SLE (Systemic Lupus Erythematosus)
- Article
- 2021-01-30
Systemic lupus erythematosus (lupus) is a chronic (long-term) autoimmune disease that can affect many parts of the body. Lupus occurs when the immune system, which normally helps protect the body against infection and disease, attacks its own tissues. This attack causes inflammation and in some cases permanent tissue damage, which can be widespread - affecting the skin, joints, heart, lungs, kidneys, circulating blood cells and brain.
If you have lupus, you may experience periods of illness (flares) and periods of well-being (remission). Lupus attacks can be mild to severe, and they are unpredictable. However, many people with lupus can control the disease with treatment.
Symptoms
The symptoms of lupus vary from person to person and can range from mild to severe. You may have only a few symptoms that affect only one part of your body, or you may have many symptoms throughout your body. Symptoms can come and go, and you may develop new symptoms over time. Some symptoms occur when the disease causes inflammation in organs, such as the joints, skin, kidneys, heart and lungs, brain and blood cells. Symptoms of lupus can include:
- Arthritis , which causes painful and swollen joints and morning stiffness.
- Fever.
- Fatigue or often feeling tired.
- Malar or "butterfly" rash that appears on the face over the nose and cheeks.
- Discoid, round scaly rash that can appear anywhere on the body.
- Sensitivity to the sun which can cause a rash.
- Hair loss.
- Ulcers, which are usually painless, in the nose and mouth (usually on the roof of the mouth).
- Change of color in the fingers and toes - bluish-purplish, white or red - due to cold and stress ( Raynaud's phenomenon ).
- Swollen glands.
- Swelling in the legs or around the eyes.
- Pain when breathing deeply or lying down, due to inflammation of the lining around the lungs or heart.
- Headache, dizziness, depression, confusion, or seizures.
- Stomach ache.
Lupus causes inflammation throughout the body, which can affect other parts of the body and lead to other problems, including:
- Lupus nephritis, which causes kidney damage that can lead to changes in kidney function, including kidney failure.
- Seizures and memory problems due to changes in the brain and central nervous system.
- Heart problems:
- Damage to the heart valve from inflammation that leads to scarring.
- Pericarditis, inflammation of the lining around the heart muscle.
- Myocarditis, inflammation of the heart muscle itself.
- Vasculitis due to inflammation of blood vessels.
- Blood clots due to high levels of certain autoantibodies called anti-phospholipid antibodies.
- Low blood cell counts, including red blood cells, white blood cells and platelets.
- Infection from a low blood cell count and some medications used to treat lupus.
- Pleurisy due to inflammation of the tissue around the lungs, making breathing painful.
- Bones weakened by glucocorticoid use.
Some people with lupus are more likely to develop other conditions such as cardiovascular disease due to inflammation of the heart and blood vessel tissue caused by lupus, which can lead to:
- Atherosclerosis in blood vessels throughout the body, which happens when fat and other materials attach to the blood vessel wall and form plaque. This can happen in blood vessels throughout the body.
- Coronary artery disease, which occurs when plaque builds up in the arteries supplying blood to the heart. This can interrupt blood flow when a blood clot or a piece of plaque breaks off, causing a heart attack.
Therapy
Doctors treat lupus based on your symptoms. The aim of the treatment is:
- Manage symptoms.
- Prevent, limit and stop flares.
- Maintain the lowest level of disease activity and achieve full remission if possible.
- Prevent or delay organ damage.
- Improve your quality of life.
Lupus is a chronic (long-term) disease and there is currently no cure for it. However, the treatments have improved dramatically, leaving doctors with more choices for treating the disease. Because symptoms can change and treatments can have side effects, your doctor may recommend a combination of treatments to treat lupus.
Treatments for lupus can include the following.
Medicines
- Anti-inflammatory drugs help treat pain or fever.
- Antimalarials, which are used to prevent and treat malaria, have been shown to be useful in the treatment of fatigue, joint pain, rashes, and inflammation of the lungs caused by lupus. These drugs can also prevent flares from returning.
- Corticosteroids help reduce inflammation in the body. Doctors prescribe these drugs in the following forms:
- Liquid or pills that you swallow.
- Cream that you apply to the skin.
- Injection.
- Intravenous (IV) infusion that doctors give to you through a tube into your vein.
Because they are powerful drugs, your doctor will prescribe the lowest dose possible to achieve the desired benefit.
- Immunosuppressants help suppress or curb the overactive immune system, and they can be given by mouth or intravenous infusion. The risk of side effects increases with the duration of treatment.
- B lymphocyte stimulator (BlyS) protein inhibitor, a type of biologic medication, can help reduce the activation and lifespan of abnormal B cells in the body, which may help control lupus.
You may need to take medications to treat or prevent complications related to lupus or side effects of the medications that treat the disease, such as heart disease, high blood pressure, osteoporosis, or infection.
In addition, your doctor can prescribe medications typically used to treat other illnesses that have symptoms similar to those of lupus. For example, medications doctors prescribe for rheumatoid arthritis can help improve some of the symptoms of lupus.
Alternative and Complementary Therapies
Some people try alternative and complementary therapies to improve symptoms. However, research has not shown whether they help treat lupus. Examples are:
- Special diets.
- Dietary Supplements.
- Fish oils.
- Ointments and creams.
- Acupuncture.
- Chiropractic Treatment.
- Homeopathy.
Some over-the-counter medicines, herbs, and supplements can interfere with other medications you are taking. Consult with your doctor before starting any new therapy.
Whatever treatment you receive, it is important that you visit your doctor regularly to monitor your illness and possible side effects of prescription therapies. Never stop your medications or treatments without talking to your doctor.
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