Lupus Symptoms and Treatment
Systemic lupus erythematosus (SLE) is an auto-immune disorder. There are many diseases in this category, one of the most common being rheumatoid arthritis.
Auto-immune diseases can be explained as the body rejecting part of its normal tissue which for an unexplained reason it suddenly considers to be foreign tissue. When the body receives a transplant (e.g. kidney, heart, etc.), the body detects the implant as foreign tissue and starts an intense inflammatory reaction in an attempt to reject it. In auto-immune diseases, this same reaction occurs but inappropriately, and directed against selected parts of the body. In SLE, the autoimmune reaction attacks joints, skin, liver, and kidney most commonly, but almost any tissue in the body can be affected.
Of all SLE cases, 85% occur in women, usually young women. SLE can have a very variable course, from a mild arthritic complaint that causes only slight intermittent discomfort to a rapidly progressive disease that leads to death within a few months. Most patients are towards the milder end of the scale.
The common characteristics of SLE are a red rash across both cheeks and the bridge of the nose ('butterfly rash'), rashes on other areas that are exposed to sunlight, mouth ulcers, arthritis of several joints, poorly functioning kidneys and anemia. In addition, patients may complain of a fever, loss of appetite, tiredness, weight loss, damaged nails, loss of hair and painfully cold fingers. Less common complaints include conjunctivitis, blurred vision, chest pain, pneumonia, heart failure, abdominal pain, constipation, depression and convulsions. The symptoms vary dramatically from one patient to another, and none will have all these problems, and most have only half a dozen of the symptoms. Arthritis is the most common link.
Because of the varied symptoms and progress of the disease, it is often difficult for doctors to diagnose SLE. Once suspected, specific blood tests can diagnose the condition. Anemia and reduced kidney and liver function may also be detected on blood tests.
Treatment will depend upon the severity of the disease. Many patients with relatively mild symptoms will require no treatment, or only occasional treatment for arthritis. Sun exposure should be avoided, and because some drugs are known to precipitate the condition, all non-essential medications should be ceased. In more severe cases, a wide range of drugs, including steroids, cytotoxics, immunosuppressives and antimalarials (used for their anti-arthritis properties), may all be used in various combinations and dosages. Patients are followed closely after the diagnosis, and while on medication, very frequent blood tests and doctor visits may be required.
There is no cure available for SLE, but nearly 90% of patients are still alive more than ten years after the diagnosis is made. Many patients are free of symptoms for months on end before a further relapse requires another course of treatment. After each attack, there is slightly more residual liver, kidney or heart damage, and eventually these problems accumulate to the point where the disease becomes life-threatening. In rare cases the SLE proceeds relentlessly to death within a relatively short time.
With careful management, compliance with treatment, and regular checkups, the outlook for most patients with SLE is quite favorable.
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