Neurological Sequelae of Lupus

Neurological sequelae of Lupus is an immune system disorder caused by an overactive immune system, which produces unregulated, large amounts of abnormal antibodies that then attack the organs and tissues of the body. Parts of the body that are affected by the resultant inflammation include:

• Blood vessels
• Joints
• Kidneys
• Lungs
• Skin
• Heart
• Nervous system

Neuro-immunological conditions are neurological disorders that are caused by inflammation or autoimmunity. These conditions can affect multiple body systems and cause a range of symptoms, such as weakness, walking problems and difficulty with speaking, swallowing or chewing.

The exact causes of neuro-immunological conditions are not fully understood, but research suggests that they may result from an abnormal immune response that attacks the body’s own tissues and cells, including the nervous system. Factors that may contribute to the development of these conditions include genetic predisposition, viral or bacterial infections, environmental triggers and exposure to toxins.

Lupus is more common in African American, Hispanic and Asian American women and is most often diagnosed in people between ages 15 and 45. A family history of lupus or other autoimmune diseases also increases risk.

Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (blood thinners), such as warfarin or heparin, to prevent your blood from clotting too easily.

If you have symptoms of lupus, work with your healthcare professional to get a diagnosis. Screening for lupus includes:

• A complete physical exam. Your doctor will look for rashes and other signs that something is wrong.
• A blood and urine test. The antinuclear antibody (ANA) test can show if your immune system is more likely to make the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not always mean you have lupus. If you test positive for ANA, your doctor will likely order more tests for antibodies that are specific to systemic lupus erythematosus (SLE).
• A skin or kidney biopsy. A biopsy is a minor surgery to remove a sample of tissue. The tissue is then viewed under a microscope. Skin and kidney tissue looked at in this way can show signs of an autoimmune disease.

Your doctor may use any or all of these tests to make your diagnosis. They also can help your doctor rule out other diseases that can be confused with lupus.

In lupus, the immune system that normally protects the body against infections and disease attacks healthy tissue, causing inflammation and other damage. Neurological complications from lupus can include:

• Headache
• Mild cognitive dysfunction
• Damage to the peripheral nerves that carry signals between the brain and spinal cord and to the rest of the body
• Seizures
• Personality changes
• Stroke
• Dizziness

Lupus can also affect other parts of the body, including the joints, skin, kidneys, lungs, heart and blood vessels. There is no cure for lupus, and treatment is symptomatic, such as aspirin and other nonsteroidal anti-inflammatory medications, corticosteroids and immunosuppressive drugs.

It can be difficult to diagnose lupus, as symptoms are very similar to other diseases. Some are born with a genetic predisposition for lupus that is then triggered by anything from infections to drugs and even sunlight.

Many people have lupus for a while before they find out they have it. If you have symptoms of lupus, tell your doctor right away. No single test can tell if a person has lupus. But your doctor can find out if you have lupus in other ways, including:

• Medical history: Tell your doctor about your symptoms and other problems. Keep track of your symptoms by writing them down when they happen. Also, track how long they last.
• Family history of lupus or other autoimmune diseases: Tell your doctor if lupus or other autoimmune diseases run in your family.
• Complete physical exam: Your doctor will look for rashes and other signs that something is wrong.
• Blood and urine tests: The antinuclear antibody (ANA) test can show if your immune system is more likely to make the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not always mean you have lupus. If you test positive for ANA, your doctor will likely order more tests for antibodies that are specific to systemic lupus erythematosus (SLE).
• Skin or kidney biopsy: A biopsy is a minor surgery to remove a sample of tissue. The tissue is then viewed under a microscope. Skin and kidney tissue looked at in this way can show signs of an autoimmune disease.

Your doctor may use any or all of these tests to make your diagnosis. They also can help your doctor rule out other diseases that can be confused with lupus.

There is no cure for lupus, and treatment is symptomatic, such as aspirin and other nonsteroidal anti-inflammatory medications, corticosteroids and immunosuppressive drugs. Treatments can help you feel better and improve your symptoms. Your treatment will depend on your symptoms and needs. The goals of treatment are to:

• Prevent flares
• Treat symptoms when they happen
• Reduce organ damage and other problems

Several different types of medicines treat lupus. Your doctors and nurses may change the medicine they prescribe for your lupus as your symptoms and needs change.

Types of medicines commonly used to treat lupus include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen and naproxen, help reduce mild pain and swelling in joints and muscles.
• Corticosteroids. Corticosteroids (prednisone) may help reduce swelling, tenderness and pain. In high doses, they can calm the immune system. Corticosteroids, sometimes just called steroids, come in different forms: pills, a shot or a cream to apply to the skin. Lupus symptoms usually respond very quickly to these powerful drugs. Once this has happened, your doctor will lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. Stopping this medicine suddenly can harm your body.

