Dr. Samay Nadery about Lupus and Arthritis

POSTED: 02/29/16 6:04 PM

St. Maarten News – Although there are certain similarities, Lupus and Rheumatoid Arthritis are two different diseases. Sometimes it is difficult to distinguish if rheumatoid arthritis is a separate disease or a symptom of Lupus. Both auto immune diseases are more common on St. Maarten than we think, Dr. Samay Nadery who works at Internal Medicine at the St. Maarten Medical Center says.

What is Lupus?

Normally, your immune system is designed to attack foreign substances of the body. Lupus is a complex disease wherein the immune system has a defect and as a result, the immune system attacks certain healthy parts of the body. The manifestation of the disease will be present in the part of the body in that process of ‘being attacked’. Lupus can cause disease in almost any part of the body; the skin, kidneys, heart, lungs, brain or joint. In very severe cases, Lupus can affect different parts of the body at the same time.

Who is at risk for Lupus?

Lupus affects mostly women and is more common and severe in women of African, Latin or Asian descent. Most Lupus patients are affected during the child bearing age.

What are symptoms of lupus?

Lupus symptoms are very similar to other diseases-and that makes it difficult to diagnose. Some symptoms are:

  • Skin rashes; butterfly shaped rash in the face
  • Swollen and painful joints
  • Sores in the mouth that doesn’t go away
  • Red and burning sensation in the eyes
  • What are the steps in diagnosing Lupus?

When a patient walks into my office, my first step is to listen to my patient. I ask a lot of questions to get an understanding about the main complaints, the duration of these complaints, the patient’s lifestyle and medical history. Once I have enough information I continue with a physical observation and examination; I sometimes include the routine details that is even unobserved by the patient, for example, how he or she walked into the office and shook my hand. I look for abnormalities and order certain examinations to rule out or confirm my hypothesis.

The main treatment begins once a diagnosis is confirmed. Though in some cases, medication is prescribed to relieve severe symptoms.

Does a blood test help with the diagnosis?

There isn’t a single test that can confirm lupus. Antibodies in the blood are responsible to fight against germs. If there is an error in the body, those antibodies are developed to fight against the healthy part of the body. At the beginning of lupus disease, not all antibodies are positive. If the disease process is for a longer period of time, then the antibodies will be present in the blood and the patient will have a positive antinuclear antibody test.

If the primary test results is negative, that does not mean the patient does not have lupus; later, the test may become positive.

Even if the test result is positive, we still cannot diagnose the patient with lupus immediately because the result may be influenced by another other disease.

That makes it very difficult to diagnose the disease.

Is lupus hereditary?

As certain ethnic groups, as I mentioned earlier, are more likely to develop lupus, there is some belief that some genes are associated in the development of this disease, though it is unclear which one.

Another condition for developing lupus is environmental. Certain drugs can cause lupus, certain infectious disease and also sun exposure can cause lupus.

So lupus cannot be prevented?

Unfortunately, there is no evidence to say that lupus is unpreventable. But there are some patients at risk, such as those with lupus in the family or patients on certain medication. These persons would be advised to avoid certain things in order to reduce the risk of developing lupus.

What treatment options are available for lupus?

Some patients do not need treatment. Lupus comes as flare, a period where the disease is active. In an active period, the attacks can be mild or severe. Treatment can be pain killers, anti-inflammatory or immune suppressions. If the symptoms are severe and affective in different parts of the body an aggressive treatment would be recommended.

For some patients with severe attacks that who does not respond to these medications, biologics are used to stop the inflammation process where it is present.

What is rheumatoid arthritis and what are the symptoms?

Rheumatoid arthritis is an autoimmune disease that occurs when the body’s immune system attacks the joints. It causes inflammation that affects the lining of the joints. Many people who have lupus also have arthritis. Some symptoms of rheumatoid arthritis are.

  • Joint pain
  • Joint stiffness
  • Joint swellings
  • Joint redness
  • Joint deformation
  • Firm bumps of tissue-rheumatoid nodules
  • Fatigue
  • Depression
  • Burning sensation in the eyes

Can arthritis be prevented?

There is no way to prevent arthritis. Once a patient is diagnosed with arthritis it is important to start the treatment on time to stop the progression of the disease and the destruction of the bone and joints.

What misconception exists with rheumatism and rheumatoid arthritis?

Rheumatism is an old term that was used to describe joint pain and inflammation. The medical term for the condition is called rheumatoid arthritis- which is, again, an auto immune disease.

When there was not much information about the disease, the word rheumatism was commonly used. Some persons had the misconception that exposing your body to hot then cold extremities would cause the disease but studies show that this is not true for rheumatoid arthritis. It is true for some persons, already with the disease, that exposure to cold weather can cause numbness, burning sensation or change in color to the joints, but this can happen even in normal weather.

What treatment options are offered at SMMC for rheumatoid arthritis?

Anti-inflammatory drugs suppress the inflammation used together with physical therapy and physical activity. Other medications are used to stop the progression of the disease and inflammation; this will stop the destruction and deformation of the joints. Immune suppression and biologics are also other methods of treatments for treating rheumatoid arthritis.

What are new treatment options in SMMC for Lupus and Arthritis?

Biologics for both Lupus and Rheumatoid Arthritis are a relatively new class of treatment. They differ from chemical drugs in that they are genetically engineered proteins.

They are being recommended in cases where the patient does not respond to the first class of treatment. For some arthritis patients, it may help to use this in the early stage of treatment.

Patients who are using biologics are responding positively to treatment. It is very important that patients with lupus or rheumatoid arthritis communicate with their physician about their treatment options. There are new ways to help patients manage their health conditions and at the SMMC we want to offer the best of medical care.

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