Spring brings more than warm weather. Flowers, pollen, and insects can add allergies to the mix for Lupus Warriors.
An allergy is a reaction by your immune system to a stimulus that does not bother other people. An allergen is, simply, a personal trigger that sends your immune system into full protection mode.
This can be problematic for people with lupus because lupus is an autoimmune disease. The body of a person with lupus already struggles to discern foreign invaders from healthy tissues. Additionally, the symptoms between the two can be similar.
Allergic reactions range from mild, like rashes or hives, to incredibly serious, like anaphylactic shock. People with severe allergic reactions may need to carry an epinephrine autoinjector (better known as the brand name EpiPen). The most common allergens are:
- NSAIDS (ibuprofen and aspirin)
- sulfa drugs
- Environmental Triggers
- pet dander
Diving deeper into allergies
Lupus isn’t the only condition with a genetic component. Allergies have a heritability component, too. The predisposition towards developing certain allergic diseases, like atopic dermatitis and asthma, is known at atopy. Interestingly, the word ‘atopy’ comes from a Greek word meaning ‘extraordinary’ or ‘uncommon.’
Traditionally, ‘atopy’ applies only to IgE-mediated allergic reactions. IgE stands for Immunoglobulin E. IgE are a type of antibody created by the immune system. When an allergen is detected, the immune system overreacts and produces IgE. The antibodies bind with the perceived invaders and release chemicals, like histamine, which lead to the allergy symptoms.
Different types of IgE are responsive to different allergens. That’s why it’s possible to be allergic to one thing or many — it depends on the number of types of IgE in the body.
There are also non-IgE-mediated allergic reactions. Common examples of these are food allergies that occur in the gastrointestinal tract with symptoms like:
Non-IgE reactions show up later, usually hours or days after exposure to an allergen. In contrast, IgE allergic reactions frequently show up within minutes of exposure.
Hypersensitivity reactions are further broken down into different types based on the biological mechanism that is triggered. You can learn more here.
Do people with lupus have more allergies?
It is interesting to look at the prevalence of allergies in people with lupus because both impact the immune system. A 1993 study found that allergies were more frequent in people with lupus when compared to control participants.
In the study, 63% of people with SLE had some type of allergic disorder (83 out of 117 participants). compared to ~30% for the control subjects. Also, Lupus Warriors were more likely to have drug allergies, skin allergies, and insect allergies.
Interestingly, the allergies were not confined to the individual with lupus. The families of participants with lupus were also statistically more likely to have allergies. The authors note that this suggests that there is a genetic influence in SLE patients – particularly since this familial link was nonexistent for other conditions like rhinitis.
Is an allergy a precursor to lupus?
In 72% of patients with a history of allergies, the first allergic reaction occurred before they were diagnosed with lupus. And, 15% of people experienced their first allergic reaction within a year of being diagnosed with lupus.
However, this data is based upon questionnaire responses. It is possible that timelines were misremembered or that true first-reactions were not perceived as such.
The first step in fighting allergies is knowing your personal triggers. Allergy tests and elimination diets are two common ways to check your body’s reaction to stimuli.
During an allergy skin test, the skin of the back or forearm is pricked slightly with a needle that contains some of a suspected antigen. Then, you look for a response. (Note: some medications can interfere with this testing method, but it is typically an economical place to start)
Elimination diets are a common way to check yourself for food allergies. As the name suggests, you remove particular foods from the diet, then reintroduce them back into your diet slowly, and one at a time. As you reintroduce foods, you take note of any new symptoms that appear.
Once you have created a personal list of triggers, you can work to avoid the allergens when possible. For unavoidable allergens, it may be necessary to try over-the-counter allergy relief, prescription products, or even carry an EpiPen. Before starting medications, check with your lupus treatment team to reduce the risk of interactions.