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Systemic lupus erythematosus

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Introduction of systemic lupus erythematosus

Systemic lupus erythematosus (SLE), commonly known as lupus is a disorder of the defense (immune) system of the body that results in various manifestations involving numerous organs. It has been estimated that about 4.6 out of every 1,00,000 individuals are affected by this disorder. Systemic lupus erythematosus is more commonly noticed in women and is often diagnosed between the ages of 15 and 35 years. The skin, joints, blood cells, kidneys, lungs and the central nervous system are commonly affected wherein painful joints are often the main symptom experienced by the affected individuals.1,2

Signs and Symptoms of systemic lupus erythematosus

Systemic lupus erythematosus may be characterized by a wide array of symptoms such as formation of rashes over the cheeks and back, sensitivity to light, ulcers in the mouth, disorders of the kidney, nervous system and the blood cells along with pain in the joints. Other general features such as fever, body ache, tiredness, loss of appetite and weight are also noticed.

Arthritis like symptoms that include pain and swelling may be noted in multiple joints that are painful to touch. The commonly involved joints are those of the hands, wrists and knees. Osteoporosis may occur in individuals suffering from SLE and who are taking corticosteroid medications for a long period of time. Various other symptoms and signs specific to the organ system affected are observed in association with these general features.2,4     

Causes of systemic lupus erythematosus

The cause of SLE has been attributed to various factors that may interact with each other or with the immune system of the body. These factors may either initiate or exacerbate the condition that is characterized by the abnormal functioning of the body’s immune mechanism. This results in formation of specialized cells known as autoantibodies that begin to attack and destroy various cells and tissues of the body.

Such a reaction may be triggered by various factors that include heredity, viral infection due to viruses such as Epstein-Barr virus (EBV) or exposure to ultraviolet (UV) light. Certain drugs such as sulfonamide antibiotics and sex hormones such as estrogen have also been associated with SLE.3

Risk Factors of systemic lupus erythematosus

Family history of SLE, female gender and exposure to UV light are the risk factors that are associated with increased incidence of SLE. Consumption of oral contraceptive drugs may often exacerbate the existing disorder.3

Lupus risk factors

Diagnosis of systemic lupus erythematosus

The diagnosis is generally based on the history and the different types of symptoms and signs and symptoms noticed. The presence of multiple symptoms involving the various organs of the body is considered as a criterion for the diagnosis. Additionally blood test to measure the levels of specific cells known as antinuclear antibodies (ANA) is performed to confirm the diagnosis. Other common blood tests to evaluate the quality and quantity of the blood cells, and their products may also be advised. Urine tests, radiographs, ECG, MRI and CT scans and other specific tests based on the organ system involved may be advised to know the extent of the disorder.1,2,5

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Treatment of systemic lupus erythematosus

Lupus is a long-term disorder that requires the affected individual to undergo various treatments for several months at a stretch. However, it is not a life-threatening disorder when identified early and appropriate interventions are initiated at an early stage. The type and duration of therapy is based on the severity and the extent of SLE.

Simple measures such as avoiding sunlight and wearing long sleeved clothes when going in sunlight are generally advised. Liberal application of sunscreen lotions with a higher protection factor (SPF 15 or higher) is also advised. If SLE is caused due to the administration of certain drugs, then the treatment will be modifying either the dosage or the type of drug being administered.

The pain associated with SLE is countered with the administration of simple painkillers or nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen, nimesulide, aceclofenac or diclofenac sodium that are available as over-the-counter medications. Drugs used to treat malarial infections are also useful in providing relief from SLE symptoms and may also be advised in certain situations. In case of severe conditions, corticosteroid ointments to be applied on the skin rashes may be advised. Other drugs, which belong to the group of immunosuppressants may be advised in low doses following the reduction of the severity of the symptoms.

Incase of other organs being affected, specific treatment is advised to resolve the symptoms and signs associated with the type of organ involved.2 ,6    

Alternative Therapies for systemic lupus erythematosus

Counselling, enrolment in social support groups and minor daily exercises such as aerobics have an adjuvant effect on the therapies being followed.

Living with Lupus

Systemic lupus erythematosus is lifelong disorder wherein the affected individuals need to visit the physician or a specialist doctor at regular intervals to know the progress of the disorder and modification of therapeutic protocol. Early diagnosis and prompt treatment have helped individuals suffering from SLE to live much longer than those with severe complications.1,2,6,7

References:

1. Hay EM, Snaith ML. Systemic lupus erythematosus and lupus-like syndromes. BMJ. 1995; 310: 1257–1261.   

2. D’Cruz DP. Systemic lupus erythematosus. BMJ. 2006; 332: 890–894.

3. Manson JJ, Isenberg DA. The pathogenesis of systemic lupus erythematosus. The Netherland J Med. 2003; 61(11): 343–346.

4. Egol KA, Jazrawi LM, DeWal H, Su E, Leslie MP, Di Cesare PE. Orthopaedic Manifestations of Systemic Lupus Erythematosus. Bulletin: Hospital for Joint Diseases. 2001; 60(1): 29–34.

5.Gill JM, Quisel AM, Rocca PV, Walters DT. Diagnosis of systemic lupus erythematosus. Am Fam Physician. 2003; 68: 2179–2186.

6.Petri M. Treatment of systemic lupus erythematosus: An update. Am Fam Physician. 1998; 57(11): 2753–2760.

7.Gordon C. Long-term complications of systemic lupus erythematosus. Rheumatology. 2002; 41: 1095–1100.

Written by: healthplus24.com team

Date last updated: February 03, 2015