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Systemic Lupus Erythematosus (SLE)
27 Jan' 21

Systemic Lupus Erythematosus (SLE)

 

Lupus is a disease in which the immune system of your body assaults your own tissues and organs (autoimmune disease). Lupus can induce inflammation in a variety of physiological systems, including the joints, skin, kidneys, blood cells, brain, heart, and lungs. 

Lupus is difficult to diagnose since its symptoms and signs are often similar to those of other illnesses. The most distinguishing symptom of lupus is a face rash that looks like butterfly wings unfolding over both cheeks. This rash appears in many but not all cases of lupus. 
 
Some people are predisposed to lupus, which can be caused by infections, certain medications, or even sunshine. While there is no cure for lupus, there are several treatments that can help control symptoms.
 
Symptoms 
There are no two cases of lupus that are the same. Symptoms and signs might appear abruptly or gradually, be moderate or severe, and be transitory or permanent. Most people with lupus have a moderate form of the disease marked by flares, which occur when signs and symptoms worsen for a period of time before improving or perhaps disappearing completely. 
 
Your lupus signs and symptoms will vary depending on which body systems are affected by the condition.
 
The following are the most common signs and symptoms: 
  • Fatigue
  • Fever 
  • Swelling, stiffness, and discomfort in the joints 
  • Rashes on the face in the shape of butterflies that cover the cheeks and bridge of the nose, as well as rashes on other parts of the body
  • Skin lesions that occur or worsen with sun exposure 
  • When exposed to cold or during stressful times, the fingers and toes turn white or blue. 
  • Breathing problems 
  • Pain in the chest 
  • Eyes that are dry 
  • Headaches, fuzziness, and memory loss 
When should you see a doctor?  
If you develop an inexplicable rash, a persistent fever, or persistent pain or exhaustion, see your doctor.
 
Causes 
Lupus is an autoimmune illness in which the immune system assaults healthy tissue in the body. Lupus is most likely caused by a mix of your genetics and your environment. 
 
It indicates that persons who have a hereditary susceptibility to lupus may get the disease if they come into contact with a trigger in the environment. However, in the vast majority of instances, the cause of lupus is unknown.
The following are some possible triggers:
  • Sunlight. In persons with lupus, exposure to the sun might cause skin lesions or induce an internal response. 
  • Infections. Infections can trigger lupus or trigger relapse in some persons. 
  • Medications. Certain blood pressure drugs, anti-seizure medications, and antibiotics can all cause lupus. When people with drug-induced lupus cease taking the medicine, their symptoms normally improve. Symptoms can sometimes last long after the medicine is stopped. 
Factors that are at Risk 
The following factors may raise your lupus risk: 
  • Women are more likely to develop lupus. 
  • Age. Lupus can affect persons of any age, however, it is most commonly diagnosed in people between the ages of 15 and 45. 
  • Race. African Americans, Hispanics, and Asian Americans are more likely to develop lupus.
Complications 
  • Lupus-related inflammation can affect numerous parts of your body, including: 
  • Kidneys. Lupus can damage the kidneys severely, and renal failure is one of the most common causes of death among lupus patients. 
  • The central nervous system and the brain. You may endure headaches, dizziness, behavioral changes, vision issues, and even strokes or seizures if your brain is impacted by lupus. Many persons with lupus have memory problems and may find it difficult to articulate themselves. 
  • Blood vessels and blood. Lupus can cause blood issues, such as anemia (low red blood cell count) and an increased risk of bleeding and blood clotting. It can potentially lead to infection.
  • Heart. Lupus can irritate your heart muscle, arteries, or heart membrane, causing inflammation. In addition, the risk of cardiovascular illness and heart attacks rises dramatically.
Diagnosis 
  • Lupus is difficult to diagnose since indications and symptoms differ greatly from person to person. Lupus symptoms might fluctuate over time and overlap with those of a variety of other illnesses. 
  • Lupus cannot be diagnosed with a single test. The diagnosis is made using a combination of blood and urine testing, signs and symptoms, and physical examination findings. 
Lab tests  
The following tests may be performed on your blood or urine: 
  •  A complete blood count is required. The number of red blood cells, white blood cells, and platelets, as well as the amount of hemoglobin, a protein found in red blood cells, are all measured in this test. The results could indicate that you have anemia, which is frequent in people with lupus. A low white blood cell or platelet count could be a sign of something more serious.
  • The rate of sedimentation of erythrocytes. The pace at which red blood cells settle to the bottom of a tube in an hour is determined by this blood test. A higher-than-normal rate could suggest a systemic illness like lupus. The sedimentation rate isn't unique to any one condition. If you have lupus, an infection, another inflammatory disorder, or cancer, it may be increased. 
  • Evaluation of the kidneys and liver. Blood tests can be used to determine how well your kidneys and liver are working. These organs may be affected by lupus. 
  • Urinalysis. If your kidneys have been impacted by lupus, an analysis of a sample of your urine may reveal an elevated protein level or red blood cells in the urine.
Imaging tests 
If your doctor feels that lupus is damaging your lungs or heart, he or she may recommend the following treatments: 
 
X-ray of the chest. Abnormal shadows in your chest picture could indicate fluid or inflammation in your lungs. 
Echocardiogram. Sound waves are used to create real-time photographs of your beating heart in this exam. It can look for abnormalities with your heart's valves and other parts. 
 
Biopsy 
Lupus can damage your kidneys in a variety of ways, and therapies vary depending on the severity of the damage. In some circumstances, a small sample of kidney tissue must be tested to establish the best treatment option. A needle or a tiny tube might be used to obtain the sample.
 
Treatment 
Lupus treatment is determined by your indications and symptoms. Determining whether you should be treated and which medications to take necessitates a thorough discussion with your doctor about the benefits and hazards. 
 
You and your doctor may need to adjust drugs or dosages as your signs and symptoms flare and subside.
The following are the most regularly prescribed lupus medications: 
  • Nonsteroidal anti-inflammatory medicines (NSAIDs) are medications that are used to treat inflammation (NSAIDs). Pain, edema, and fever associated with lupus can be treated with over-the-counter NSAIDs such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, and others). Prescriptions are available for stronger NSAIDs. NSAIDs may cause stomatitis as a side effect.
  • Antimalarial medicines are used to treat malaria. Medications like hydroxychloroquine (Plaquenil), which are routinely used to treat malaria, influence the immune system and can help reduce the likelihood of lupus flares. Stomach discomfort and, in rare cases, damage to the retina of the eye is possible side effects. When using these medications, it's a good idea to get your eyes checked on a regular basis. 
  • Corticosteroids. Prednisone and other corticosteroids can help to reduce lupus inflammation. Steroids in high doses, such as methylprednisolone (Medrol), are frequently used to treat significant renal and brain diseases. Weight gain, easy bruising, thinning bones, high blood pressure, diabetes, and an increased risk of infection are all possible side effects.
  • Immunosuppressants. In severe forms of lupus, immune-suppressing drugs may be beneficial. Azathioprine (Imuran, Azasan), mycophenolate (Cellcept), methotrexate (Trexall, Xatmep, others), cyclosporine (Sandimmune, Neoral, Gengraf), and leflunomide (Sand immune, Neural, Gengraf) are among examples (Arava). An increased chance of infection, liver damage, lower fertility, and an increased risk of cancer are all possible side effects. 
  • Biologics. In some people, a different form of drug called belimumab (Benlysta) that is given intravenously lowers lupus symptoms. Nausea, diarrhea, and infections are some of the side effects. Depression can deteriorate in rare cases. 
  • Rituximab (Rituxan, Truxima) may be effective in the treatment of some cancers.

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