influence the course of RA, leading to an increase in the activity of the disease and an increase in disability associated with RA.
One study found that post-menopausal women with RA had significantly higher levels of joint damage visible on radiography and significantly greater levels of physical disability than their pre-menopausal counterparts.3
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What About Side Effects
All drugs have some potential side effects, and you and your doctor will need to balance the risk of side effects with the need to control your symptoms. Sometimes this may mean taking additional medications to protect against the side effects of others.
Treatments such as calcium, vitamin D tablets and drugs called bisphosphonates may be given to guard against the bone-thinning condition osteoporosis. This condition can be a risk for people who take steroids at high doses or for long periods. You may be given DMARDs instead of high doses of steroids.
If you have lupus, and especially if youre on a DMARD or biological therapy, youll be more prone to infection. Take care to avoid contact with people with infectious diseases like chickenpox or if theyve recently been in hospital. You should discuss your vaccination status with your rheumatologist or GP. You might need to avoid live vaccines.
If you suffer from a severe infection or require antibiotics you may need to stop your DMARD treatment for a short time, and restart them once youve recovered from the infection.
Please visit our information pages on drugs for more information about your medication.
You might also need to wait for a period of time after coming off any of these drugs before it is safe to get pregnant. If you become pregnant unexpectedly while on one of these drugs, talk to your healthcare team as soon as you can.
If you can, its best to try for a baby when your lupus is not active.
What Is Causing My Irritable Bowel Syndrome
According to the National Institute of Diabetes and Digestive and Kidney Diseases , Irritable Bowel Syndrome is not one singular symptom but a complex grouping of symptoms, many of which can occur together.
A lot of people think of IBS as being just an ongoing case of upset stomach, but the truth is that IBS is the result of serious changes occurring within your gastrointestinal tract.
Like RA and other autoimmune disorders , the underlying cause of IBS is not yet scientifically known. However, researchers and doctors speculate that multiple things can cause IBS.
Some of the most commonly-reported issues that seem to cause IBS to include stress, anxiety, depression, intolerance or sensitivity to certain foods, bacterial infections, and an overabundance of unhealthy bacteria in the small intestine.
Again, as with autoimmune diseases, some individuals seem to be genetically predisposed to IBS.
The key to figuring out what is causing your IBS is to focus on the foods that you consume.
While there is no hard-and-fast medical test for this, you can attempt to undergo a gut detoxification process with the help of a trained nutritionist.
As Choung and Talley state, numerous studies on those who do diet eliminations and challenges have shown that the removal of trigger foods can improve IBS symptoms.
Some of the foods known to be culprits behind IBS symptoms include wheat, dairy, fried food, hot spices, caffeinated beverages, and gluten.
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Causes Of Autoimmune Disease
Doctors do not know exactly what causes the immune system to turn on the bodys own tissues, but they have identified what populations are most at risk.
Women are twice as likely to develop them as men, particularly women of childbearing age. Different autoimmune diseases are more common in different racial and ethnic groups.
In addition, some of these illnesses appear to be hereditary. In most cases, people who have a first-order relative with a particular autoimmune disease are more likely to develop the illness than the general population.
There are many hypotheses about what triggers an autoimmune illness. According to Healthline, Some doctors believe that our homes are too clean, with little exposure to bacteria.
This is called the hygiene hypothesis. Others, such as Dr. Amy Myers, blame the Western diet, environmental contamination, stress, and other causes.
Most doctors and scientists believe that people with autoimmune diseases have genes that leave them susceptible.
The diseases are then activated by an unknown environmental trigger. This would explain why these diseases can run in families but do not affect everyone in the family.
Most people with autoimmune diseases will have times when they have few symptoms and times when their symptoms are very severe.
These are known as remissions and flares. One of the goals of treatment is to reduce the severity of flares and lengthen the time of remissions.
