Mental health and neurological symptoms such as disturbed dream sleep, hallucinations or depression and loss of balance may act as a warning signal for the onset of autoimmune disease such as lupus, also known as Systemic lupus erythematosus (SLE), according to an international research team. Lupus is an autoimmune inflammatory disease known for its effect on many organs, including the brain.
The team led by researchers at the University of Cambridge and King's College London in the UK, maintained that such symptoms can act as an early warning sign that an individual is approaching a “flare,” where their disease worsens for a period.
For the study, they surveyed 676 people living with lupus and 400 clinicians, as well as carried out detailed interviews with 69 people living with systemic autoimmune rheumatic diseases (including lupus) and 50 clinicians.
The results, published in the journal eClinicalMedicine, showed that disrupted dream sleep was the most common symptom experienced by three in five patients.
Of these, a third went on to develop lupus disease a year later. Just less than one in four patients reported hallucinations, seen in 85 per cent of people with lupus.
Further, three in five lupus patients and one in three with other rheumatology-related conditions also reported increasingly disrupted dreaming sleep - usually vivid and distressing nightmares - just before their hallucinations. The patients reported that the nightmares were often vivid and distressing, involving being attacked, trapped, crushed, or falling.
Melanie Sloan from Cambridge University called on doctors to speak to their patients about these types of symptoms and write down each patient's progression.
“Patients often know which symptoms are a bad sign that their disease is about to flare, but both patients and doctors can be reluctant to discuss mental health and neurological symptoms, particularly if they don't realise that these can be a part of autoimmune diseases,” said Melanie, the lead author from the varsity's Department of Public Health and Primary Care.
Dr Rudrarpan Chatterjee and Dr Amita Aggarwal, both from Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow in a separate review published in ScienceDirectlate last year noted that while the lupus is treatable, most patients in India bear healthcare costs as out of pocket expenses. “While this has been recently addressed by a new policy (Ayushmaan Bharat scheme) that offers low-cost insurance at the national level to everyone within the social security scheme of the Indian Government, a lot of rheumatological conditions at present do not have coverage under this scheme.”The review titled, ‘Challenges in the diagnosis and management of SLE in India,’ further attributed the lack of financial aid to the rare nature of these diseases and a lack of awareness even in policy making circles.
“Though SLE has recently been included in this scheme, the benefits are available only once the diagnosis is made and only for inpatient care.” Researchers estimate that over 1 million cases of Lupus are diagnosed in India every year.
