Why Does Lupus Cause Hair Loss
One of the complications of lupus can be damage to your skin and hair loss. People with lupus can develop scarring on their skin and scalp from rashes. This can cause your hair to thin and fall out. You could also experience hair loss as a side effect of some medications that treat lupus hair loss can be a side effect of steroids. If your hair is thinning or falling out, talk to your healthcare provider. Sometimes, changing your medications can help with this issue. Your provider might also recommend using gentle shampoos .
Three Case Reports Of Rhupus Syndrome: An Overlap Syndrome Of Rheumatoid Arthritis And Systemic Lupus Erythematosus
Gul Devrimsel
1Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
Abstract
We present the clinical and serological characteristics of three patients with rhupus. The 3 patients with rhupus presented ACR criteria for SLE as well as for RA, ANA positive with a titer of 1/100 in all patients, and positive anti-DNA in 2 of the 3 patients, with the predominance of symmetrical polyarthritis. We found anti-CCP positivity and rheumatoid factor positivity and high titers in all patients, positive anti- anti-SSA in one patient, and positive anti- anti-Sm in one patient. Renal and liver function tests were normal in all patients. The 3 patients achieved clinical remission with DMARD treatment.
1. Introduction
2. Case Reports
2.1. Patient 1
A 50-year-old female was admitted with the complaints of intermittent pain in hand joints and morning stiffness for the past nine years. She gave a history of alopecia, fever, fatigue, malar rash, and oral ulcers for the last nine years. On physical examination, she had oral cold sores, tenderness and swelling on the 2. and 3. proximal interphalangeal joints bilaterally, tenderness on the wrist joints bilaterally, swan neck deformity on second finger of the right hand, and bilateral ulnar deviation. X-ray findings of the hands are shown in Figure 1.
2.2. Patient 2
Renal and liver function tests were normal.
2.3. Patient 3
3. Diagnosis and Treatment
4. Discussion
Dry Mouth And Dry Eyes
Have you suddenly found your mouth to be more parched than usual, and your eyes feel dry and puffy? These are yet more common symptoms of lupus. Or, more specifically, theyre symptoms of another autoimmune disease that people with lupus often get.
Its called Sjogrens disease. It leads to dry mouth and dry eyes, because it causes the glands responsible for tears and saliva to malfunction and lymphocytes can accumulate in the glands, saysHealthline. The source adds that women with lupus may find that this condition also causes vaginal dryness and dry skin.
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Lupus Is More Likely To Cause Chest Pain And Shortness Of Breath
Lupus can also attack other organs, such as the heart, lungs, and kidneys . If the lungs are affected, a person may experience shortness of breath and pleurisy, an inflammation of the linings of the lungs and chest that causes chest pain when you take a deep breath. If the heart is affected, it can also cause shortness of breath as well as chest pain that changes when you lean forward.
RA does sometimes affect the heart and lungs, but the symptoms arent quite the same, Dr. Agarwal explains. People with RA can also have shortness of breath but pleurisy is less common. And RAs impact on the heart usually in the form of coronary artery disease or heart attacks isnt seen until a person has had RA for several years.
What Are Symptoms Of Rheumatoid Arthritis And Lupus
Symptoms of both rheumatoid arthritis and lupus that are similar include:
- Joint pain and stiffness
- In rheumatoid arthritis, joint pain and stiffness usually begins in the small joints, such as those in the fingers or toes, or may occur in a single, large joint, such as the knee or shoulder. It usually affects the same joints on both sides of the body .
- In lupus, joint pain and stiffness often moves from one part of the body to another and does not tend to affect both sides of the body in the same way. Only a few joints are affected at one time, usually the fingers, wrists, and knees.
Other symptoms of rheumatoid arthritis that are different from lupus may include:
- Numbness and tingling in the hands
- Feeling unwell
- Sjögren’s syndrome
Other symptoms of lupus that are different from rheumatoid arthritis may include:
- Skin changes
- A “butterfly rash” that appears as redness over the cheeks and nose after sun exposure and is in the shape of a butterfly. The rash only lasts a few days and often returns.
