Lupus Systemic Erythematosus (SLE)

Systemic Lupus Erythematosus is a chronic (long- lasting) inflammatory rheumatic disease which can affect various parts of the body, especially  the skin, joints, muscles, heart, lung, nervous system, blood, and kidneys. Lupus involves inflammation agents, virus, bacteria). (the immune  system’s response to kill foreign

There are several types of lupus:

Discoid lupus affects the skin and is always limited to the skin. It is identified by a rash that may appear on the face, neck, and scalp. Discoid lupus is diagnosed by examining a biopsy of the rash. In approximately 10 percent of patients, discoid lupus can evolve into the systemic form of the disease, which can affect almost any organ or system of the body. This cannot be predicted or prevented. Treatment of discoid lupus will not prevent its progression to the systemic form. Individuals who progress to the systemic form probably had systemic lupus at the outset, with the discoid rash as their main symptom.

Systemic lupus is usually more severe than discoid lupus, and can affect almost any organ or system of the body. For some people, only the skin and joints will be involved. In others, the joints, lungs, kidneys, blood, or other organs and/or tissues may be affected. Generally, no two people with systemic lupus will have identical symptoms. Systemic lupus may include periods in which few, if any, symptoms are evident («remission») and other times when the disease becomes more active («flare»). Most often when people mention «lupus,» they are referring to the systemic form of the disease.

Drug-induced lupus occurs because of a reaction to drugs. Symptoms, however, disappear once the drugs are discontinued. The symptoms of drug- induced lupus are similar to those of systemic lupus. The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or  hypertension) and procainamide (used to treat irregular heart rhythms

WHAT CAUSES SLE?

The cause of SLE is not known. Scientists believe that hereditary and environmental factors are involved. Some of the environmental factors that may trigger the disease are: infections, antibiotics (especially those in the sulfa and penicillin groups), ultraviolet light, extreme stress, certain drugs, and hormones.

Although lupus is known to occur within families, there is no known gene or genes which are thought to cause the illness. There are recent discoveries of a gene on chromosome 1 which is associated with lupus in certain families. Previously, genes on chromosome 6 called «immune response genes» were also associated with the disease.

In SLE the body’s immune/defence system turns against itself and attacks various organ systems. The immune system loses its ability to tell the difference between foreign substances (antigens) and its own cells and tissues. The immune system then makes antibodies directed against «self.» These antibodies,  called  «auto-antibodies,»  react with the «self» antigens to form immune complexes. The immune complexes build up  in the tissues and can cause inflammation, injury to tissues, and pain.

WHO GETS SLE?

Studies suggest that certain people may  inherit the tendency to get lupus.  New cases of lupus are more common in families where one member already has the disease. Only 10 percent of lupus patients will have a close relative (parent or sibling) who already has or may develop lupus. Statistics show that only about 5% of the children born to individuals with lupus will develop the illness.

Signs & Symptoms

Although lupus can affect any part of the body, most people experience symptoms in only a  few organs. The following classification of 11 symptoms helps doctors tell the difference between people who have lupus and people who have other connective tissue disorders:

Malar (MAY-lar) rash (a butterfly shaped rash over the cheeks and across the bridge of the nose); Discoid rash (scaly, disk-shaped sores on  the  face, neck and/or chest); Sensitivity to sunlight; Oral ulcers; Arthritis (pain, stiffness in joints); Serositis (inflammation of the lining around the heart, lungs, and/or abdomen, causing pain and shortness of breath); Kidney problems (protein leak); Central nervous system problems; Blood problems   (anemia);  Problems  with  the  immune

system (risk of infection); Antinuclear antibodies (autoantibodies that react against the body’s own cells); Other symptoms include: Anemia; Fatigue; Sensitivity to cold (Raynaud’s phenomenon); Weight loss

HOW IS LUPUS DIAGNOSED?

Lupus is sometimes difficult to diagnose because there is no single set of symptoms. Diagnosis is usually made by a careful review of a person’s entire medical history coupled with an analysis of the results obtained in routine laboratory tests and some  specialized tests  related to immune status (

usually made by a careful review of a person’s entire medical history coupled with an analysis of the results obtained in routine laboratory tests and some specialized tests related to immune status (test that can detect a group of antibodies found in the blood of almost all people with lupus). Currently, there is no single laboratory test that can determine whether a person has lupus or not.. Some other lab tests include:

A complement test (C3, C4, CH50, CH100) measures the amount of complementary proteins circulating in the blood.

A sedimentation rate (ESR) or C-reactive protein (CRP) may be used to measure inflammation levels.

A urine analysis issued to detect kidney problems. Chest X-rays may be taken to detect lung damage. An EKG can detect heart problems.

FLARES (WHAT TRIGGERS LUPUS?)

Scientists have noted common features in many lupus patients. In some, exposure to the sun causes the sudden development of a rash and then possibly other symptoms. In others, an infection, perhaps a cold or a more serious infection, does not get better, and then complications arise. These complications may be the first signs of lupus. In still other cases, a drug taken for some illness produces the signalling symptoms. In some women, the first symptoms and signs develop during pregnancy. In others, they appear soon after delivery. Many people cannot remember or identify any specific factor. Obviously, many seemingly unrelated factors can trigger the onset of the disease.

WHAT IS THE TREATMENT?

Early diagnosis and treatment are important for preventing complications. Not everyone with SLE  has the  same symptoms.  Therefore, each person must work out an individual plan with her rheumatologist. For the vast majority of people with lupus, effective treatment can minimize symptoms, reduce inflammation, and maintain normal bodily functions.

PREGNANCY AND LUPUS:

If you are a woman with SLE and plan to become pregnant, you should check with your doctor. He/ she may check for an autoantibody that can cause heart problems in newborn babies.