| |
Systemic lupus
erythematosus
Systemic lupus erythematosus has several other names –
disseminated lupus erythematosus, SLE, lupus or lupus erythematosus.
But whatever you call it, it is a chronic autoimmune disease that
affects the skin, joints, muscles, kidneys and other organs.
In systemic lupus erythematosus patients develop antibodies that
target tissues within their bodies instead of foreign cells. It is
the immune system gone wrong and attacking it’s own body instead of
bacteria and viruses. Systemic lupus erythematosus is more common in
women who are between 20 and 40 years. It is also most common among
blacks and asian populations.
Within systemic lupus erythematosus there is a component that
affects the skin called discoid lupus.
The precise reason for SLE is unknown but researchers theorize a
number of potential causes including ultraviolet light, genetics,
viruses and drugs. Some scientists believe that the immune system of
some patients are more sensitive to the ultraviolet rays, viruses
and drugs because of a genetic predisposition since SLE appears to
‘run’ in families.
Drug induced lupus happens in only 5% of the cases with drugs that
are known to stimulate the immune system and thankfully it resolves
when the medication is discontinued. Women also have a worsening of
symptoms premenstrually. This coupled with the fact that most
patients are women have led scientists to begin researching the
hormonal ties to SLE.
Symptoms of SLE may vary from person to person and they may change
in an individual over time. Almost all have joint pain and arthritis
of the fingers, hands, wrist and knees. Some generalized symptoms of
systemic lupus erythematosus include pain, fatigue, nausea and
vomiting, muscle aches, swollen glands, seizures, psychosis,
sensitivity to light, skin rash, arthritis, and pleural effusions.
Other symptoms that can occur are nosebleeds, blood in the urine,
coughing up blood (from vasculitis or inflammation of the blood
vessels), difficulty swallowing, mouth sores, hair loss abdominal
pain. Over half of patients with systemic lupus erythematosus
develop a red, painless, non-itching characteristic butterfly rash
over the bridge of the nose and onto both cheeks.
A diagnosis is based on the presence of four out of eleven
characteristics of the disease. There is no one simple conclusive
test. The presence of systemic lupus erythematosus will
significantly alter the results of other test as well.
The eleven criteria for diagnosis are: · "butterfly" rash over
cheeks and face · discoid skin rash · photosensitivity · mucus
membrane ulcers · arthritis: 2 or more swollen joints ·
pleuritis/pericarditis: inflammation of the lining tissue around the
heart or lungs · kidney abnormalities · brain irritation: evident by
seizures and/or psychosis · blood count abnormalities · immunologic
disorder · antinuclear antibody
The outlook for patients with systemic lupus erythematosus has
improved and the 10 year survival rate is over 85%. There is no one
treatment for SLE. The goal is to protect the organs and decrease
the symptoms.
Patients with systemic lupus erythematosus can lessen their flares
by staying out of the sun since ultraviolet light will increase the
symptoms; stay on the corticosteroids without abrupt withdrawal and
tell your doctor of all fevers since the steroids and
immunosuppressant therapies will decrease your immune system and you
are at risk for infection.
With improved diagnosis and treatment of systemic lupus
erythematosus patients are living more functional lives and have a
longer survival rate.
|
|
