There are different types of lupus. The most common is Systemic Lupus Erythematosus (SLE), which affects many parts of the body. Other types include:
- Cutaneous lupus, which causes a characteristic butterfly-shaped rash across the face, usually when exposed to sunlight.
- Drug-induced lupus is caused by an overreaction to certain medications. The symptoms are similar to SLE except that they are transient and disappear once the medicine is stopped.
- Neonatal lupus is an acquired autoimmune disorder that is present at birth and caused by transfer of autoantibodies from pregnant mother to child. Symptoms including a rash, which is sensitive to sunlight, liver and blood problems resolve within 6-12 months of birth. The most serious complication of neonatal lupus, congenital heart block, results in permanent injury to the heart and requires a pacemaker.
The exact cause of lupus is unknown, although it’s likely a combination of genes, hormones and environmental factors.
Because the symptoms of lupus are varied and unpredictable, diagnosis can be difficult and take time. A combination of prescribed medications and lifestyle changes mean many people with lupus can lead an almost-normal life. However, it’s a chronic inflammatory disease with the most serious health risks being cardiovascular disease, kidney disease and stroke. People with lupus have an increased risk for developing atherosclerosis (hardening of the arteries), myocarditis and endocarditis (inflammation in the heart), which can result in heart murmurs.
The immune system
One way our immune system protects us is through the production of antibodies, which attack bacteria and viruses. However, people with lupus produce ‘autoantibodies’ that attack their own tissues. These autoantibodies cause inflammation, pain, and damage to various parts of the body. Over time, this leads to long-term organ damage and even organ failure.
Our lupus research at Garvan seeks to identify and isolate the immune cells responsible for making these autoantibodies, and determine how they’re different from normal immune cells. This helps us target the bad cells while preserving the rest of the immune system.
It's likely that certain genetic variations cause some people to be more susceptible to lupus. But understanding these variations can also point to more targeted treatment options. Our research uses cellular genomics to help accelerate the development of such treatments.
- Diagnosis & Treatment
There does appear to be a genetic predisposition to lupus, so if your parents had an autoimmune disease, you’re more likely to develop a disease like lupus. However, genes alone do not determine who gets lupus. It is likely that several factors, many of which have not yet been identified, cause disease.
Women aged between 15 and 45 are also more likely to be affected.
Other risk factors and triggers include:
- exposure to sunlight, which is common cause of flare-ups
- medications – antibiotics, blood pressure and anti-seizure drugs
- infections like a cold or viral illness
- ethnicity – lupus is more common in Indigenous Australians, Africans, Hispanics, Asians and Native Americans.
Symptoms vary greatly between individuals and can fluctuate between active periods (flares) and times of minimal or no symptoms (remission). They include:
- Sun-sensitive rashes on the face and body
- Painful inflammation of one or more joints, which may cause the disease to be mistaken for rheumatoid arthritis
- Impaired kidney function due to severe inflammation and blood vessel blockages
- Mouth ulcers
- Chest pain due to pleurisy (inflammation of the lining of the lungs)
- Blood clotting problems
- Hair loss
- Unexplained headaches, fits or mood swings
- Extreme fatigue
- Recurrent miscarriages.
Considering the variety of lupus symptoms, it’s very important to confirm a correct diagnosis. This is done by reviewing medical history and performing a complete physical examination, including blood tests for anti-DNA antibodies which are a hallmark of systemic lupus erythematosus, taking skin and kidney biopsies to ascertain the extent of the disease, and checking for abnormalities in blood cells.
This also means ruling out a range of diseases which have similar symptoms.
Current treatment focuses on improving quality of life by minimising flare-ups and the expression of symptoms. This includes lifestyle modifications, sun protection and diet.
Further disease management includes medication such as anti-inflammatories, steroids and immunosuppressant drugs.
Read more about how our research is hoping to find better and targeted drug treatments for lupus.