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    A Visual Guide to Understanding Lupus

    What Is Lupus?

    Lupus is a lifelong disorder of the immune system. Immune cells attack the

    body's own healthy tissues, leading to inflammation and tissue damage.

    Symptoms may be limited to the skin, but more often lupus also causes

    internal problems such as joint pain. In severe cases, it can damage the heart,

    kidneys, and other vital organs. Although there's no cure, there are

    treatments that can minimize the damage.

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    Lupus Symptom: Joint Pain

    Joint and muscle pain is often the first sign of lupus. This pain tends to occur

    on both sides of the body at the same time, particularly in the joints of the

    wrists, hands, fingers, and knees. The joints may look inflamed and feel

    warm to the touch. But unlike rheumatoid arthritis, lupus usually does not

    cause permanent joint damage.

    Lupus Symptom: Butterfly Rash

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    A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and

    bridge of the nose. Other common skin problems include sensitivity to the

    sun with flaky, red spots or a scaly, purple rash on various parts of the body,

    including the face, neck, and arms. Some people also develop mouth sores.

    Lupus Symptom: Nail Changes

    Lupus can cause the nails to crack or fall off. They may be discolored with

    blue or reddish spots at the base. These spots are actually in the nail bed, the

    result of inflamed small blood vessels. Swelling may also make the skinaround the base of the nail look red and puffy.

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    Lupus Symptoms: Fever and Fatigue

    Most people with lupus experience some degree of fatigue. In many cases, it

    is severe enough to interfere with exercise and other daily activities. Most

    patients also run a low-grade fever from time to time. This unexplained fever

    may be the only warning sign in some people.

    Lupus Symptom: Light Sensitivity

    Many people with lupus are unusually sensitive to the sun and other forms

    of ultraviolet light. A day at the beach may trigger a skin rash in areas

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    exposed to sunlight and may worsen other lupus symptoms. Certain

    medications can make people with lupus even more sensitive to UV light.

    Lupus Symptom: Hair Loss

    The symptoms of lupus tend to come and go, and this includes hair loss.

    Patients may go through periods where their hair falls out in patches or

    becomes thinner all across the scalp. Once the flare-up is over, new hair is

    likely to grow back.

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    Lupus Symptom: Raynaud's

    Some people with lupus develop a condition called Raynaud's phenomenon.

    Their fingers and toes become painful, numb, and tingly in response to cold

    temperatures or emotional stress. This happens when small blood vessels

    spasm and restrict blood flow to the area. During an attack, the fingers and

    toes may turn white or blue. People can also have Raynaud's without having

    lupus or any serious health complications.

    Lupus or Something Else?

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    When lupus begins, it can look a lot like rheumatoid arthritis, which causes

    joint pain and swelling, or fibromyalgia, which causes fatigue and pain. One

    aspect that sets lupus apart is the combination of skin rashes with joint pain

    and fatigue. There are also lab tests that can help distinguish lupus from

    other diseases.

    Diagnosing Lupus

    Diagnosing lupus can be tricky. The disease can mimic other conditions, and

    it often takes a different course in different people. Many people have it foryears before developing tell-tale symptoms. Although there is no one test for

    lupus, certain proteins usually show up in a patient's blood. A blood test for

    antinuclear antibodies (ANAs) can provide a critical clue. Other lab tests

    may check cell counts, kidney function, and clotting time. A tissue biopsy of

    an involved organ such as the skin or kidneys sometimes helps with

    diagnosis.

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    Who Gets Lupus?

    Anyone can get lupus. But it affects women 10 times more often than men.

    Aside from being female, your odds of getting the disease are higher if you

    are:

    African-American, Latino, or Asian

    Between the ages of 20 and 40

    Related to someone with lupus

    Types of Lupus

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    When people say "lupus," they usually mean systemic lupus erythematosus

    (SLE), the most common and serious type. But there are other types.

    Cutaneous lupus erythematosus -- also called discoid lupus -- is limited to

    the skin and doesn't cause the organ damage that sometimes occurs with

    SLE. The most common symptom is a circular rash. Drug-induced systemic

    lupus causes temporary lupus symptoms in people who take certain

    medications.

