Some of us have experienced the loss of someone with lupus. I remember being shocked when I learned of the death of a classmate from complications associated with the disease. Yes, I knew she had been suffering with the illness for many years, but I certainly did not expect it to steal her away in the prime of her life.

Lupus (systemic lupus erythematosus) is a disease in which antibodies and other components of a person's immune system (that usually fight infections) are directed against his or her own cells.

Lupus overwhelmingly affects women compared to men. The disease occurs more often during a woman's childbearing years. Black, Hispanic and Asian women are more likely to have lupus than white women. The cause of this ravaging disease is not known but it is partly hereditary, with someone's risk for the disease being higher if they have a close relative such as a mother or sister with the disease. Symptoms of this disease include a rash, hair loss or alopecia, photosensitivity (the development of a rash after being exposed to ultraviolet light), fever, fatigue, arthritis, muscle ache and weight loss. The disease may initially affect one organ of the body or may start affecting several organs such the heart, lungs, kidneys and brain at the same time.

Lupus is diagnosed if a person has four or more specific sets of symptoms and if they have certain auto-antibodies in their blood. It may take several visits to the doctor before a diagnosis is made because someone may need to have multiple examinations over time to confirm the condition. Before making the diagnosis, the doctor must carefully review the patient's medications because some of them (including several used to treat high blood pressure) can cause lupus-like symptoms.

Abnormalities of cervix

If someone with lupus has symptoms which are not life-threatening, such as arthritis or joint and muscle pain, they may only need painkillers. However, for more serious symptoms, high doses of corticosteroids and cytotoxic (cancer-killing) drugs may have to be used. Women with lupus are more likely to have abnormalities of their cervix and they should do their Pap smear at least once per year. They can use hormonal methods of birth control, but if they have certain types of antibodies, they should avoid those containing oestrogens. Women who are on medication that lowers their immunity are more likely to have yeast infections and genital herpes. These women should also avoid using intrauterine devices for contraception.

Lupus can cause some serious complications in pregnancy including pre-eclampsia (high blood pressure and protein in the urine), preterm labour and preterm birth (labour and delivery before 37 weeks of pregnancy), miscarriage, foetal growth abnormalities and foetal death. A woman can have a lupus flare or worsening of her condition in pregnancy. If lupus has affected a woman's kidneys, she is even more likely to develop pre-eclampsia and it can be very difficult to distinguish whether her symptoms are due to worsening of her lupus or to pre-eclampsia.

However, flares usually occur in the first trimester of pregnancy and, fortunately, the flares are not usually severe and can be treated with steroids. Steroids, however, may have side effects and should be avoided early in the first trimester because it may cause an increased risk of cleft lip and palate (i.e. a facial abnormality) in the baby.

Like my former classmate, lupus cost many women their lives but, fortunately, with modern treatment women are living longer with the disease.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.