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
· 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.