What is the lupus life expectancy? Come find out how people with systemic lupus erythematosus live directly from a doctor.
In this article, you will obtain everything you need to know about Systemic lupus erythematosus. Its symptoms, cause, complications, and treatment. Besides, we will talk about how all those elements have to do with the lupus life expectancy. Keep on reading to get pearls on this topic directly from a doctor.
What is systemic lupus erythematosus?
Systemic Lupus Erythematosus (SLE), or simply lupus, is an autoimmune disorder. Autoimmune diseases happen when the immune system begins attacking the body tissues.
An immune system is a group of cells within organs throughout the body in charge of protecting it from viruses, bacteria, and parasites. Immune cells have control measures, which involve many mechanisms to prevent damage to the body while stopping potential infections. If these mechanisms become altered, the immune system might attack the body by mistake.
When there is immune system activation, and it attacks the body. It causes inflammation in different locations. Inflammation is a typical response that involves four main characteristics: redness, heat, swelling, and pain of the inflamed tissue.
When inflammation is not adequately controlled, it can result in damage that disrupts normal function. Lupus can affect many parts of the body like the brain, the liver, the kidneys, the skin, and the joints. Lupus can also damage the heart and lungs.
Overall, the most common organ complication is in the kidney. Since lupus is so different from one person to another, individualized care from several specialists is very important.
The name lupus originates from the Latin term for “wolf” because the skin rash on the face resembles a wolf’s bite. The word erythematosus originates from the Greek word for “red” because of the color of facial lesions. These two characteristics make up the disease’s name, but not all patients with lupus have them.
Besides, lupus can vary over time, and symptoms may change. Continuous supervision with a doctor is always needed. SLE manifests in periods of activity, episodes that are called “flares.” During a lupus flare, people tend to feel sick, and the symptoms tend to get worse.
Who is at risk of getting SLE? Does lupus run in families?
Overall, lupus erythematosus is about ten times more frequent in women. The most common age for lupus to develop is from 15 to 45 years, women’s reproductive years. Children and men can also develop SLE, but it is not very frequent.
African descendants, Hispanics, Asians, and American natives are more at risk than Caucasian whites. Many studies propose a genetic component in lupus patients. Some have found sets of twins where one twin’s risk is higher if the other twin has lupus. This situation strongly suggests that lupus has some relation with families.
However, many SLE patients do not have family members with lupus. This supports the idea that lupus patients have a genetic predisposition, but environmental factors determine the disease’s development.
Healthy people with a family member with SLE only have a slightly higher risk of developing the condition. Being at risk or having family members with SLE means that a person can develop the disease.
Some people with lupus patients in the family also have altered exams (ANA tests are explained below). These exams can indicate an abnormal immune system function as it happens in lupus erythematosus. These healthy people with altered exams are at even higher risk of developing lupus.
Sadly, there is no effective treatment to prevent lupus development. Therefore, there is no reasonable reason for practicing lupus exams on healthy patients. These exams, besides, can be altered in healthy people who do not develop SLE.
What are the symptoms of lupus?
In theory, lupus can affect any part of the body, thus causing a very wide variety of symptoms. A lupus patient’s classic symptoms can include fatigue, weight loss, low-grade fever, and a sun-sensitive rash.
The rash is more frequent in sun-exposed areas like the cheeks, the neck, or the upper chest. The face rash sometimes has a characteristic butterfly shape and might be confused with a condition called rosacea.
Another common symptom of lupus erythematosus is arthritis or arthralgias. Arthralgia is the medical term for joint pain, while arthritis involves inflammation and will be further explained. These general symptoms above and arthralgia can be very similar to a mild viral infection like infectious mononucleosis.
Arthritis in SLE patients can be similar to rheumatoid arthritis. Pain, swelling, redness, and heat in a joint are the staple of inflammation of the joints (arthritis). Morning stiffness and multiple affected joints on both sides of the body (symmetric arthritis) can occur in both diseases. However, when arthritis occurs in different joints and is asymmetric, it is more likely to be lupus. For example, arthritis on the left wrist and the left knee is asymmetric.
