Complications of Recurrent Lupus Activation

Pathophysiology of Lupus

  1. Usually the immune system attacks the various bacteria, viruses, and other invading foreign micro-organisms that enter one’s body and help prevent serious illness.
  2. In individuals with history of autoimmune conditions, the immune system mistakenly & repeatedly attacks and damages one’s own body tissues and organs. Lupus is an autoimmune condition, where one’s immune system attacks their own body tissues and organs.
  3. This attack by the immune system can involve many different organs, such as, skin, kidneys, heart, lungs, and brain.
  4. Attack by the immune system can cause injury & inflammation in the affected tissues & organs, and lead to their compromised function.
  5. Many factors, such as, exposure to environmental allergens, intake of certain medications, exposure to certain infectious diseases, etc., can act as triggers for lupus activation.
  6. Exposure to various triggers and activation of an inflammatory response can occur in bouts, contributing to periodical flaring-up of lupus episodes.
  7. Lupus can vary widely among individuals with respect to the triggering factors activating the symptoms, organs involved, extent of organ involvement, and management measures.

 Complications of Recurrent Lupus Activation

Lupus can vary widely among individuals with respect to the factors triggering the lupus response, organs involved, and extent of organ involvement. This variation in organs involved and extent of involvement contributes to the difference in complications presenting over a period of time.

Individuals with history of poorly controlled lupus can present with the following complications:

  1. Progressive inflammatory damage to the heart muscle and lining around the heart can result in increased fluid accumulation around the heart, poor cardiac function, reduced ability of heart on pumping blood, and consequent reduced blood supply to all essential organs, thus affecting their overall function. Involvement of blood vessels supplying the heart muscle can result in episodes of severe chest pain and myocardial infarction (heart attack).
  2. Progressive inflammatory damage to the skeletal structures, such as bone tissue and joints, can result in inflammation of the involved bones and joints, with persistent swelling of the affected limbs, and stiffness in the joints with limited range of motion. This can contribute to limitation of individual independence on overall ADL/IADL performance and activity.
  3. Progressive inflammatory damage to the blood vessels can result in increased risk for episodes of internal bleeding, narrowing of blood vessels, poor blood pressure control, compromised blood circulation to essential organs, and formation of blood clots.
  4. Progressive inflammatory damage to the kidneys and renal structures can result in episodes of abdominal discomfort, loin pain, and compromised blood supply to the kidneys & filtering units in the kidneys. This can contribute to compromised kidney function and renal failure with back-up and retention of fluid & wastes in the body. Reduced renal function in these individuals can also contribute to poor blood pressure regulation and consequently, increased risk for stroke.
  5. Progressive inflammatory damage to the lung tissue and lining around can result in increased fluid accumulation in the chest cavity, difficulty breathing, reduced oxygenation, and increased risk for chest infections.
  6. Progressive inflammatory damage to the red, white, and platelet cells in blood can result in anemia, increased risk for infection, and episodes of internal bleeding.
  7. Inflammatory damage to the brain and spinal cord structures can result in episodes of headaches, dizziness, confusion, back pain, and neuropathy. Recurrent damage to the nervous tissues with unresolved lupus activity can result in altered thought processes, mood & behavior changes, seizures, and progressive memory loss leading to dementia. Progressive inflammatory damage to the nerve tissues can also result in decreased or altered sensitivity to temperature changes, position changes, etc., resulting in increased risk for skin integrity, poor balance, accidents, and falls. Progressive involvement of nerve tissue controlling vision and hearing can lead to diminishing vision and hearing function. Progressive inflammatory damage to the blood vessels in the brain can result in increased risk for bleeding and stroke.
  8. Multiple organ & tissue involvement over recurrent bouts of lupus activation can lead to exhaustion, fatigue, and progressive loss of organ function.

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