- Circular patches of raised, scaly skin , which often leave a scar
- Sensitivity to sunlight which causes a skin rash after ultraviolet exposure
- Hair loss
- Painless ulcers or sores in the mouth
- Gender
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Does A Positive Antinuclear Antibody Test Mean I Have Lupus
Testing positive for antinuclear antibodies alone does not mean you have lupus. The ANA test is positive in most people with lupus, but its also positive in many people who do not have lupus. Because of this, a positive ANA alone isnt enough to diagnosis you with lupus. Your provider will typically look for at least three other clinical features before making a diagnosis of lupus.
The Role Of Blood Tests
The results of a complete blood count can also be revealing, he adds: Its more common for lupus patients to have a low white blood cell count, low platelet count, and certain forms of anemia.
Rheumatologists also check for the presence of certain autoantibodies in the blood to help make their diagnosis. The most basic test is the antinuclear antibodies test. People with lupus are almost always positive for ANA however, people with RA sometimes test positive as well, as do some healthy people.
If you get a positive ANA result for lupus, your rheumatologist will then order additional autoantibody tests including anti-double stranded DNA, anti-Smith, and antiphospholipid tests that help confirm a diagnosis of lupus.
If RA is suspected, your doctor will order tests that are more relevant for RA. These include rheumatoid factor and anti-cyclic citrullinated peptide antibodies, as well as tests that measure inflammation in the body, such as erythrocyte sedimentation rate and C-reactive protein .
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Sensitivity To Sunlight And Cold Temperatures
Sun exposure can cause a lupus rash to develop or flare. People with lupus are also at risk of developing Raynauds, a condition in which the small blood vessels in the hands and feet suddenly constrict when exposed to cold or stress.
Other lupus symptoms include fever neuropsychiatric issues such as depression, anxiety, seizures, or psychosis brain fog fatigue headaches mouth ulcers kidney problems and chest pain.
Read more here about lupus symptoms.
Rheumatoid Arthritis Lupus And Fibromyalgia
Rheumatoid arthritis, or RA, is an autoimmune disease, meaning that your body confuses healthy tissue for diseased tissue and subsequently attacks it.
As autoimmune disorders are frequently difficult for doctors to identify due to their sometimes vague symptoms and individualistic tendencies, it can be difficult for doctors to differentiate between RA and other diseases like lupus or fibromyalgia.
Some people may even have RA and lupus, fibromyalgia or other autoimmune diseases, which can make diagnosis and treatment even trickier.
In order to explore RA and its links to lupus and fibro, we need to first understand the differences.
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Herbs For Treating Ctds And Autoimmune Diseases
To strengthen the bodys own anti-oxidant status and liver removal of toxins, choose from amla fruit, dandelion root, milk thistle seed, wheat sprouts, and white peony root.
I often use two or three grams of concentrated wheat sprouts for a minimum of six weeks early in the therapy.
To directly remove inflammation and swelling, make a combination of herbs that reduce heat or heat and dampness such as ashwaghanda root, boswellia gum, honeysuckle flower, licorice root, raw rehmannia root, rhubarb root, willow bark, guduchi stem, and turmeric root
Essential fatty acids are critical to use
To modulate the immune system and reduce autoimmune attack, assuming the patient cannot tolerate biologics, use either low-dose prednisone high doses of vitamin D3. This part of the protocol is critical, not as an end in itself, but to buy time for the cleansing and dietary therapies to work.
For digestive support and to help the body eliminate protein or sticky deposits, use high doses of digestive enzymes These should be used along with guduchi stem or kaishore guggul.
To remove dampness and swelling, choose from black atractylodes, coix, dandelion leaf, and phellodendron bark.