Talk to your doctor about any side effects you may have or. Also tell your doctor:

• If your medicines no longer help your symptoms
• If you have new symptoms
• If you want to become pregnant
• About any vitamins or herbal supplements you take—they might not mix well with medicines you use to treat lupus
• If you take antimalarial drugs. Medicines that prevent or treat malaria also treat joint pain, skin rashes, fatigue and lung inflammation. Two common antimalarial medicines are hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen). Studies found that taking antimalarial medicine can stop lupus flares and may help people with lupus live longer.
• If you take BLyS-specific inhibitors. These drugs limit the amount of abnormal B cells (cells in the immune system that create antibodies) found in people with lupus. A common type of BLyS-specific inhibitor that treats lupus symptoms, belimumab, blocks the action of a specific protein in the body that is important in immune response.
• If you are taking immunosuppressive agents or undergoing chemotherapy. These medicines may be used in severe cases of lupus, when lupus affects major organs and other treatments do not work. These medicines can cause serious side effects because they lower the body’s ability to fight off infections.
• About any other medicines you are taking. You may need other medicines to treat illnesses or diseases that are linked to your lupus—such as high blood pressure or osteoporosis. Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (also known as blood thinners), such as warfarin or heparin, to prevent your blood from clotting too easily. You cannot take warfarin during pregnancy.

Some individuals diagnosed with lupus find success treating symptoms with alternative medicine. Some try creams, ointments, fish oil or supplements they can buy without a prescription. Some people try homeopathy or see a chiropractor to care for their lupus. Some people with lupus who try these types of treatments say that they help.

Research studies have not shown any benefits to these types of treatments. And research studies have not been done to see if these treatments hurt people with lupus.

Talk to your doctor or nurse before trying any alternative medicine. Also, don’t stop or change your prescribed treatment without first talking to your doctor or nurse.

Several different types of medicines treat lupus. Your doctors and nurses may change the medicine they prescribe for your lupus as your symptoms and needs change.

Types of medicines commonly used to treat lupus include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen and naproxen, help reduce mild pain and swelling in joints and muscles.
• Corticosteroids. Corticosteroids (prednisone) may help reduce swelling, tenderness and pain. In high doses, they can calm the immune system. Corticosteroids, sometimes just called steroids, come in different forms: pills, a shot or a cream to apply to the skin. Lupus symptoms usually respond very quickly to these powerful drugs. Once this has happened, your doctor will lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. Stopping this medicine suddenly can harm your body.

Talk to your doctor about any side effects you may have or. Also tell your doctor:

• If your medicines no longer help your symptoms
• If you have new symptoms
• If you want to become pregnant
• About any vitamins or herbal supplements you take—they might not mix well with medicines you use to treat lupus
• If you take antimalarial drugs. Medicines that prevent or treat malaria also treat joint pain, skin rashes, fatigue and lung inflammation. Two common antimalarial medicines are hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen). Studies found that taking antimalarial medicine can stop lupus flares and may help people with lupus live longer.
• If you take BLyS-specific inhibitors. These drugs limit the amount of abnormal B cells (cells in the immune system that create antibodies) found in people with lupus. A common type of BLyS-specific inhibitor that treats lupus symptoms, belimumab, blocks the action of a specific protein in the body that is important in immune response.
• If you are taking immunosuppressive agents or undergoing chemotherapy. These medicines may be used in severe cases of lupus, when lupus affects major organs and other treatments do not work. These medicines can cause serious side effects because they lower the body’s ability to fight off infections.
• About any other medicines you are taking. You may need other medicines to treat illnesses or diseases that are linked to your lupus—such as high blood pressure or osteoporosis. Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (also known as blood thinners), such as warfarin or heparin, to prevent your blood from clotting too easily. You cannot take warfarin during pregnancy.

Some individuals diagnosed with lupus find success treating symptoms with alternative medicine. Some try creams, ointments, fish oil or supplements they can buy without a prescription. Some people try homeopathy or see a chiropractor to care for their lupus. Some people with lupus who try these types of treatments say that they help.

Research studies have not shown any benefits to these types of treatments. And research studies have not been done to see if these treatments hurt people with lupus.

Talk to your doctor or nurse before trying any alternative medicine. Also, don’t stop or change your prescribed treatment without first talking to your doctor or nurse.

Start by seeing your family doctor and a rheumatologist, a doctor who specializes in the diseases of joints and muscles such as lupus. Depending on your symptoms or whether your organs have been hurt by your lupus, you may need to see other types of doctors. These may include nephrologists, who treat kidney problems, and clinical immunologists, who treat immune system disorders.