Who Develops Rheumatoid Nodules
Most commonly, rheumatoid nodules develop in patients already living with rheumatoid arthritis for some time. They generally dont precede other rheumatoid arthritis symptoms.
Research suggests that rheumatoid nodules are commonly found in patients who possess high levels of the protein rheumatoid factor, an antibody seen in a handful of autoimmune disorders. This may mean that the patients may require treatment with drugs in the class of immunomodulators, such as Methotrexate.
Similarly, research has also shown an increased likelihood of developing nodules in rheumatoid arthritis patients who smoke, even though a direct link between smoking and the formation of rheumatoid nodules is still unclear.
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Need For New Therapies
Treatments for these diseases typically have been aimed at decreasing inflammation and pain by slowing down tissue damage and reducing complications. Most people with RA have only a partial response to available drugs, and many only respond to drugs for a limited period of time. In the case of lupus, no effective targeted therapies exist for the most severe forms of the disease. Research is needed to better understand the underlying disease process and identify parts of the immune system that aren’t functioning correctly. This insight will help reveal the most promising new biological targets for drug development and match existing drugs to patients with specific molecular profiles who are most likely to benefit.
Has Treatment Progressed For Arthritis
Progress is being made in all major types of arthritis. This research is proceeding more quickly in some areas than others. For example, for osteoarthritis, peoples lifestyles have been improved and their pain reduced through advances in injections, medicines and exercises however, there are no medicines yet that clearly stop the process of osteoarthritis.
For RA, in the last 15 years there have been major advances in management with the development of the biologic agents, such as etanercept and adalimumab . The role of these biologic medications in lupus remains an area of controversy. However, progress in lupus management has been made, and one biologic agent, the previously mentioned belimumab , is now FDA-approved for lupus treatment. For lupus patients, there is much cause for optimism. Lupus is now the focus of with a number of medications.
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Lupus Vs Rheumatoid Arthritis: Getting The Correct Diagnosis
With no definitive test for RA or lupus, rheumatologists must instead rely on a patients medical history, physical exam, and blood, urine, and imaging tests to make a diagnosis.
Since both conditions cause the same joint symptoms and can limit range of motion, that part of the physical exam isnt all that revealing, Dr. Agarwal says. What Im really looking for are things like rashes and swelling of the ankles that would indicate lupus.
What Is Inflammatory Arthritis
The clinical hallmarks of inflammation include redness, swelling, warmth and pain. If the patient has gout, the joint is very hot and red. In contrast, a person with osteoarthritis, which involves much less inflammation, will not tend to have warmth or redness in the joint, even if some swelling, pain and stiffness are present. For someone with lupus and joint pain, the first question the rheumatologist will consider is whether it represents the inflammatory arthritis that is commonly part of lupus.
Immunology Database And Analysis Portal
The partnership is using several new or developing technologies to analyze information from single cells and groups of cells involved in autoimmunity collecting tissue samples, including synovium from people with RA and kidney from people with lupus for molecular analysis developing computational tools to integrate different data types to characterize molecular pathways and making the data available to the broad research community for further analysis through dbGaP and ImmPort . The first datasets were released in 2018.
Researchers mining the data can seek to identify treatment targets to develop medicines for diseases of interest. The data also has potential implications for precision medicine, as AMP RA/SLE researchers identify differences in the pathways active in the tissue of different patients.
The Impact Of Both Conditions On The Joints
Both of these conditions can be challenging to diagnose, especially if the condition is caught early and when symptoms are relatively minor.7,8 Both lupus and RA are painful and cause damage to the joints.2,3 However, the type of arthritis that is most closely associated with lupus typically causes less joint damage than RA.9 People with RA are more likely than those with lupus to require surgery for severe joint damage.
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Disability Benefits For Lupus
Social Security Disability Lawyers: Riverside, Orange & San Bernardino Counties
Rheumatoid Arthritis and Systemic Lupus Erythematosus are examples of Autoimmune Disorders . These are potentially serious illnesses where a person’s own immune system goes rogue and attacks the body, rather than protecting the body from infection. In effect, the immune system becomes hyperactive and uncontrolled, causing inflammation and damage to many parts of the body, including the joints, muscles, skin, and, in some cases, the internal organs.