To strengthen the connective tissue itself, choose from herbs and nutrients like glucosamine sulfate, gotu kola leaf, bamboo sap , flavonoid-rich fruits, multi-mineral combinations, hawthorn,stoneroot and MSM. In scleroderma cases, MSM is also useful topically, as a cream.
Acupuncture can be helpful.
How Is Lupus Diagnosed
There’s no single test that shows you have lupus. Your doctor will do a physical exam and may ask you to get some blood and urine tests that give clues about your condition. They may also suggest you get a chest X-ray to look for fluid or inflammation in your lungs or an echocardiogram to see if you have problems with your heart.
Your doctor may say you have lupus if you have at least four of 11 signs of the disease that are laid out by experts at the American College of Rheumatology:
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Oral And Nasal Lesions
The large majority of lupus sufferers report the painful development of sores or lesions inside the mouth or nose. The mouth sores are very similar to canker sores, which can make eating, drinking, and speaking very painful. In the case of sores located within the nostrils, breathing may become restricted, and the patient may experience pain and tenderness when coming in contact with the lesions.
A related symptom can result from light exposure, or photosensitivity. Some people with lupus can develop lesions on their skin surfaces after prolonged periods in the sun, while others report that their skin problems seem to get worse after going outside on a sunny day. The link between lupus skin lesions and sunlight isnt fully understood by doctors, but the bottom line is that if you start to experience these symptoms, you should visit your doctor for an explanation.
Treatments For Lupus And Rheumatoid Arthritis
Unfortunately, at this point, there is no cure for either lupus or rheumatoid arthritis. Both diseases are managed with symptomatic treatment including:
- Nonsteroidal anti-inflammatory drugs to relieve inflammation and pain.
- Immunosuppressive drugs, which dampen the immune response.
- Corticosteroids. Injections of corticosteroids into the joints can ease inflammation and reduce pain.
- Physical therapy
Specific treatment for rheumatoid arthritis includes disease-modifying anti-rheumatic drugs .
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About Rheumatoid Arthritis And Lupus
Rheumatoid arthritis and lupus are relatively common, severe disorders. About 1.5 million people or about 0.6 percent of the U.S. adult population have rheumatoid arthritis. Estimating how many people in the U.S. have lupus is difficult because symptoms vary widely and onset is often hard to pinpoint. Both conditions are autoimmune diseases that occur when the immune system mistakenly attacks parts of the body that it is designed to protect. They represent just two of a larger number of autoimmune disorders, including multiple sclerosis, Crohns disease, ulcerative colitis, type 1 diabetes, and psoriasis. These diseases share common flaws in immune function and regulation, leading to inflammation that destroys tissues. They can last a lifetime, cause severe disability, greatly affect quality of life, and are associated with increased risk of death.
Differences Between Rheumatoid Arthritis And Lupus
Rheumatoid arthritis and lupus are both autoimmune diseases that attack your body in a similar fashion. In autoimmune diseases, your immune system is unable to distinguish between certain healthy tissues and dangerous pathogens, like viruses or bacteria. It begins to attack, creating autoantibodies that damage your organs and tissues.
The specific parts of the body the immune system attacks are determined by what disease you have. While RA and lupus are similar, their differences are important when it comes to how you’re diagnosed and treated.
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How Are These Autoimmune Diseases Treated
While there are currently no curative treatments for these autoimmune diseases, there are courses of action that can lead to periods of remission or a reduction in flare-ups. Depending on the symptoms, there is a range of options that may be used singularly or in conjunction with each other. The symptoms that affect the skin are often the first and sometimes the only ones that appear and are often comparatively easier to treat than those that affect internal organs.
- Lupus: Over-the-counter anti-inflammatory drugs such as Motrin may be used in some patients to treat swelling and pain. Another option to treat inflammation is corticosteroids, though side effects can include a higher risk of contracting infections. Anti-malarial drugs including Plaquenil are often used to treat the symptoms of lupus because theyve been shown to alleviate joint pain, improve skin rashes and help reduce flare-ups significantly. Doctors may also prescribe immunosuppressants such as Azasan , which suppress the immune system to prevent it from attacking the cells it shouldnt be attacking.
