Lupus erythematosus is one of the most complex systemic diseases in which the immune system begins to attack the body’s own cells. In lupus erythematosus, the skin, joints, blood cells and kidneys are primarily affected, but many other organs can be affected. 90% of lupus erythematosus patients are women of childbearing age between 20 and 45.
Causes of systemic lupus erythematosus
The exact reason why some people get systemic lupus erythematosus (SLE) and others do not is unknown. But scientists speculate that the disease has a genetic predisposition. For example, it is not uncommon for members of the same family to get lupus erythematosus.
In lupus erythematosus there is a failure of the immune system, it ceases to distinguish between “their own” and “foreign cells” and begins to produce antibodies against the DNA of cells in the body. The appearance of a large number of antibodies leads to the formation of inflammation throughout the body.
Several factors can trigger the onset of the disease:
- taking certain medications: antibiotics, sulfonamides, vaccines;
- changes in the ratio of hormone levels (androgens and estrogens);
- prolonged exposure to the sun;
- hypothermia of the body;
- disorders of the endocrine system;
- prolonged stress.
In addition, there is an assumption that the disease can be provoked by a viral infection.
Symptoms
While discoid lupus erythematosus mainly affects the skin, SLE is a more serious, systemic disease that leads to inflammation of not only the skin, but also many internal organs.
Most often, SLE begins with the appearance of unmotivated weakness, a person loses weight for no reason, has a fever, “breaks” joints.
The American College of Rheumatologists has developed a system of criteria for diagnosing systemic lupus erythematosus. If a patient has at least 4 out of 11 signs, it means that the disease is systemic lupus erythematosus.
These symptoms are:
- The appearance of a red-colored rash (butterfly-shaped) on the nose and cheeks, redness in the décolletage area and on the back of the hand;
- the appearance of disc-shaped scales on the face, scalp, chest;
- increased skin sensitivity to sun exposure;
- ulcers in the oropharynx;
- soreness and swelling in the joints, stiffness of movement;
- lesions of the serous membrane of the lungs, heart, peritoneum;
- kidney damage;
- dysfunction of the central nervous system (gratuitous convulsions, depression, etc.);
- hematologic disorders (decrease in the number of blood cells);
- immunologic disorders (secondary infections may occur);
- formation of antinuclear antibodies (action of the immune system against cells of its own body).
In addition to these symptoms of SLE, patients may also experience fever, hair loss, up to complete baldness, muscle pain, decreased or increased appetite, possible nausea, vomiting, diarrhea and other signs.
Diagnosis of systemic lupus erythematosus
Diagnosis of systemic lupus erythematosus is a complex sequential process consisting of several steps. First, a detailed collection of symptoms and signs in the chronological sequence of their occurrence is required. Second, a set of specific tests is required to confirm the diagnosis. Each case history of systemic lupus erythematosus is individualized, just as the treatment mechanism for each patient is individualized.
It is important to determine the degree of disease progression, provoking factors, identify the affected organs and systems. At the reception, the rheumatologist asks about complaints, clarifies whether there were reactions to the sun, painful sensations in the joints, hair loss, skin rashes. The doctor also conducts a visual inspection, palpation.
To clarify the diagnosis, laboratory and instrumental studies are used:
- Blood tests (clinical, biochemical, immunological). Allows you to identify the inflammatory process, anemia, determine metabolic disorders, assess the state of internal organs, detect markers of systemic diseases of connective tissue.
- Medical ultrasound. Ultrasound detects abnormalities in the work of internal organs.
- Angiogram. An examination of blood vessels to determine their pathologic condition.
- Radiographs. Necessary to diagnose changes in the respiratory system, bones, joints.
It is obligatory to carry out differential diagnosis to exclude diseases that may manifest similarly.
Treatment of systemic lupus erythematosus
It is almost impossible to affect the cause of the development of SLE, but with a competent approach it is realistic to prevent the lesion of new organs and systems, and get rid of exacerbations.
The treatment regimen may include taking such medications as:
- glucocorticosteroids
- cytostatics
- immunosuppressors
- detoxification agents
- anti-inflammatory drugs
- symptomatic medications.
The doctor selects a combination of remedies individually – depending on the severity of the pathology, complications, individual characteristics. Treatment helps to regulate the immune system, reduce or stop the inflammatory process, and reduce the risk of infections.
Prevention
With timely medical attention, the outcome of the disease is quite favorable. Remission can last for a long time. Compliance with the recommendations for systemic lupus erythematosus allows you to avoid complications and progression of pathology.
Preventive recommendations are reduced to basic rules:
- minimize the time spent in the sun as much as possible
- avoid bad habits
- control body weight
- avoid stress
- regularly see a doctor and undergo check-ups.
