Diagnosing a disease can be compared to a puzzle, and in the case of lupus, this assembly tends to be longer and more challenging. On World Lupus Day, celebrated on May 10, the warning is about the varied and non-specific signs of the condition, which make early identification difficult.

According to the Brazilian Society of Rheumatology (SBR), Brazil has between 150 and 300 thousand people with the disease, which mainly affects women between 20 and 45 years old, although it can occur at any age and gender. The difficulty in diagnosing became popular even in pop culture, such as in the series Doctor House, in which lupus was often considered and discarded. And this is not fiction.

“The disease can be confused with other conditions, requiring a detailed investigation, with clinical evaluation and specific laboratory tests”, explains rheumatologist Leonardo Zambom, from Hospital e Maternidade São Luiz Osasco, from Rede D’Or.

What is lupus?

Lupus is an autoimmune disease in which the immune system It starts attacking healthy cells in the body itself, which can cause inflammation in various organs. The condition can present itself in two main ways:

• Cutaneous lupus: restricted to the skin, with reddish spots, especially in areas exposed to the sun (face, ears, chest and arms);
• Systemic lupus: more serious, and can affect multiple organs, in addition to joints and skin.

Among the most common symptoms of lupus are fever, weight loss, loss of appetite, weakness and discouragement. Others are specific to each affected organ, such as joint pain, spots on the skin, inflammation of the pleura, hypertension and/or kidney problems.

The manifestations of the disease can affect patients’ work, social and emotional lives. No cure, Treatment is adapted to each case. “Lupus has a multifactorial origin, involving genetic, hormonal, immunological and environmental factors. Sun exposure, infections and even some medications can act as triggers”, highlights Leonardo Zambom.

Exams and investigation

Diagnosis usually begins with the Antinuclear Factor (ANA) test, which identifies the presence of autoantibodies, common in patients with lupus. Other tests, such as Anti-SM (Anti-Smith), help confirm the diagnosis, while Anti-DNA works as an indicator of disease activity. General tests, such as blood count, kidney function and urine analysis, are also essential to assess possible impacts on the body.

Treatment and quality of life

Although there is no cure, lupus can be controlled. The basis of treatment includes medications such as hydroxychloroquinein addition to corticosteroids and immunosuppressants in the most active cases. In specific situations, immunobiological therapies may also be indicated.

“Today there is an important advance in personalized medicine, which allows treatment to be adjusted according to the profile of each patient, increasing the chances of controlling the disease and improving quality of life”, concludes rheumatologist Leonardo Zambom.

By Samara Meni