What is Systemic Lupus Erythematosus?
There are several autoimmune diseases among which systemic lupus erythematosus or SLE is one. In other words, the body’s immune system fails to recognize healthy tissues, so it attacks healthy tissues leading to chronic inflammation. It is more common among women and Asians as well as African Americans.
What is the cause of Systemic Lupus Erythematosus?
The immune system works imperfectly under the impact of SLE. The system begins producing autoantibodies in place of protective antibodies. As a result of this the antibodies begin attacking the patient’s healthy tissues. The exact reason why this happens is not yet known. Perhaps both environment and heredity may have a role to play in it.
The consistent attack leads to vasculitis or abnormal blood vessels and inflammation. Additionally, antibodies can eventually enter into the cells of organs and damage those tissues. Sunlight, drug allergies, and viruses may have a possible role to play in lupus, other than the hereditary factors.
Who gets Systemic Lupus Erythematosus?
Lupus is most common among people in the age group of 10 to 50 years. However, within the 10-50 age groups those in 20-30 are more commonly affected by SLE. The population most commonly affected is Asians and Blacks, although it can be present in every ethnic and racial group. It affects 8 to 10 times more women than men.
It is estimated that up to 10 percent of the population suffering from lupus that is isolated to the skin will eventually develop the systemic form of lupus. Systemic Lupus Erythematosus is also prevalent among certain drug users. The following regions can be affected by SLE as well:
What are the symptoms of Systemic Lupus Erythematosus?
There can be a wide range of symptoms in SLE, such as:
- Mouth sores
- Heart and lung inflammation
- Neurological problems
- Kidney problems
In addition, hair loss, loss of appetite, muscular pain, fatigue, photosensitivity, pleuritis, and poor circulation are some other symptoms associated with SLE.
Often, non-itchy and non-painful skin rashes accompany SLE. Skin manifestations can at times appear as scars. Most of the people who have SLE develop what is known as butterfly rash, a kind of facial rash typically over the nose bridge. While rashes can be painless, scarring can lead to permanent hair loss. However, treatment can heal the rash without leading to permanent scarring.
How is Systemic Lupus Erythematosus diagnosed?
Typically, the diagnosis of lupus is confirmed with 4 of the 11 signs. The physician will conduct a physical exam and examine the chest using a stethoscope to hear the abnormal sound associated with pleural friction or heart friction. A number of other tests are conducted for the diagnosis of SLE including:
- Antibody tests
- Kidney biopsy
In addition to these tests urine analysis may also be conducted. In fact the range of tests can be very large that can alter some of the tests’ result such as ESR, rheumatoid factor, liver function, Coombs’ test, cryoglobulins, C3/C4, antithyroglobulin and antithyroid microsomal.
How can Systemic Lupus Erythematosus affect pregnancy and new born?
SLE may present challenges to pregnant women whose pregnancies may be at “high risk”. These pregnancies require expert care under a qualified obstetrician and skilled rheumatologist. Regular fetal monitoring may be required. Pregnant women with SLE are at an increased risk of miscarriage. The presence of certain antibodies like lupus anti-coagulant and cardiolipin identifies the risk of miscarriage and so some women may require blood thinning medications so as to prevent miscarriage.
Women with previous history may need to continue with blood thinning medication even after pregnancy. There is an increased risk of lupus antibodies getting transferred to the fetus leading to the newborn developing lupus illness. The other complications like anemia and congenital heart block are distinct possibilities.
According to NIH, there is no cure for SLE. However, the treatment can considerably reduce and minimize the symptoms. In addition, someone with SLE is recommended to get immunizations as well as preventive heart care and tests to determine osteoporosis that can cause bone thinning. Support groups may be useful in getting over depression.
What does the future hold for people suffering from Systemic Lupus?
Over the decades, there has been a gradual improvement in the life of people with SLE. This has been possible due to improvement in tests, monitoring, and treatment. The disease is being understood more clearly leading to improved treatment strategies. Stem cell transplants are under active consideration as a treatment strategy.
However, those suffering from SLE are at an increased risk of cancer and heart disease. One of the most popular drugs to have shown promising results is DHEA. It has been found helpful in combating thinking difficulties and fatigue. An important finding is that oral contraceptives do not increase the risk of flares.
What is the treatment for Systemic Lupus?
There is no treatment that can cure systemic lupus, but there are therapies that can suppress the symptoms. The severity and extent of the disease determines the course of treatment. Three FDA approved drugs for treatment of lupus disease are aspirin, prednisone, and hydroxychloroquine. With rapid progress in the science of genetics, new promising drugs are in the offing. In addition, there are drugs to treat conditions associated with lupus.