Disability Benefits for Systemic Lupus Erythematosus
In lupus, the immune system can attack not only the joints , but it frequently attacks the skin , the lungs , kidneys , central nervous system , and the liver .
Other Autoimmune Disorders
Although RA and lupus are some of the more common disorders, there are many others. In all of them, it’s the immune system that is at fault, causing persistent inflammation and damage to various parts of the body.
In Polymyositis and Dermatomyositis , the muscles and the skin are inflamed, which causes debilitating muscle weakness and skin rashes.
In Vasculitis, the blood vessels become inflamed, causing rashes and tissue damage.In Psoriasis and Psoriatic Arthritis, the skin and the joints become inflamed, causing plaques on skin and damage to the joints.
In Ankylosing Spondylitis, the spine and sacroiliac joints become inflamed, causing back pain and stiffness, and loss of motion as the disease progresses.
Blood And Blood Vessels
Lupus may also cause anaemia, which is when you have a lack of red blood cells. These cells carry oxygen around the body, and if you dont have enough of them you can get out of breath and tire quickly. If you have these symptoms you should tell your doctor or nurse specialist.
People with lupus might also have a low number of platelets, cells that help the blood to clot. If you find that you are bruising easily or notice bleeding from the gums or nose you should let your doctor or nurse specialist know. Lupus can also affect your white blood cells, which are important in fighting infections.
Some people with lupus are more at risk of developing blood clots in veins or arteries. This problem is usually caused by antiphospholipid antibodies. These autoantibodies can also affect pregnancy, causing an increased risk of miscarriage.
If blood clots occur blood thinning medication will be needed.
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Rheumatoid Nodules: Are Rheumatoid Nodules Dangerous
A variety of symptoms can occur when suffering from rheumatoid arthritis. The sporadic, yet chronic nature of the disease is such that symptoms may come and go over time and manifest in different ways.
One of the most common skin-based symptoms of rheumatoid arthritis is the development of nodules. These rheumatoid nodules occur in about one-quarter of rheumatoid arthritis patients, both men and women and their severity can vary from patient to patient. Although nodules are generally not dangerous or debilitating, there are treatment options available if it becomes necessary to have them reduced or removed.
The Role Of Imaging Tests
Imaging tests such as X-rays can be very helpful in determining the correct diagnosis of lupus vs. rheumatoid arthritis.
This is because lupus, unlike RA, rarely causes joint erosions. Your doctor may also order a chest X-ray if youre experiencing symptoms such as shortness of breath that could indicate lupus urine and blood tests can show whether your kidneys have been affected.
Iii Joint Pain Unrelated To Lupus Arthritis
Not all joint pains are due to lupus. Other conditions that need to be considered include the following:
refers to the death of bone tissue . Depending on its severity may either cause no symptoms, cause significant joint pain, and/or often collapse of the bones.
This condition is relatively common in lupus , but does not relate to the disease activity. In fact, osteonecrosis often happens when the lupus is quiet. It is often attributed to long-term use of high doses of glucocorticoids.
The most common joints to be affected are the hips , followed by the knees and shoulders. The diagnosis is often made by a plain . However, in early stages an MRI is necessary to show the problem.
Early stages may benefit from conservative therapy including pain medication and limited weight bearing. In more advanced disease, surgery is required. In cases of hip bone collapse, will need to be performed.
Osteoporotic Bone Fracture
may occur in lupus due to the disease or the medications used .
Usually, patients complain of sudden pain in a localized area of the spine, sometimes after only minimal trauma. X-rays will usually show the fracture as a compression of a vertebra. Sometimes MRI will be necessary for subtle cases. Fractures may also involve long bones such as the hip.