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Lupus: an autoimmune disease that disproportionately affects young women

Singer Selena Gomez continues to raise awareness about lupus since she publicly revealed her diagnosis in 2015. Recently, she announced on Instagram that she had a kidney transplant due to the disease.

What is lupus? We spoke with a Sunnybrook expert about the disease, which disproportionately affects women in their twenties and thirties.

“Women are nine times more likely to get lupus than men, and especially women in their younger years,” says Dr. Shirley Chow, a rheumatologist of Sunnybrook’s Holland Musculoskeletal Program.

Lupus is an autoimmune condition that can cause swelling of joints and inflammation of tissues and in organs. Normally, the body’s immune system forms antibodies to fight infections or cells it recognizes to be separate or external. With lupus, the immune system no longer differentiates and begins to attack itself.

“We think that estrogen, in younger women, may play a role in increased risk for overactive or altered immune response,” says Dr. Chow.

I’m very aware some of my fans had noticed I was laying low for part of the summer and questioning why I wasn’t promoting my new music, which I was extremely proud of. So I found out I needed to get a kidney transplant due to my Lupus and was recovering. It was what I needed to do for my overall health. I honestly look forward to sharing with you, soon my journey through these past several months as I have always wanted to do with you. Until then I want to publicly thank my family and incredible team of doctors for everything they have done for me prior to and post-surgery. And finally, there aren’t words to describe how I can possibly thank my beautiful friend Francia Raisa. She gave me the ultimate gift and sacrifice by donating her kidney to me. I am incredibly blessed. I love you so much sis. Lupus continues to be very misunderstood but progress is being made. For more information regarding Lupus please go to the Lupus Research Alliance website: www.lupusresearch.org/ -by grace through faith

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Condition has ‘a thousand faces’

Lupus affects each individual differently. “It is the disease with a thousand faces,” says Dr. Chow, who adds that affected areas include the skin, joints, hair, heart, kidneys, lungs, blood, joints, brain and heart.

First diagnosis can be tricky

Systemic lupus erythematosus or SLE is the most common and serious type. Initial diagnosis can be difficult, says Dr. Chow, as lupus is systemic or affects the entire body, is very individualized, and symptoms range from flu-like symptoms such as fatigue, fever, joint pain and severe headache, to a red rash across the cheeks and nose, sensitivity to sunlight, hair loss, hives, fingers and toes changing colour in the cold, and a mild or severe decrease in kidney function. Because symptoms can be wide-ranging, Dr. Chow recommends individuals at risk for lupus should check in with their doctor.

A special blood test called antinuclear antibody (ANA) test can help determine if there is autoimmune activity, but does not provide a definitive diagnosis. And a positive ANA test does not make the diagnosis of lupus, as this result can be seen in up to 20 percent of the normal population. Other clinical features should be present, and more specific antibody tests, anti-dsDNA and anti-Sm antibodies, may be present. That’s where rheumatologists are the trained experts to help diagnose this disorder.

Potential triggers

Lupus is not contagious, but does have possible triggers. Colds, trauma, stress, and exposure to chemicals or sunlight can bring on an overactive immune response.

“Major hormonal shifts such as pregnancy require special attention. Though most moms with lupus have healthy babies, some may have high-risk pregnancies and should consult their family doctor or obstetrician,” says Dr. Chow.

Living with lupus

Most individuals with this lifelong condition can choose to be as active as they want to be. The key, Dr. Chow says, is to prevent or manage flare-ups that can happen from time to time, where symptoms become intense. She says a healthy diet, getting regular exercise and adequate sleep, not smoking, wearing sunscreen, getting immunized regularly and lowering your stress levels – these all have benefits to help individuals manage their unique condition. In severe flare-ups, short-term-use medications can help to relieve symptoms.

If lupus is left untreated, resulting inflammation in an affected area or organ can lead to tissue damage or possible loss of function. It is important to work with your health care provider to find the best treatment for each individual.

About the author

Natalie Chung-Sayers

Natalie Chung-Sayers is Sunnybrook's Communications Advisor for the Holland Musculoskeletal Program and the St. John's Rehab Program.

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