It’s a chronic autoimmune disease that affects one in every 1,000 Canadians. It is difficult to diagnose because of the wide range of symptoms that come with it – from fatigue to joint pain, kidney damage and facial rashes. Linked to inflammation in the body, it can target major organs (kidneys, lung, heart, etc.) and can be potentially fatal if left untreated. Fortunately, researchers are providing greater insight into lupus, which is leading to improved treatment and earlier diagnoses.

What causes lupus

For 25 years, Dr. Paul Fortin has focused his research on what causes lupus. He’s a professor of medicine at Laval University in Quebec City and Canadian Research Chair, autoimmune systemic rheumatic diseases. “It’s very complex,” he says. “It is known as a disease with 1000 faces.” Aside from being a challenging disease to diagnose, its root cause has been difficult to pin down. Two people may test positive for antibodies, yet only one may develop lupus in time. The reasons why is where research is headed.

Dr. Fortin’s research determined a combination of genetic predispositions (some 30 genes are associated with lupus), plus a trigger, are behind lupus. New research will centre on what those triggers are. They could include: viruses, hormones (90 percent of lupus patients are women), major health events like surgery, pregnancy or injury, and environmental factors like ultraviolet light (UVB rays especially).

Fifty years ago, lupus was a disease with a poor prognosis because of the increasing severity of damage caused by inflammation in the body over time. Dr. Fortin cites improved methods of testing (like blood tests screening for the presence of the antibodies tied to lupus) and better diagnoses as prime reasons why patients can live fulfilling lives through successful disease management.

"It’s no secret that lupus has a significant effect on the body’s major organs, but research is now examining the impact on brain function."

Decoding the lupus-brain link

It’s no secret that lupus has a significant effect on the body’s major organs, but research is now examining the impact on brain function. Dr. Zahi Touma, assistant professor of medicine, a clinician/scientist, division of rheumatology at the University of Toronto, presented his findings at the European Congress of Rheumatology in Rome.

“Lupus patients are prone to cognitive impairment,” says Dr. Touma. “Some can have difficulties with short-term memory, multi-tasking and finding the right words while speaking.” These symptoms can happen early in the development of the disease. He has focused on the creation of an easy-to-use screening tool to identify the condition affecting 47 percent of those with systemic lupus erythematosus (SLE), according to his research.

The identification of cognitive impairment caused by the disease allows lupus patients to manage their condition more effectively. That could include adopting coping strategies like writing things down to aid memory. Dr. Touma continues to study the effects of lupus on the brain and ways to measure them. His detective work continues.