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SYSTEMIC LUPUS ERYTHEMATOSUS

Definition

SLE is an autoimmune chronic inflammatory condition which involves various systems of the body such as skin, joints, and kidneys. The symptoms of SLE are similar to many other illnesses and hence the patients are not easily diagnosed with SLE.

Most of the patients of SLE come up with skin symptoms. The skin symptoms mimic many other diseases and hence SLE remains undiagnosed and untreated.

Symptoms

There can be an involvement of any system of the body producing the following signs and symptoms:

  • General symptoms
  • Fatigue, tiredness, fever, joint pains, weight loss or weight gain
  • Musculoskeletal system
  • Joint pains, morning stiffness, muscle pains, frank arthritis, avascular necrosis
  • Skin symptoms
  • Malar rash, sensitivity to light, discoid lupus
  • Hair loss with brittle hair shafts
  • Kidneys
  • Acute or chronic renal failure or other nephritic diseases, protein or casts in urine, glomerulonephritis
  • Nervous or psychiatric symptoms
  • Seizures or psychosis or confusion of mind
  • Peripheral neuropathy or myelitis
  • Pulmonary system
  • Pleurisy, pleural effusion, pneumonitis, pulmonary hypertension, interstitial lung disease
  • Gastrointestinal system
  • Nausea, vomiting, abdominal pain, improper digestion
  • Heart symptoms
  • Pericarditis or myocarditis, pericardial effusion
  • Hematologic symptoms
  • Anemia (decrease in hemoglobin)
  • Thrombocytopenia (decrease in platelet count)
  • Leucopenia (decrease in white blood cells)
  • Lymphopenia (decrease in the count of lymphocytes)

Causes

SLE is an autoimmune disease wherein the cells of the body attack themselves recognizing them as some foreign substance.

Risk factors that can lead to SLE are:

  • Genetic predisposition
  • Too much exposure to sunlight
  • Certain viral infections like Epstein-Barr virus
  • Hormonal changes especially during child bearing period(pregnancy) or menopause in women
  • Toxins such as cigarette smoke or silica particles
  • Certain drugs can cause SLE
  • Emotional upset or stress

Diagnosis

SLE is difficult to diagnose because of its multi systemic involvement which mimics many other diseases. However, the following criteria can help in diagnosing SLE:

  • Increased levels of ANA antibodies
  • Increased anti-dsDNA antibody levels
  • Presence of anti-Sm antibodies
  • Serositis
  • Oral ulcers
  • Arthritis
  • Sensitivity to light
  • Blood disorders
  • Kidney diseases
  • Malar or discoid rash

The following tests are to be carried out in people who are suspected of having SLE:

  • CBC with differential count
  • Serum creatinine
  • Urinalysis with microscopy
  • Complement levels
  • Liver function tests
  • Creatine kinase assay
  • Spot protein/spot creatinine ratio
  • Autoantibody tests
  • Joint radiography
  • Chest radiography and chest CT scanning
  • Echocardiography
  • Brain MRI/ MRA
  • Cardiac MRI
  • Arthrocentesis
  • Lumbar puncture
  • Renal biopsy

Self help

  • Stop smoking.
  • Avoid exposure to bright sunlight by using full sleeves clothes or sunscreens.
  • Proper rest to the body and mind.
  • Stopping certain medications that can lead to SLE; or taking alternative medicines that are harmless.