Lupus: Adherence to medication key in preventing risk of organ failure

As Kenya joins the world in creating awareness about lupus disease, experts are calling on people with the condition to strictly adhere to medication to prevent organ failure.

Dr Fred Otieno, a rheumatologist and an Assistant Professor at Aga Khan University, explains that lupus is an auto-immune disease, which causes the body’s immune system to destroy tissues instead of fighting germs and bacteria.

“An individual can inherit the lupus gene, but having the gene does not mean someone will have the disease. There are a lot of factors in genes that provide the state of lupus,” he says.

Dr Otieno says lupus can affect any part of the body leading to, for example, hair loss, rashes on the face, ulcers in the mouth and nose, eye problems leading to blindness, chest complications and heart problems.

Some patients experience abdominal problems, ulcers, intestinal problems, liver and kidney issues and infertility, in addition to causing low platelet levels.

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Some people with lupus are at risk of developing blood clots in the veins or arteries, with the antibodies also shown to affect pregnancy, causing a great risk of miscarriage.

The brain and nervous system can be involved. One out of three people with lupus might experience migraines, anxiety and depression, dizziness, memory loss or confusion.

“Occasionally, lupus directly affects the heart and more often causes inflammation in the line of tissues around the heart, which leads to breathing difficulties and sharp pain in the chest,” he explains.

It may also cause narrowing of the blood vessels that can give rise to the risk of heart attacks and stroke. Therefore, close monitoring and early treatment of factors such as cholesterol and high blood pressure is important.

Patients who present with symptoms of the disease undergo antibody tests.

“Both laboratory and clinical tests are done to diagnose lupus,” explains Dr Otieno.

According to the rheumatologist, lupus commonly affects women of reproductive age between 15 and 49 years, although men and older people can also be affected.

“Lupus is nine times more common in women compared to men. There are more young people affected by lupus and only one in 15 cases begin after the age of 50,” says the expert.

He adds: “There are rare cases of lupus in children, and most of the time they are usually before the age of five. Lupus is directly passed from a parent to their children, but if there is a close relative with lupus, you are at an increased risk of developing it.”

While the disease is not curable, it is treatable. There are medications used to boost one’s immune system.

“Drugs used to treat lupus depend on the severity of the disease and the body parts affected. Treatment is most of the time changed depending on symptoms flair-up or improvement,” the specialist says.

But there is another problem. Drugs used for treating the disease lower patients’ immunity yet they are mandatory for patients to reduce and/or avoid the risk of infections caused by lupus.

“Patients are encouraged to take medication as prescribed to ensure the kidneys are not permanently damaged. Lupus can cause high blood pressure, particularly if the kidneys are involved,” he says.

Additionally, medicines used in treating lupus (steroids) can also raise blood pressure, particularly when used in high doses.

“Lupus may also affect the bone marrow causing anaemia, and other blood cells like platelets or white cells could also be affected,” Dr Otieno says.

 According to him, although there is no data on lupus in Kenya, the trends indicate the disease is not rare.

“We need to do epidemiological studies to know the actual number of people suffering from the disease for informed decisions,” he says.