Additionally, because ultraviolet light can cause flare-ups, patients are advised to be very careful with sun exposure, wearing sun-protective clothing, hats and sunscreen with a high SPF. There are certain local treatments that can be helpful but number one is sun protection, says Dr. Ramachandran.
Ra Vs Oa: Which Is Worse Rheumatoid Arthritis Or Osteoarthritis
Rheumatoid arthritis is a complex autoimmune disease with fluctuating symptoms and resultant complications that create a unique pattern in each patient. Often times, RA symptoms are confused with osteoarthritis symptoms. This confusion happens commonly during the initial stages of arthritic symptoms.
Despite the fact that both types of arthritis cause joint pain, the two diseases have different diagnostic criteria. Both are considered to be chronic and non-curable diseases, however, they have entirely different causes, symptoms, prognoses, and treatments.
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Causes Of Lupus And Rheumatoid Arthritis
The cause of either autoimmune disease remains a mystery. Still, certain risk factors may lead to the development of both lupus and rheumatoid arthritis.
Both conditions share a hereditary aspect. These autoimmune diseases rarely pass from parent to child, however having a family member with lupus or rheumatoid arthritis boosts the chances of developing the disease. For example, having a close relative with RA increases the risk factor by three to five times.
About 1 in 2,000 people in the U.S. live with lupus. Studies show that about 10 percent of people with lupus also have a family member with the condition. An identical twin with lupus increases the likelihood of the other twin developing it by 24 percent to 35 percent.
Differences In Complications Of Rheumatoid Arthritis And Lupus
Since lupus is more likely than RA to attack internal organs, there is a higher possibility of long-term heart and kidney damage with lupus. People with lupus can also develop a complication called lupus nephritis, which could lead to kidney failure.
During RA flare-ups, symptoms can sometimes become severe and trigger complications beyond joint pain and swelling. Some people with RA may experience heart or lung damage. RA increases the risk of blocked arteries or inflammation of the sac that surrounds the heart. Rheumatoid nodules may develop in the lungs and, in rare cases, may rupture causing a collapsed lung.
About 1 percent of people living with rheumatoid arthritis usually those who have had severe RA for at least 10 years develop rheumatoid vasculitis . RV is caused when blood vessels become inflamed, leading to a red, irritated rash or skin ulcers, numbness, tingling, and pain due to a lack of blood flow. Symptoms of RV are most prominent in the fingers and toes.
A chronically low white blood cell count, an enlarged spleen, high blood levels of rheumatoid factor proteins, and rheumatoid nodules are risk factors that can signal the development of rheumatoid vasculitis. Treating RA and keeping flare-ups to a minimum is key to avoiding not only rheumatoid vasculitis, but also further RA complications like joint deformities.
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What Makes Yale Medicines Approach To Treating These Autoimmune Diseases Unique
At Yale Medicine, we get together to discuss complicated cases to try to give the patients an interdisciplinary approach to their care, says Dr. Ramachandran. Theres definitely an advantage to have everyone on the same page,” she says.
Yale Medicine dermatologists also receive many referrals from doctors throughout the region.
“Through referrals, we see some of the more complicated cases, Dr. Ramachandran says. The doctors here truly care about their patients and try to come up with the best possible treatment regimens, working together to help patients with more challenging conditions.
Thyroid Problems And Weight Changes
In many cases, lupus and thyroid problems go hand in hand. And because one of the thyroids key functions is to control the bodys metabolism, when it isnt functioning properly, weight gain or weight loss can occur.
With weight loss, it may sometimes be hard to notice it as it can happen gradually. In some cases, however, it may happen very quickly . Weight gain, on the other hand, tends to occur slowly, even though there have been no dietary changes to cause it, and may be due to swelling in the feet or legs.
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