Systemic Lupus Erythematosus (SLE)

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- Dr.Aarush Manchanda,MD


DEFINITION

Lupus is a disorder of the autoimmune disease. In autoimmune diseases, the body harms its own healthy cells and tissues. This leads to inflammation mage to various body tissues. Lupus can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Lupus is characterized by periods of illness, called flares, and periods of wellness (remission).
Although lupus is used as a broad term, several kinds of lupus exist.
 
Systemic lupus erythematosus is the most common form of the disease. The symptoms of SLE may be mild or serious.

Discoid lupus erythematosus refers to a skin disorder in which a red, raised rash appears on the face, scalp, or elsewhere. The raised areas may become thick and scaly and may cause scarring. The rash may last for days or years and may recur. A small percentage of persons with discoid lupus have or develop SLE.

Drug-induced lupus refers to a form of lupus caused by specific medications. Symptoms are similar to those of SLE and typically resolve when the drug is stopped.

Neonatal lupus is a rare form of lupus affecting newborn babies of women with SLE or certain other immune-system disorders. At birth, the babies have a skin rash, liver abnormalities, or low blood counts, which resolve entirely over several months. However, babies with neonatal lupus may have a serious heart defect. Physicians can now identify most at-risk mothers, allowing for prompt treatment of the infant at or before birth. Neonatal lupus is very rare, and most infants of mothers with SLE are entirely healthy.

At present, no cure for lupus exists. However, lupus can be very successfully treated with appropriate drugs, and most persons with the disease can lead active, healthy lives.


INCIDENCE

Anyone can get lupus; however, more women than men have the disease.

In the United States, lupus is 3 times more common in black women than in white women and is also more common in women of Hispanic/Latino, Asian, and Native American descent. Persons who are black or Hispanic/Latino tend to develop lupus at a younger age and have more symptoms at diagnosis. They also tend to have a more severe form of the disease than white patients do. In addition, lupus can run in families, but the risk that a child or a brother or sister of a patient will also have lupus is still quite low.

It is difficult to estimate how many persons in the United States have the disease because its symptoms vary widely and its onset is often hard to pinpoint.


ETIOLOGY

Lupus is a complex disease, the cause of which is unknown. In addition, some autoantibodies join with substances from the body's own cells or tissues to form molecules called immune complexes. A buildup of these immune complexes in the body also contributes to inflammation and tissue injury in persons with lupus. Researchers do not yet understand all the factors that cause inflammation and tissue damage in lupus.


SYMPTOMS

Each person's experience with lupus is different, though patterns exist that permit accurate diagnosis. Symptoms can range from mild to severe and may come and go over time.

Common symptoms of lupus include painful or swollen joints, muscle pain, unexplained fever, skin rashes, and extreme fatigue. A characteristic skin rash may appear across the nose and cheeks-the so-called butterfly or malar rash. Other rashes may occur elsewhere on the face and ears, upper arms, shoulders, chest, and hands.

Other symptoms of lupus include chest pain, unusual hair loss, sensitivity to the sun, anemia, and pale or purple fingers or toes from cold and stress (Raynaud's phenomenon). Some persons also experience headaches, dizziness, depression, or seizures. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times.

The following systems in the body also can be affected by lupus.

 Kidneys: Inflammation of the kidneys can impair their ability to get rid of waste products and other toxins from the body effectively. Usually no pain is associated with kidney involvement, though some persons may notice that their ankles swell. Most often the only indication of kidney disease is an abnormal urine or blood test.

 Lungs: Some persons with lupus develop pleuritis. Persons with lupus also may get pneumonia.

 Central nervous system : In some persons, lupus affects the brain or central nervous system. This can cause headaches, dizziness, memory disturbances, vision problems, stroke, or changes in behavior.

 Blood vessels: Blood vessels may become inflamed, affecting the way blood circulates through the body. The inflammation may be mild or severe.

 Blood: Persons with lupus may develop anemia, leukopenia, or thrombocytopenia. Some persons with lupus may have abnormalities that cause an increased risk for blood clots.

  Heart: In some persons with lupus, myocarditis, endocarditis, or pericarditis can occur, causing chest pains or other symptoms. Lupus can also increase the risk of atherosclerosis

Despite the symptoms persons with lupus can maintain a high quality of life overall. One key to managing lupus is understanding the disease and its impact.

Learning to recognize the warning signs of a flare can help a person take steps to ward it off or reduce its intensity. Many persons with lupus experience increased fatigue, pain, a rash, fever, abdominal discomfort, headache, or dizziness just before a flare.

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