May is Lupus Awareness Month:
Lupus is a chronic autoimmune disease in which the body’s immune system becomes hyperactive and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs. Under normal function, the immune system makes proteins called antibodies in order to protect and fight against antigens such as viruses and bacteria. Lupus makes the immune system unable to differentiate between antigens (a substance capable of inducing a specific immune response) and healthy tissue. This leads the immune system to direct antibodies against the healthy tissue – not just antigens – causing swelling, pain, and tissue damage. Any part of the body can be affected by lupus as it has an array of clinical manifestations affecting the skin, joints, brain, lungs, kidneys, blood vessels and other internal organs.
When speaking about voice loss, we are typically talking about a hoarse, breathy voice which is known by the name ‘dysphonia.’ By itself, dysphonia is not simply a symptom of lupus. It can be caused by laryngitis, a cold, allergies, or even speaking or singing too loudly without resting (like cheering or screaming). The quality of the voice may also change in other ways. It could be raspy, strained, or simply softer and lower in pitch.
The connection between voice issues and lupus appears to be related to the only joint in the throat: the cricoarytenoid joint. The cricoarytenoid joint, located in between the cricoid and paired arytenoid cartilage in the larynx, are diarthrodial joints that tighten the vocal cords when they come together for speech and move apart for breathing.
As a diarthrodial joint, the cricoarytenoid joint has a fibrous joint capsule around it that consists of synovial fluid that lubricates the outside portion of the bones. Lupus causes inflammation that affects the synovial lining, which in return, places pressure on the vocal cords. The swelling is what is thought to cause the voice issues with lupus.