Lupus is more common than you might think, affecting around 4,000 to 5,000 patients in Singapore. Find out more about the condition.
Lupus is not a disease one hears about too often but when it strikes, it can affect a number of organs. Lupus is an autoimmune condition where the immune system — which normally protects us against infections and illnesses — starts to attack the body’s own tissues. A long-term illness, it can cause inflammation in the skin, organs, and other areas in the body.
According to Dr Chuah Tyng Yu, Consultant, Department of General Medicine (Rheumatology), Sengkang General Hospital, there are two main types of lupus: discoid lupus and systemic lupus erythematosus (SLE). These range from mild to severe. The former affects skin while the latter can attack multiple organs.
Lupus tends to affect women of childbearing age (15-45 years). While the exact reason is not known, it is thought that the sex hormone, oestrogen, plays a role in women who are genetically susceptible. It is important for pregnant women to let their gynaecologist know if they are diagnosed with lupus. However, Dr Chuah also lets on that she is also seeing it in the elderly these days.
Lupus is two to three times more common in Asians compared to Caucasians and tends to have more severe clinical manifestations in them. It is estimated to affect nine out of every 10,000 Singaporeans.
The body’s immune system normally makes antibodies to fight infections but with lupus, the body also makes auto antibodies that attack the tissues. “At the moment, there is no scientific evidence to explain why some people get lupus while others don’t. It is possible that it is a result of a mix of genetic, hormonal, and environmental factors,” explains Dr Chuah.
The factors that can trigger the immune system, causing the disease, include: genes, environment such as viral infections, sunlight, certain medications and smoking. If the cause is medication, it is called drug- induced lupus which usually gets better when the patient gets off the medication that is causing it.
According to Dr Chuah, symptoms vary greatly between patients. In fact, the symptoms can be so wide-ranging that the condition has been dubbed the disease of a thousand faces. The symptoms may seem general. However, if they are persistent and do not go away, it is best to check with your primary care doctor who may run some tests to investigate further and refer you to a rheumatologist. For most people with lupus, regular check-ups are important to ensure their vital organs are unaffected to prevent serious complications.
While there is no cure for the disorder, there have been many medical advancements in treatment in the past five to 10 years, and most patients can lead normal lives. The medication used to treat lupus will depend on its seriousness for the patient and which parts of the body are affected. Dr Chuah also reveals that the medication may be adjusted whenever symptoms flare up or improve. For example, when lupus is active, the dosage of the medication may be increased. Similarly, medication can be reduced when symptoms are minimal.
“It’s important for patients to stick to the medication faithfully and to work closely with their doctor so they can clarify any queries they may have about their medication, such as the side effects,” she explains.
She added that adopting a healthy diet, exercising regularly, and not smoking can lower the risk of developing serious complications. She also advised those with lupus to reach out to groups such as the Lupus Association Singapore, which provides support for patients and their families.
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