Systemic lupus erythematosus, abbreviated as SLE, is an autoimmune disorder that affects many parts of the body. An autoimmune disorder is a condition in which the body, for reasons that medical science usually does not understand, creates antibodies against its own tissues.
A person with SLE produces antibodies against many of his or her own tissues. This autoimmune reaction can damage many parts of the body. These include: brain and nervous systemdigestive systemeyesheartjoints and muscleskidneylungskin
Because SLE affects so many different parts of the body, the disease has many signs and symptoms. These are best listed by organ system.
It should be emphasized that an individual patients with SLE will exhibit some combination, not all, of these symptoms, and some have involvement of only one organ system. The symptoms come and go in an irregular time pattern. Some persons with lupus can identify "triggers" that usually bring on the symptoms.
Signs and symptoms that affect the whole body: fatiguefeverloss of appetitenauseaweight loss
Signs and symptoms that affect the skin: hivesloss of scalp hairred "butterfly rash" on the face, which extends over the cheeks and bridge of the nose in the shape of a butterflyred, raised rashes in areas exposed to the sunsensitivity to the sunulcers of the mouth, nose, or vagina
Symptoms and signs that affect the muscles, bones, and joints: arthritishand deformitiesjoint pain, especially in the hands, wrists, and kneesloss of the blood supply to bone, especially hips and shouldersmuscle pains and weaknessserious infection within a joint
Signs and symptoms of kidney involvement: blood in the urinedecrease in kidney function or kidney failureprotein in the urinewhite blood cells in the urine
Signs and symptoms affecting the nervous system: bleeding in the brain, known as intracerebral hemorrhageheadaches, including migrainesloss of coordinationmemory loss, problems with concentrationnumbness, pain, or a feeling of "pins and needles" in the hands and feetproblems with the major nerves in the head and faceseizuresstrokes
Signs and symptoms involving the blood: anemia, which is a low red blood cell countlow blood platelet countlow white blood cell countproblems with both blood clotting and bleeding
Signs and symptoms involving the heart: fluid collection in the sac around the heart, known as pericardial effusionheart attackheart valve problemsinflammation and infection in the heartinflammation of the lining of the heart
Signs and symptoms involving the lungs: cough, including coughing up bloodfluid in the lunginflammation in the lunginflammation of the lining of the lungsshortness of breath
Signs and symptoms affecting the digestive system: abdominal distressdiarrheaenlargement of the liverintestinal perforation due to inflammation of blood vesselsloss of appetitenausea and vomitingrectal bleeding caused by ulcerations
Symptoms and signs affecting the eye: blindnessconjunctivitis, which is inflammation of the outer lining of the eyedamage to the retina, which may cause visual impairments
The exact cause of systemic lupus erythematosus is unknown. It is believed to be an autoimmune disorder. SLE tends to run in families. Certain medications have been known to cause systemic lupus erythematosus. These include procainamide, hydralazine, isoniazid, and chlorpromazine.
Events that may trigger the disease include infection, stress, exposure to toxins, and sunlight. Women account for 80% to 90% of cases of SLE. It is more common in black women than in white women. SLE is also more common in Asian, Hispanic, and Native American women.
Most cases of systemic lupus erythematosus cannot be prevented. It may be helpful to avoid medications that cause SLE, but not everyone who takes these medications will develop the disease.
A complete medical history and physical examination are important tools for diagnosing SLE. Blood tests also play an important role. A blood test called an ANA looks for antibodies that the person has produced against his or her own tissues.
Other tests used to diagnose SLE include the following: CT scanchest X-ray electrocardiogramkidney biopsyMRI scanspinal tap
SLE is a long-term disease that flares up, then quiets down, then flares up again. Persons with SLE often have a significant decrease in the quality of daily life. Many complications of SLE put the person at risk. Many of the medications used to treat the disease also have significant side effects. SLE can be fatal, often as a result of kidney failure, infections, or heart attack.
There is no evidence that SLE is a contagious disease that can be passed from one person to another. However, it does tend to run in families. Pregnant women with SLE have an increased risk of miscarriages, stillbirths, and premature infants.
Although there is no cure for SLE, certain things can help prevent flare-ups. Persons with SLE should avoid intense sun exposure. Liberal use of sunscreens, long-sleeved shirts, and hats are helpful.
Since infections are common, persons with SLE should seek prompt evaluation of fevers. A yearly flu vaccine is recommended. If the spleen is removed, the person should receive the pneumococcal vaccine. Individuals should also receive antibiotics before any dental procedures.
A number of medications are used to treat SLE, including the following: antimalarial medications, such as hydroxychloroquine (i.e., Plaquenil) are used to treat skin problems and arthritis.Anti-rheumatic drugs such as methotrexate (i.e., Rheumatrex, Trexall) and cyclophosphamide (i.e., Cytoxan)corticosteroids, such as prednisone and methylprednisolone. These reduce the immune system response.nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. These medications reduce fever and treat pain.powerful cytotoxic medications, which kill cells. These are used to treat nephritis, a serious kidney problem.
Individuals with end-stage kidney disease may benefit from kidney dialysis or a kidney transplant.
The medications used to treat lupus have significant side effects. Unfortunately, some of these side effects can mimic the symptoms of the disease itself.
NSAIDs can cause stomach irritation, allergic reaction, and decreased kidney function.
Antimalarial medications can cause rash, muscle weakness, and nerve problems.
Corticosteroids have a host of possible side effects. These include weight gain, high blood pressure, osteoporosis, and increased risk of infection.
The cytotoxic medications can cause problems with the bladder and with blood cell production.
Systemic lupus erythematosus is a chronic disease that fluctuates over time. The best way to manage it is by active collaboration between the individual and his or her healthcare professionals.
Periodic examinations allow the healthcare professional to monitor the activity of the disease and determine possible complications. A variety of blood tests help in the monitoring of the disease. Any new or worsening symptoms should be reported to the healthcare professional.
