Lupus Pneumonia

Systemic Lupus is an autoimmune disease that impacts over 1.5 million people in the United States, according to The Lupus Foundation of America. As with all autoimmune disorders, it can affect every major part of your body. It is a chronic disease believed to occur, when the body cannot differentiate between a threat to its system and healthy tissue. As a result, SLE carries some serious risks. One of the risks is to your lungs. The Lupus Genetics Project at U.C.S.F., tested 282 patients, and found 42 patients had had pneumonia. .That is a pretty high risk! But why, you may ask, should we be at such risk for pneumonia? Because we are so often immunosuppressed.

According to Dr. Nathan Wei, immunosuppression can occur when the body's defenses are worn down by illness, injury and stress. Yet, it can also be caused by the medications we take to quiet down our immune responses, to ease symptoms and halt further damage. Drugs like prednisone, Imuran, cyclosporin, Embrel and Humira all cause this immunosuppressive response. When we become (tired) immunosuppressed, our bodies lack the strength to fight off infections or to heal from injuries. As a result, areas of our bodies that are often most affected by SLE cannot defend well, and we develop some nasty infections very quickly. One of these is pneumonia.

I'm fighting pneumonia right now. Since August, I have had a severe injury, a debiltating bacterial dysentery, and a major sciatic nerve inflammation. Off and on through the end of last year, high dose corticosteroids were administered, due to almost constant flares. Add the truly cold weather we've been having, it is not surprising how this happened. Why is it dangerous? Because often we don't even know we have a pneumonia. I got lucky. After telling my doctor my shoulders hurt badly enough that I couldn't lift my arms, she sent me immediately to the lab. Reading the results she put me on a conservative 40 mg per day. That night, as I walked in my door, I began coughing and brought up a large amount of sputum. Even after all these years as a lupus patient, I was surprised. I am sharing this with you, so that you can be aware at all times, of what your body is trying to tell you.

What are the symptoms of lupus pneumonia? The Lupus Foundation suggests:

~ Tightened or "heavy" chest sensation
~ Breathlessness, with or without exertion
~ Fatigue
~ Dizziness
~ Coughing with sputum
~ Fever, though with "silent" pneumonia, it may be absent

I had noticed that tightness in my chest, but put it down to being out in the cold. God was looking out for me, because with the large dose of prednisone at the office, it must have reduced the inflammation enough to allow me to cough. But, because of my own carelessness, it is not resolving as easily as it should. Don't let this happen to you.

The other closely related lung issue is pneumonitis. This is much more serious and needs to be treated carefully. Though many of the symptoms are the same, there are some that usually only occur with pneumonitis. Pneumonitis can cause serious inflammation of the entire respiratory system. From the trachea down through the lungs. There is normally no productive cough. The alveoli, or air sacs in the lungs can be inflamed, causing severe oxygen depletion. At its worst, it can cause hemhorrage. Or lead to long term damage to your lungs. Here are the symptoms to watch for:

~ Shortness of breath
~ Rapid shallow breathing
~ Cough
~ Fever
~ Bluing of the lips and fingers
~ Rarely, coughing up blood.

Some patients with pneumonitis, develop a chronic form of this disease, and have scarring of their lungs as a result.

As patients, we must take responsibility for monitoring our bodies. It helps if you have a spouse or other loved one who knows you well enough to spot something before it goes too far. And take care of yourselves. Right now, many of us have to go out in bitterly cold weather. This in itself causes stress on an already overworked system. Bundle up. Avoid crowds if you are currently taking immunosuppressents. Try and ramp up your immune system with fruity smoothies, loads of veggies and fruits. Take a good multivitamin, like GNC's Ultra Mega Womens. If you have children, and they get sick with the flu or other infections, let YOUR doctor know. An early warning can change what might be a disaster, into something that can be handled before you reach crisis.

Most of all, take care of yourself. If it's bitter outside, cuddle up in the bed with the TV, a good book and a few treats, Tomorrow will take care of itself.

Sources

The Lupus Foundation
About Lupus
www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding.aspx

PubMed.org
Clinical and genetic risk factors for pneumonia in systemic lupus erythematosus..
http://www.ncbi.nlm.nih.gov/pubmed/17665457

Dr. Nathan Wei, nationally recognized, board certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit
Nathan Wei, MD, FACP, FACR
www.arthritis-treatment-and-relief.com/sle-pneumonia.html