Do your lupus symptoms also get worse in cold weather?
The cold season just started, and I am already dealing with a lupus flare. As the temperature changes, my entire body is in pain. Unfortunately, it is entirely normal. When we are lupus patients, that are times while we move that all the joints hurt.
Unluckily, new data revealed that changes in weather and atmospheric conditions made specific lupus symptoms more likely to flare up in individuals with the chronic disease. The research presented at the 2019 American College of Rheumatology–Association of Rheumatology Professionals Annual Meeting found evidence to back up what I and many other patients with systemic lupus erythematosus (SLE) have long observed: our symptoms can worsen or improve with changes in weather, such as temperature or humidity fluctuations.
SLE, the most common type of lupus, can affect the whole body. Symptoms can include rash, arthritis, fever, fatigue, headaches, and sun sensitivity. George Stojan, MD, an assistant professor of medicine in the division of rheumatology at the Johns Hopkins Medical School in Baltimore, and the co-director of the Hopkins Lupus Center, says that his “ultimate goal is to create a model using climate and atmospheric factors that can predict when certain flares might occur, and then prevent them.”
Previous research has shown significant seasonal variation in lupus disease activity, such as renal flares being more common in the winter months and increased arthritis symptoms occurring in the spring and summer months; but this is the first study that looked at the link between organ-specific lupus flares and atmospheric changes before patient visits, says Dr. Stojan.
For the new study, the researchers looked at data from 1,628 patients with lupus treated for flares at Johns Hopkins between 1999 and 2017. Then, using data from the Environmental Protection Agency (EPA), the researchers looked at atmospheric conditions, such as measures of ozone concentration, temperature, residual wind, relative humidity, and barometric pressure, ten days before the patients’ doctor visits. The researchers adjusted for factors like age, sex, income, ethnicity, residence in rural versus urban areas, and how close patients lived to areas with higher pollution levels, such as living near highways and airports.
They found specific and robust associations between atmospheric variables and organ-specific lupus flares, says Stojan. The data showed:
- An increase in temperature was associated with joint complaints, rashes, and serositis (inflammation of the membrane around the lungs or heart).
- Higher temperature and ozone concentration were associated with a decrease in renal flares (kidney inflammation).
- An increase in humidity was associated with joint issues and serositis.
- The residual wind was associated with joint, neurologic, hematologic, and pulmonary problems.
- Higher particulate matter concentration was associated with pulmonary issues and serositis.
No single environmental or atmospheric variable was shown to be linked to all lupus flares. That means, while the weather variables mentioned above appear to be associated with these types of lupus flares, the data does not necessarily indicate that lupus flares are weather-related. It’s also important to note that the findings are correlational, not causational.
The study may one day provide patients with a way to do something to prevent their flares actively. “If we know the triggers, we may be able to educate patients and say, ‘Today, you need more sunscreen protection,’ or ‘If your workplace is by a hot stove in a restaurant kitchen, you may want to find a way to adjust your work environment during times when you’re likely to have a flare,'” says Shivani Garg, MD, assistant professor and the director of the Lupus and Nephritis Clinic at the University of Wisconsin School of Medicine and Public Health in Madison.
By using what scientists know about climate and atmospheric factors, such as pollution in a particular region and how they change over time, scientists may one day even devise models to predict when specific flares might occur and help prevent them, says Stojan. Let’s hope for it!