Lupus (Systemic Lupus Erythematosus)

General Illness Information

Common Name: Lupus (Systemic Lupus Erythematosus)

Medical Term: None Specified

Description: A chronic inflammatory disorder of connective tissue, of unknown cause. Involves major organs such as skin, joints, kidneys, brain, heart, lungs, etc. Occurs predominantly in young women, also occurs in children

Causes: Lupus is an autoimmune disease. This means that the body’s defenses against infection attack the body’s own tissue. This causes inflammation. Areas of the skin and/or joints become painful, red, and swollen. Other parts of the body can also become inflamed.

The exact cause of lupus is not known.

Prevention: There are no known preventive measures. If you have a family history of Lupus, take adequate precautions against sun exposure, reduce stress, stick to a healthy well-balanced diet and see your physician regularly for check-ups.

Signs & Symptoms

SLE can take many forms and does not affect everyone in the same way. Some of the more common symptoms are:

  • Disk-shaped patches of rash
  • Joint pain and swollen joints
  • Fatigue and weakness
  • Sharp chest pain when you take a deep breath
  • Fever over 100 degrees F (37.8 degrees C).
  • Shortness of breath.
  • Rapid or irregular heartbeat.
  • Swelling of the lymph glands.
  • Anemia.
  • Increased sensitivity to the sun causing a sun- sensitive rash.

Risk Factors

  • Gender: Females are much more likely to develop SLE
  • Genetic factors. The incidence is higher among blacks, Hispanics, Native Americans and Asians.
  • Stress.
  • Pregnancy
  • Exposure to sunlight, or ultraviolet rays.
  • Use of certain drugs, such as hydralazine, procainamide, methyldopa and chlorpromazine.
  • Family history of Lupus.

Diagnosis & Treatment

Patients with vague, recurrent symptoms may require long-term observation before a final diagnosis can be made. Laboratory studies of antinuclear antibodies, blood count and sedimentation rate aid in the diagnosis. Other specialized tests such as anti-double stranded DNA antibodies are usually done to confirm the diagnosis.

General Measures:

Dietary Recommendations. Cultivating a healthy diet low in saturated fats and high in whole grains and fresh vegetables and fruits is essential.

Prevention Against Infections. Patients should minimize their exposure to crowds or people with contagious illnesses. Immunizations against influenza and pneumococcal pneumonia are usually recommended, although flu shots can cause flares. Careful dental hygiene is also important.

Avoiding SLE Triggers. Simple preventative measures include avoiding overexposure to ultraviolet rays and wearing protective clothing and sunblocks. Allergy shots, which increase certain SLE antibodies, should be avoided. In general, SLE patients should use only hypoallergenic cosmetics or hair products.

Reducing Stress. Chronic stress has profound physical effects and influences the progression of SLE. Patients should try to avoid undue emotional or physical stress. Getting adequate rest of at least 8 hours and possibly a nap during the day may be helpful. Maintaining social relationships and healthy activities help prevent the depression and anxiety associated with the disease.

Medications:

  • Severe SLE is treated with corticosteroids, also called steroids, which suppress the inflammatory process, and help relieve many of the complications and symptoms, including anemia and kidney involvement.
  • If skin and joint pains are the predominant symptoms, antimalarial drugs may be prescribed, the most common one being hydroxychloroquine (Plaquenil). Others include chloroquine (Aralen) or quinacrine (Atabrine).
  • For very active SLE, particularly when kidney or CNS involvement or acute blood vessel inflammation is present, drugs known as immunosuppressants are often used, either alone or with corticosteroids. These drugs suppress the immune system by damaging cells that grow rapidly, including those that produce antibodies. The most common immunosuppressants are azathioprine (Imuran), methotrexate (Rheumatrex), and cyclophosphamide (Cytoxan).
  • Dehydroepiandrosterone (DHEA) is a hormone that is produced in the fetus. SLE patients have very low levels of DHEA. Studies suggest that treatment with DHEA (GL701) may offer some modest benefits, particularly in helping to prevent loss of bone density in patients taking steroids.
  • Plasmapheresis (plasma exchange) allows the removal of antibodies and other immunologically active substances from the blood of a person with SLE.
  • A number of genetically designed drugs are being developed to target harmful immune factors without damaging other parts of the immune system.
  • Patients have reported benefits from certain herbs, such as essiac (used in tea and other preparations).

Activity:

Remain as active as possible. However, extra rest may be needed especially during periods of relapse.

Diet:

Cultivating a healthy diet low in saturated fats and high in whole grains and fresh vegetables and fruits is essential. Obtaining most proteins from vegetables, particularly soy, and avoiding dairy and meat products may help protect the kidneys. Patients should take extra calcium and vitamin D, particularly if they are on corticosteroids. Supplements of vitamins B12, B6, and folate may be necessary, especially in people whose blood tests show high levels of homocysteine.

Possible Complications :

  • Bacterial or viral pneumonia, lung inflammation.
  • Impaired kidney function, nephritis.
  • Pericarditis.
  • Seizures, cerebral dysfunction.
  • Arteriosclerotic heart disease.
  • Osteoporosis.
  • Bleeding disorders.

Prognosis

During the past two decades, the prognosis has improved markedly. Provided the initial acute phase is controlled, the long-term prognosis is usually good. Flares are rare after menopause, although late-onset SLE does occur and may be difficult to diagnose. The 10-yr survival in most developed countries is over 95%. This very improved prognosis underlines the paramount importance of early diagnosis of SLE.

Other

Nothing Specified.

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