    Medical Treatments for LupusThere are ways to control the symptoms of lupus. These include

    corticosteroid creams for rashes and nonsteroidal anti-inflammatory drugs

    (NSAIDs) for joint pain and fever. Antimalarial medications can help fight

    joint pain, ulcers, and rashes. Corticosteroids may also be given as pills. In

    severe cases, they can be given intravenously. People with severe lupus may

    benefit from drugs that suppress the immune system.

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    Self-Care for Lupus

    Making some changes to your routine can also help reduce lupus flare-ups:

    Cover up when you're in the sun.

    Don't smoke.

    Exercise regularly.

    Improve your stress management skills.

    Also be sure to get plenty of rest. Some people with lupus need up to 12

    hours of sleep a night.

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    Lupus and Kidney Problems

    As lupus progresses, it can interfere with the body's organs. Up to three out

    of four people with lupus can develop kidney problems. These problems

    may not cause symptoms, though some people notice swelling in their legs

    or ankles. Most patients only learn about their kidney trouble when a urine

    test reveals blood or abnormal protein levels.

    Lupus and Heart Problems

    The most common heart problem linked to lupus is an inflammation of thesac around the heart. This may cause severe pain in the left side of the chest.

    People with lupus are also more likely to develop plaques that narrow or

    clog the arteries. This can lead to coronary artery disease. Other

    complications include heart valve disease and inflammation of the heart

    muscle. Call 911 immediately for chest pain, rather than trying figure out the

    cause yourself.

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    Lupus and Lung Problems

    The tissue surrounding the lungs becomes inflamed in about a third of

    people with lupus. This may lead to painful breathing, or chest pain, or it

    may not cause any symptoms at all. Sometimes lupus causes chest pain that

    is not related to the lungs or the heart. Instead, the pain comes from an

    inflamed chest muscle or rib joint. Any chest pain should be promptly

    evaluated by a doctor.

    Lupus and Digestive Problems

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    Digestive problems are not common with lupus, but some people may

    experience belly pain, nausea, vomiting, difficulty swallowing, or

    inflammation of the liver or pancreas. This can be related to lupus itself or

    medications used to treat the disease. Some people tend to lose weight

    during lupus flare-ups.

    Lupus and Anemia

    Lupus and the medications used to treat it can contribute to anemia in some

    patients. This means the body has too few red blood cells, because it is notmaking enough, or red blood cells are being destroyed more quickly than

    they can be replaced. Symptoms include fatigue and shortness of breath.

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    Lupus and the Nervous System

    Lupus can trigger a wide range of problems with the nervous system, most

    commonly headaches. Mild memory problems are a less common complaint

    that may come and go over time. Some people with lupus have a greater risk

    for a stroke, and in rare cases, the disease can lead to seizures.

    Lupus and Mental Health

    Depression and anxiety are a risk for people with lupus. This may be the

    result of the condition's affect on the nervous system combined with the

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    emotional strain of coping with a chronic illness. Be sure to discuss any

    concerns about your mood with your doctor or other health care provider.

    There are highly effective treatments for depression and anxiety.

    Lupus and Pregnancy

    Most women with lupus can get pregnant, though the condition increases the

    risk of complications during pregnancy. Because lupus symptoms come and

    go, the best time to get pregnant is when symptoms are at a minimum.

    Women who conceive when symptoms are in remission are less likely tohave complications. Make sure your obstetrician knows you have lupus.

    Your medications may be modified and you may undergo extra monitoring

    to ensure a successful pregnancy.

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    Neonatal Lupus

    Most babies born to women with lupus are entirely healthy. But in rare

    cases, the newborn of a mom with lupus may have neonatal lupus. This

    condition can cause a skin rash, anemia, or liver problems. The symptoms

    usually go away after a few months and don't cause permanent damage.

    However, some babies with neonatal lupus can be born with a serious heart

    problem.

    Living with Lupus

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    The fatigue and joint pain associated with lupus can make it more difficult to

    do your job or care for your children. You may have to cut back on activities

    or ask for help when symptoms flare up. But most people with lupus are able

    to continue with their usual activities.

    Outlook for Lupus

    Thanks to improvements in treatments for lupus, people with the condition

    are living significantly longer. The outlook for any given individual depends

    on how severe the disease is, and whether any vital organs are affected. Butmost people with lupus can expect to live a normal or nearly normal life

    span.

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