Systemic Lupus Erythematosus
What is it?
Systemic Lupus Erythrmatosus (SLE)
is an autoimmune disorder in which the body’s
immune system begins to attack it’s own tissues
and cells. Lupus can affect many different body
systems such as the kidneys, the joints, skin,
heart, lungs, blood vessels, and brain.
Who gets it?
SLE is more common in women,
and three times more common in black women than in
white women. It also is more common among women
who are Hispanic, Asian, or Native American. SLE
can be hereditary and run in families, but that
risk factor is not as strong as others.
What causes it?
The actual cause of the disease
is unknown. It is thought that there is not one
single cause, but that it is a combination of
several factors. The include genetics,
environment, and possibly hormonal factors. The
cause may be different from one person to another.
Genetics is thought to be a factor because of the
fact that it runs in families. Environmental
factors being looked at as possible causes are
sunlight, stress, certain medications, and
infectious causes such as viruses. These factors
may be what helps to trigger the disease in
someone who is genetically at risk. It is not a
contagious disease itself, though.
What are the symptoms?
Symptoms of the disease vary
widely from person to person. They can be mild or
severe, and can come and go over time. The most
common symptoms include extreme fatigue, painful
or swollen joints, unexplained fever, and skin
rashes. A skin rash that appears on the nose and
cheeks—commonly called the butterfly rash—may
be a symptoms, or the rash could be on the face
and ears, upper arms, shoulders, chest and hands.
Some other less common symptoms include chest pain
with deep breathing, hair loss, sensitivity to the
sun, anemia, pale or purple fingers and toes from
cold and stress, headaches, dizziness, depression
and seizures. Some people will have only one body
system that is affected by the disease, but others
can have symptoms in many parts of the body.
Diagnosis
The diagnosis of SLE can be
difficult. Because the symptoms are vague, and
commonly indicate other problems, it may take
several months or even years for the diagnosis to
be made accurately. A complete medical history,
accurately given by the patient, is very important
to making the diagnosis early. Physical
examination and laboratory studies can also be
helpful in the diagnosis. The most useful
laboratory studies identify certain blood
autoantibodies frequently seen in patients with
SLE. Some of these tests include the antinuclear
antibody test (ANA), anti-DNA, anti-Sm, anti-RNP,
anti-Ro, and anti-La. The results of these tests
are considered along with the medical history and
the symptoms to determine if a person has SLE.
Other lab tests that can be
done are a complete blood count, Erythrocyte
sedimentation rate, urinalysis, blood chemistries,
complement levels, and a test for syphilis. If he
still doesn’t have a diagnosis, the physician
may need to do a skin or kidney biopsy to try to
verify the diagnosis.
Treatment
Treatment for SLE will depend
mostly on the body systems affected by the
disease. Treatment plans are tailored to the
individual patient’s needs and may change over
time. The goals of the plan are to prevent a
flare, to treat them when they do occur, and to
minimize complications. Several medications can be
used to treat SLE. Joint pain, swelling, and fever
will be controlled by nonsteroidal
anti-inflammatory drugs (NSAIDS). It has been
found that antimalarial medications such as
hydrochloroquine, chloroquine, and quniacrine are
useful in treating SLE. They help with fatigue,
joint pain, skin rashes, and inflammation of the
lungs. The most common medication used for
treating SLE is corticosteroid hormones. These
include prednisone, hydrocortisone,
methylprednisolone, and dexamethasone. These too
help decrease inflammation. When the kidneys or
central nervous system is affected,
immunosuppressive drugs such as Cytoxan or Imuran
may be used to block the body’s immune response.
This helps to slow down the overactive immune
system that is attacking the body’s tissues and
causing the symptoms. Unfortunately, most of these
medications have significant side effects, but
they are the only way to decrease the symptoms.
There is no cure for the disease.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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