Lupus: Signs and symptoms to watch for

Lupus is an autoimmune disease that affects 1 in 1,000 Canadians. The disease mistakes the body's healthy tissues for intruders. When the immune system fights the healthy tissues, it causes inflammation and creates the symptoms of lupus.

“It's a complex disease that can affect many of the body's systems such as the skin, blood, heart, kidneys and lungs, just to name a few,” says Dr. Lianne Butterfill, a physician in the Family and Community MedicineProgram at North York General Hospital.
Dr. Lianne Butterfill, Family Physician, North York General Hospital
Family Physician Dr. Lianne Butterfill

According to Lupus Canada, a person with lupus may experience:
  • joint pain, sometimes with swelling, redness and heat
  • a red rash across upper cheeks and bridge of the nose
  • an unusual reaction to sunlight
  • a red scaly rash
  • small, usually painless sores inside the nose or mouth
  • chest pain, worse when lying down or inhaling
  • swelling of feet and legs, weight gain
  • seizures or severe psychological symptoms
  • abnormalities in blood chemistry which show up in blood tests
Common symptoms of lupus
Common symptoms of lupus*
“Lupus can also present with symptoms such as fatigue and fever which can also be associated with many other diseases and infections,” says Dr. Butterfill. “Because of this, it can sometimes take months to years before enough signs and symptoms manifest in order to make the diagnosis.”

"Although the symptoms for lupus aren't very clear, it is commonly diagnosed by positive immunological markers and other findings in blood work,” says Dr. Butterfill. “Ancillary tests to check hematuria, impaired kidney function, inflammation of the lining of the lungs can also be done as well as other tests.”

The cause in most cases for lupus is unknown; however, a small percentage can be triggered by certain medications. Lupus tends to occur more commonly in women of child bearing age and certain ethnicities, such as Native and African Americans, seem to be more predisposed to the development of the disease.

Treatment and lifestyle changes

The treatment for lupus is targeted at the body's system that the disease is affecting. Most of the medications target pain control or suppressing the immune system in order to prevent it from attacking itself.

Dr. Butterfill explains that, “Since lupus is a disease of a chronic inflammatory state and because most of the medical management works by suppressing the immune system, people afflicted by this disease are at a higher risk of developing cardiovascular disease and infections.”

There are some preventative health measures she encourages patients to follow:
  • Exercise regularly.
  • Eat a well-balanced diet.
  • Maintain a normal body mass index.
  • Reduce alcohol intake.
  • Quit smoking.
  • Apply daily sun protective measures.
  • Ensure immunizations are up to date.
“Most individuals diagnosed with lupus will have multiple doctors involved in their circle of care,” says Dr. Butterfill. “A rheumatologist will be responsible for treating the overall disease; however there may be other specialties involved depending on additional systems that may be affected such as a nephrologist, cardiologist or neurologist.”

There may also be specialists involved in monitoring for potential complications or side effects of some of the medications, such as an ophthalmologist. Family physicians can also play a central role by regularly monitoring blood work and doing preventative health screenings.

If you think you are experiencing any of these symptoms, or have concerns, please speak with your family physician.
September 6, 2018

Accepting new patients: Dr. Lianne Butterfill will be accepting new patients as well as referrals for prenatal/maternity care as of October 1, 2018. Her office, New Family Medicine Network, is located at 1110 Sheppard Avenue East, suite 501. Please call 416-223-0555 or fax 416-223-0540.

This article first appeared in the September 2018 issue of The Pulse, North York General Hospital's community newsletter. Subscribe to receive 10 issues per year.

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*Image of common lupus symptoms by Mikael Häggström, used with permission [Public domain] via Wikimedia Commons..