Lupus (Butterfly) Disease

Lupus is a disease that can be seen in people all over the world, but it is statistically more common among Asians, African Americans, and Hispanics. The best statistical studies on lupus have been conducted in Europe. According to these studies, lupus affects approximately one in every 2,500 people. About 15% of those diagnosed with lupus are under the age of 18. On the other hand, lupus is more frequently observed in women during adolescence and their reproductive years.

What is Lupus?

Lupus is an autoimmune disease also known as the butterfly disease. As with other autoimmune diseases, lupus occurs when the immune system attacks healthy tissues. The kidneys, blood, skin, central nervous system, and joints are typically affected by lupus.

In medical terminology, lupus is referred to as systemic lupus erythematosus. The name combines Greek and Latin words. Lupus is derived from the Latin word for wolf, referring to the butterfly-shaped rashes on the skin that resemble wolf marks. Erythematosus is Greek for red, indicating the color of the rashes. The term systemic indicates that the disease affects multiple organs.

One of the biggest challenges in diagnosing lupus is that it affects multiple organs. However, the most characteristic symptom is the butterfly-shaped red rash on the face. In addition, lupus is often called "the great imitator" because its symptoms are similar to those of many other diseases.

Causes of Lupus

There are several factors that can cause lupus. Among them, genetic predisposition is one of the most significant. Additionally, hormonal changes during adolescence, severe mental stress, and exposure to sunlight can trigger the disease. Certain medications and viral infections are also known to contribute to the onset of lupus. Environmental factors are crucial because the immune system attacks healthy tissues in lupus patients.

How is Lupus Diagnosed?

Diagnosing lupus is extremely challenging, as the disease can only be diagnosed by eliminating other possible conditions. There are no characteristic symptoms or specific markers for lupus. Instead, it is often confused with other autoimmune diseases and many other conditions. Therefore, a series of tests must be performed, and at least four of the 11 diagnostic criteria must be met.

Blood Tests

Blood tests play a crucial role in diagnosing lupus. These tests can help determine whether the disease has affected organs and, if so, which organs are involved. The following tests are particularly important:

• The Anti-Nuclear Antibody (ANA) test is positive in most lupus patients. However, since this test can also be positive in other diseases, it is not sufficient for diagnosis on its own.

• The Anti-Double Stranded DNA (Anti-dsDNA) test is another test used in suspected lupus cases. If it is positive, there is a high probability that the patient has lupus. If the test is repeated and shows an increase, it indicates disease progression. Therefore, after diagnosis, patients should have their Anti-dsDNA levels monitored regularly.

• If the Anti-Ro Antibody test is positive, the patient may experience dizziness and Sjögren's syndrome. In addition, dryness of the skin and the presence of rashes (known as malar rash) are expected. If this antibody is detected during pregnancy, close monitoring is required because these antibodies can be passed from mother to baby.

• The Antiphospholipid Antibody test is the final blood test used in diagnosing lupus. If this test is positive, patients are at risk of blood clotting or miscarriage and should be closely monitored.

Urine Tests

Urine tests are used to determine whether lupus has affected the kidneys. This test measures the levels of protein and red blood cells in the urine. High levels of these substances are considered evidence of kidney involvement.

Treatment Methods for Lupus

There are various treatment methods available for lupus. The most important factor in determining the treatment method is whether the disease is classified as mild or severe. Based on the symptoms observed in patients, a treatment plan is created using a combination of methods.

Mild Lupus

Mild lupus primarily affects the skin rather than the organs. The most characteristic symptom is the butterfly-shaped rash on the nose. Additionally, other skin areas on the body may also be affected.

Mild lupus also affects the joints, causing inflammation and pain. The term "mild lupus" does not imply that the symptoms are mild; rather, the symptoms can significantly impact the patient's quality of life. Early diagnosis and treatment are essential for managing flare-ups more effectively.

Exercise

Exercise is a crucial component of lupus treatment. Regular exercise helps keep muscle tissues active and plays an important role in managing the disease. In addition, regular exercise boosts the body's overall resistance and helps suppress lupus.

If lupus affects the joints, exercise can help manage these symptoms. It is important to follow an exercise program designed by specialists, which typically includes stretching, pulling, and releasing movements. Exercise also helps boost motivation and combat chronic fatigue in lupus patients.

Reducing Stress

Stress can prevent organs and tissues from functioning properly or on time. As a result, a confused immune system may attack these non-threatening tissues more aggressively. Lupus patients experience more flare-ups during stressful periods. Therefore, it is crucial for patients to maintain optimal stress levels after diagnosis to prevent disease progression.

Sun Protection

Exposure to harmful sunlight can trigger lupus flare-ups. Therefore, it is important for patients to protect their skin from the sun year-round, whether in summer or winter. Wearing protective clothing and using high-SPF sunscreen are essential.