On the other hand, arthritis of both wrists or both knees is symmetric. Besides the most common symptoms, other more specific manifestations of the disease may occur.
A very particular expression of lupus is Raynaud’s syndrome. This phenomenon is where the fingers or toes become pale or blue when exposed to cold or stressful events. The fingers become pale firstly; then they might turn blue, and finally red. Raynaud’s does not only happen in lupus, as it can appear in other autoimmune diseases.
When lupus affects a specific organ, the symptoms are more specific and depend on the targeted organ.
What are the organ-specific symptoms of lupus?
Anemia is a common blood finding in lupus patients. Anemia is a condition in which blood hemoglobin (an oxygen-transporting protein) is low. When hemoglobin is low, oxygen supply to the tissues is inadequate.
You might feel tired, sleepy, and look pale. Anemia is more common in disease onset. Low lymphocyte count is another common finding in SLE. Lymphocytes are a type of cell from your immune system. They are usually low when the disease is more active.
Manifestations of lupus on the skin vary from one person to another. Specialists classify lesions according to their length. This means they can be acute (hours or days), sub-acute (weeks), and chronic (months).
Acute rashes are the most common form. They appear on the face, chest, arms, or any part exposed to sunlight. This feature of sun sensitivity is called photosensitivity. Mouth and lip blisters are also types of acute lesions.
Subacute lesions are not very common among SLE patients. Medications like terbinafine, TNF-α inhibitors, anticonvulsants, and proton pump inhibitors (PPIs) are common subacute lesion triggers.
NF-α inhibitors are a kind of medication used to treat other autoimmune diseases like rheumatoid arthritis and inflammatory bowel disease. Omeprazole, pantoprazole, or lansoprazole are PPIs. They treat gastritis and acid reflux.
The chronic cutaneous lupus erythematosus (lupus of the skin) manifests as discoid lupus. Discoid lupus happens only in the neck, head, and face. Lesions heal slowly and frequently leave scarring. It is more common in skins of color. Discoid lupus leaves significant white scars.
A dry or red eye is one of the most common eye symptoms. It usually comes with mouth dryness and it is called Sjögren’s syndrome.
When the disease affects the intestines, loss of appetite, nausea, vomiting, abdominal pain and diarrhea are frequent. Other intestinal complications exist, although uncommon.
What are the potential complications of lupus that could decrease the lupus life expectancy?
One of the most widespread complications of lupus is renal failure. This is a condition in which the kidney can no longer maintain its function of filtering the blood. Approximately half of the lupus patients have kidney damage to some degree. Sadly, kidney transplant in these patients is possible but more problematic.
Around 30% of SLE patients have a condition called pleural effusion. The pleura is like a bag that covers the lungs. In a pleural effusion, the bag fills with a liquid that makes it difficult for the lung to take in air. It feels difficult to breathe with pleural effusion, and some chest pain or discomfort can also appear.
Another one is pulmonary hypertension when pulmonary blood vessels are affected. The heart has difficulty pumping the blood through the lungs to get oxygen.
A feared eye complication is retinal inflammation (retinitis). The retina is an internal layer of the eye that receives light in order to see. An affected retina might affect sight.
Another form of complication is vasculitis. This is a condition where the blood vessels are inflamed. Vasculitis can affect any organ.
When vasculitis affects the brain’s blood vessels, patients can have seizures, dementia, or psychosis. Seizures are a misfunction of the brain cells. They usually manifest as a loss of consciousness and generalized and uncontrolled movements in the entire body.
Dementia is a loss of cognitive functions. Patients with dementia have trouble remembering things, choosing words, or doing simple math. Psychotic patients have trouble differentiating reality from their imagination. Hallucinations and delusions are frequent in psychotic patients. Other neurologic conditions without vasculitis are also possible.
Complications in the intestine are not that common. However, because of the use of anti-inflammatory medication, patients should be careful of gastritis and peptic ulcer disease.
Can lupus affect the heart and vessels?
Chest pain is the leading cardiac symptom in lupus patients and pericarditis is one of the main forms of heart disease in lupus.
