Ask the Doctor: Lupus
Q. My sister was just diagnosed with lupus. She is 56. Can you tell me more about this disease?
A. Lupus is one of those diseases that was categorized for us in medical school, as if it were somehow illuminating, as a connective tissue disease. Connective tissues is the name given to the group of body parts that no one, at least no one who is not a rheumatologist, can intuitively characterize. It includes tissues that have an extensive extracellular matrix of collagen and elastin which function, when healthy, like a rubber band, returning the tissue to its original length. There, that ought to clear things up.
Lupus, also called Systemic Lupus Erythematosus or SLE, is best understood as a disease in which the body's own immune system targets, in error, the body's connective tissue. When the body's connective tissue is under attack, the resulting inflammation damages the tissue. Episodes of intense inflammation produce worsening symptoms known as "flares".
Lupus flares may include symptoms of feeling tired all the time, unexplained fevers, joint pain, muscle pain, ulcers in mucous membranes, a red rash on the face, inflammation of parts of the heart, kidney trouble, headache, having trouble thinking clearly, depression, anxiety, psychosis, and many other potential symptoms. Because Lupus may affect so many different parts of the body (that connective tissue is everywhere!) with such varied symptoms, and because it has a waxing-and-waning nature, it is common for the diagnosis to take time to become apparent to doctors and patients, even if it is considered early and even with early testing.