Severe Lupus

In severe lupus, skin deformities and joint involvement are more intense, and organ and system involvement may also occur. Severe lupus can cause inflammation and significant damage to the affected organs, potentially leading to organ failure and even death. During flare-ups, lupus can cause seizures, malar rash, paralysis, stroke, pericarditis, and arthritis.

Corticosteroid Therapy

Corticosteroid therapy serves two purposes: reducing inflammation in the joints and other organs caused by lupus and suppressing the immune system to control the disease. Doctors determine the appropriate dosage and medications based on the results of diagnostic tests. This therapy is typically used for patients whose central nervous system and kidneys are affected. Additionally, these patients often have hemolytic anemia.

Immunosuppressive Drugs

Immunosuppressive drugs are used during severe lupus flare-ups to suppress the immune system. These drugs are necessary when the immune system attacks healthy tissues aggressively during flare-ups. Since immunosuppressive drugs also suppress the immune system's normal functions, it is important to implement methods that boost the body's overall resistance alongside treatment.

Side Effects of Severe Lupus Treatment

The medications used in severe lupus treatment can cause side effects in patients. Some of these side effects are common, while others are rare. Doctors provide comprehensive information on potential side effects based on the patient's condition. Possible side effects during treatment include:

• Sudden weight gain,
• Increased body hair,
• Skin sensitivity,
• Increased blood pressure,
• Indigestion,
• Heartburn,
• Depressive mood,
• Tuberculosis,

Nutrition for Lupus Patients

Lupus patients must carefully follow the prescribed treatment plan. Additionally, maintaining proper nutrition to support the treatment is crucial for achieving better results. Lupus patients should include the following in their diet:

• Choose whole grains over refined grains.
• Opt for organic and unprocessed foods.
• Consume plenty of vegetables and fruits to meet vitamin and mineral needs.
• Incorporate antioxidant-rich foods into your diet.
• Include nutrient-dense foods like almonds, walnuts, and hazelnuts.
• Add bone broth to your diet for its significant benefits to the immune system.
• Include omega-rich fish in your diet.
• Boost your immune system by incorporating yogurt, kefir, olive oil, turmeric, ginger, Epsom salt, basil, green tea, milk, cucumber, and melon into your diet.
• Finally, lupus patients are advised to drink plenty of water throughout the day.

There are two key points to consider in the diet of lupus patients. The first is maintaining normal cholesterol and triglyceride levels in the blood; the second is following a diet that prevents kidney problems.

In addition, since medications used in the treatment of lupus, especially in children and adolescents, can affect blood sugar levels and cause weight gain in the long term, their diet should be adjusted to mitigate these risks. Continuous monitoring and following a diet plan tailored to their changing needs are essential.

Low-Calorie Diet

Studies on autoimmune diseases, including lupus, have shown that low-calorie diets slow disease progression. Therefore, lupus patients are advised to reduce their daily caloric intake by 30% to 40%. A low-calorie diet not only reduces infection levels in the blood but also decreases the release of nephritis-related antibodies, protecting the kidneys. Moreover, since the medications used in treatment can lead to weight gain, this diet helps reduce the risk of obesity.

Taurine-Rich Diet

Taurine, an amino acid found in high amounts in red meat, eggs, and white meat, plays an important role in regulating immune responses in lupus. It reduces the excessive secretion of inflammatory cytokines and helps suppress oxidative stress. These benefits prevent the death of healthy cells due to lupus. Additionally, taurine helps prevent an increase in blood cholesterol levels. However, taurine should be consumed through food rather than supplements, as it can exacerbate the disease in some patients.

Healthy Fat Consumption

Controlling blood cholesterol is important for lupus patients. Therefore, they should avoid foods high in saturated fats. Patients should stay away from plant-based saturated fats like cocoa butter and coconut oil, as well as animal-based saturated fats like margarine, cream, and tail fat. Instead, they should incorporate healthy fats like omega oils, walnut oil, and flaxseed oil into their daily diet. Omega-3 fatty acids help lower cholesterol and increase good cholesterol levels, while omega-6 oils can increase creatinine levels and inflammatory markers.

Calcium-Rich Diet

In addition to supporting normal immune function with minerals like zinc, selenium, copper, and iron, lupus patients should also ensure adequate calcium intake. Lupus patients are at higher risk for osteoporosis. To prevent this, they should consume 1,500 mg of calcium and 800 IU of vitamin D daily.

Avoid Excessive Protein Consumption

Lupus patients should avoid high-protein diets, opting instead for moderate protein intake. Excessive protein consumption can accelerate bone mineral loss in lupus patients. Therefore, protein intake should be limited to 0.6 grams per kilogram of body weight per day. This restriction should be managed under the guidance of a dietitian, as low protein intake can lead to chronic kidney failure.

Lupus Mortality Rate

Due to the effective management of lupus symptoms and complications, the mortality rate within the first 10 years after diagnosis is 10%.