The pericardium is a bag that covers the heart. In pericarditis, the bag inflames, and it causes chest pain. This chest pain usually gets better when leaning forward.
Another form of heart affection is myocarditis. This condition is the inflammation of the heart muscle itself. Myocarditis is a very serious condition that can ultimately cause heart failure.
In heart failure, the heart is unable to pump blood correctly. Vasculitis can also affect the heart’s blood vessels and cause intense pain, similar to a heart attack. Yet, vasculitis of the heart vessels is not frequent.
Lastly, lupus can cause inflammation of the inner-most layer of the heart: the endocardium. This condition is called endocarditis. In lupus, it receives the name of Libman-Sacks endocarditis. This condition damages the normal function of the heart valves.
Heart valves are tissue tags inside the heart that assure blood flow in the correct direction. Endocarditis rarely causes the valves to work unproperly. However, when the valves work unproperly, heart failure is possible.
Also, when lupus is associated with antiphospholipid syndrome, blood clots are more common than in the general population. Blood clots can travel inside the blood vessels and interrupt blood flow anywhere.
The brain and the lungs are two common places where blood clots are deposited. In the brain, it interrupts the blood flow and can cause a stroke. In the lungs, it causes sudden chest pain and difficulty breathing. A clot in the lungs (pulmonary thromboembolism) is a very serious condition that can be fatal.
What is an antiphospholipid syndrome, and how is it related to lupus life expectancy?
Antiphospholipid antibody syndrome (APS) is an autoimmune disease where the immune system produces antibodies against a substance called phospholipids.
The immune system produces antibodies (proteins) to attack disease-causing entities like viruses or bacteria. In this case, the target of the antibodies is phospholipids. This makes the blood clotting mechanisms more active.
APS is approximately five times more frequent in women than men. It is a frequent cause for them of miscarriages, preterm births, and low birth weight babies. Also, it is usually associated with other autoimmune diseases; despite that, it can also occur alone.
Around 40% of all lupus patients have antiphospholipid syndrome. Although 4 out of 10 SLE patients have APS, only half of them will experience thrombosis or miscarriages.
Thrombosis occurs when a blood clot forms in an artery and interrupts blood flow. To diagnose the antiphospholipid syndrome, a blood test is necessary. A nurse or lab technician draws blood from one of the forearm veins and sends it to the lab.
In the lab, a technician performs tests to determine the presence of antiphospholipid antibodies. Several tests and antibodies exist. At least one has to be positive on two occasions. Also, the presence of clots is necessary to make the diagnosis.
Many people live with antiphospholipid autoantibodies without having clots in their lives. Treatment includes anticoagulant medication (blood thinners, like Heparin or Warfarin) and medications to inactivate platelets (like Aspirin or Clopidogrel). Platelets are blood cells that are closely related to the clotting function.
Are the kidneys severely affected?
Kidney damage in systemic lupus erythematosus is very common. It manifests as an inflammation of the kidneys. The medical term is lupus nephritis. The main symptoms of kidney damage are high blood pressure, low urine production, and foamy urine. Urine can be of a dark color.
When doctors suspect renal involvement, they might perform some blood tests to assess your kidney function. A urinalysis is also important and will help determine the cause.
If it is lupus causing kidney problems, a renal biopsy will determine the type of lupus nephritis. A kidney biopsy is essential for doctors to choose the right treatment. Approximately half of all lupus patients develop evident kidney manifestations, but biopsies show that the remainder without symptoms also has renal disease.
Renal complications increase lupus mortality by all causes and decrease lupus life expectancy. For example, renal complications increase the risk of cardiovascular disease. And it also increases the risk of infections due to dialysis.
This dialysis is a process where a machine filters the blood the same way the kidneys would. End-stage renal failure lupus patients need dialysis to remove the waste the kidneys are not removing. Sadly, approximately 1 out of 5 patients with systemic lupus erythematosus will need dialysis in the disease’s normal course.
What tests are needed in lupus?
Tests depend on the moment of the disease. In patients who do not know if they have systemic lupus erythematosus, tests are different from those diagnosed.
To make the diagnosis, the main test is the anti-nuclear antibodies (ANA). These antibodies attack components of the cellular nucleus. The part where the genes are located.
ANA can be anti-double-stranded DNA or anti-Smith antibodies. Both are specific to SLE, but not all SLE patients have them.
Apart from that, other important tests are assessing antiphospholipid antibodies and the levels of complement proteins in the blood. Complement proteins are blood proteins that fight off potential disease-causing agents. They are different from antibodies because compliment proteins do not have specific targets.
In lupus levels of some complement proteins are usually low. C3 and C4 are the complement proteins measured in SLE. Besides testing, doctors will have findings from the physical exam that will support the diagnosis. This means that only the lab results are not enough to confirm someone has lupus.
On the other hand, when a patient is already known to have lupus, doctors will ask for other tests to screen for specific organ damage. The following is a non-exhaustive list of the possible tests.
- Complete blood count to assess hemoglobin and white blood cell levels. White blood cells are immune system cells.
- To inform about inflammation in the body Erythrocyte Sedimentation Rate and C-reactive protein tests are useful.
- Complement levels are also helpful in determining disease activity.
Systemic Lupus Erythematosus is hard to diagnose because of its many possible scenarios. In some opportunities, it is not evident when symptoms are too mild.
What is the lupus treatment and how does it affect life expectancy?
Systemic lupus erythematosus doesn’t have a cure yet, but medication can reduce the disease’s effects and complications.
Since it is an autoimmune disease, its treatment’s main goal is to decrease the body´s inflammatory response. The lupus treatment depends on the severity of the patient’s disease and if there is an organ affected.
One of the most used drugs is hydroxychloroquine, a drug habitually used against malaria. Hydroxychloroquine is the main pillar in the treatment of SLE, especially in the long term. This medication can prevent and treat flares and joint inflammation, mouth sores, and rashes. Many scientific studies showed that this drug could greatly increase life expectancy and life quality overall.
When the disease gets more severe and complications start to happen, specialists use other drugs to reduce inflammation. These are corticoids (Prednisone, among others) in high doses, so there will be immunosuppression and decreased inflammation in affected organs. The downside of this medication is that it causes several side effects, and some of them can be dangerous.
As there is immunosuppression, the patient becomes susceptible to infections of any kind since the body cannot protect itself now. Although it definitely reduces organ damage, if the patient is not taken care of, an infection could be fatal. Other side effects of this medication are weight gain, increased blood pressure, violet stretch marks, weakened bones, depression, etc.
Other immunosuppressant drugs are methotrexate, cyclophosphamide, and rituximab. To control and reduce the pain because of lupus, patients can also take non-steroid anti-inflammatory drugs (NSAIDs). Examples of these are ibuprofen, paracetamol, diclofenac, naproxen, and many others.
A new drug called Belimumab was recently approved but studies are still inconclusive on whether it produces enough benefits.
How severe is lupus? What is the lupus life expectancy?
Lupus can be a very serious condition. In the past, lupus life expectancy was short. In fact, only about 50 % of SLE patients survived five years after the diagnosis.
Nowadays, the lupus life expectancy has raised, the 15-year survival rate is over 80%. In other words, after diagnosis, more than four-fifths of people live longer than fifteen years. The treatment has improved lupus life expectancy for the patients and has reduced disease complications.
However, cardiovascular disease and organ failure are still important causes of death; hence, diminishing lupus life expectancy. Sadly, complications because of lupus treatment are also important today.
For example, infections are a common treatment complication. Medicines used in lupus weaken your immune system, and a weakened immune system cannot attack viruses and bacteria.
Today people can live with lupus even 40 years after the diagnosis. Compared to several other diseases, lupus life expectancy is not bad at all.
Does the lupus life expectancy worry you? Do you have symptoms of it?
This is a systemic lupus erythematosus or LUPUS Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this condition. Therefore, it will tell anybody who uses it the likelihood of their symptoms being because of lupus. It is free and would only take a few minutes. Keep in mind that lupus life expectancy is different between people who receive treatment for the disease and people who do not. That is why the diagnosis of this disease is key.