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A focus on SYSTEMIC LUPUS ERYTHEMATOSUS
Systemic lupus erythematosus (SLE) is an inflammatory disorder, which is manifested in protean, and follows a remitting and relapsing course. The disease is also regarded as an autoimmune disease. This implies that the immune system within a patient attacks a healthy tissue instead of attacking harmful substances such as viruses and bacteria. Consequently, this leads to inflammation. Most of the victims of this disorder are women, particularly those who are in the childbearing age. It affects the kidneys, the skin, the brain, joints and other organs. Systemic lupus erythematosus among children develops within the age of 3-15 years within the ratio of 4:1 for girls and boys (Crow, 2011). If not managed carefully and early enough, the impact of SLE to a person’s body can be disastrous. This paper presents general information on Systemic Lupus Erythematosus.
The Development of SLE
Zakeri et al (2011) explains that autoantibodies are present in SLE patients many years before they are actually diagnosed for the disorder. In addition, the presence of autoantibodies among patients with SLE appears on a gradual pattern, and follows a predictable course. Further, there is a developmental accumulation of particular autoantibodies within a person prior to the onset of SLE.
Some of the potential complications for people with SLE include unusual deposits within the kidney cells. When there is unusual deposit in the kidney cells, it may result into a condition identified as lupus nephritis. When this problem occurs, it may lead to kidney failure and the patient will need to undergo kidney transplant and dialysis. Further, the condition can lead to damages such as blood clotting in the lungs or legs, and may destroy the red blood cells leading to anemia. For pregnant women, it may lead to pregnancy issues including miscarriages and stroke. Other complications include inflammation and extremely low count of blood platelet (blood platelet are important in stopping bleeding) (Zakeri et al, 2011).
Until today, the specific cause of SLE has not yet been established. Those who are more vulnerable include women within the childbearing age, people from the Asian origin and African American. However, it is believed by experts in the field that the disease may be genetic. According to these experts, some people are born with particular genes, which interfere with the body’s immune system. Such people are vulnerable to acquiring lupus. Consequently, there are a number of factors, which could instigate the lupus attacks. These include, but not limited to sunlight, viral infections such as those that cause mononucleosis. Nonetheless, these factors may not trigger lupus for all people, but only for some individuals (Thomas, and Donald, 2014).
Signs and Symptoms
Lupus symptoms differ on a wider scale. Furthermore, these symptoms develop on a gradual basis until they become extreme. The stage where the symptoms are worse are identified as flares or relapses. On the other hand, the stage where these symptoms could be put under control are identified as remissions. Common symptoms include swelling, joint pain, skin rash, a fever, hair loss and mouth sores. As time goes, people with lupus begin to develop problems with their nervous system, lungs, heart, and blood cells (Bertsias et al, 2011).
SLE can affect most parts of the body, hence its development and presentation varies, ranging from fulminant and indolent. The signs and symptoms among children are different with those found on adults. General signs and symptoms that can be used in identifying the condition include ulcers, malar rash, renal involvement, urinary cellular casts, fever, thrombocytopenia, lymphadenopathy and hemolytic anemia (Tsokos, 2011).
Among adults, there are more symptoms, which include sicca, and pleuritis, which manifests as twice as in children. For women who are within the childbearing age, the presentation of this disorder may be in inform of joint pain, triad fever, and rashes. These manifestations should trigger an investigation of the existence of SLE. Other common manifestations among patients include changes in weight, arthralgia, frank antritis, avascular necrosis and arthropathy. If not treated early enough, the condition may lead to acute nephritic disease and chronic renal failure. Other manifestations include psychosis, seizures, pleural effusion, pneumonits, interstitial lung disease and pulmonary hypertension. (Thomas, and (Donald, 2014).
Clinical diagnosis of SLE is normally done by combining laboratory evidence and clinical findings. It is important to understand how the disease is diagnosed since this understanding will assist clinicians in recognizing SLE and classifying it on the basis of target-organ manifestations. The Systemic Lupus International Collaborating Clinics (SLICC) classifies an individual as having SLE upon identification of biopsy-proven lupus nephritis with anti-dsDNA antibodies or ANA. Other criteria in diagnosis of SLE include the presence of renal involvement, discoid rash, neurologic disorder, immunologic phenomena, photosensitivity, oral ulcers and serositis(Tsokos, 2011)
SLE is tested using different mechanisms, depending on the type of patients with the disorder. This owes to the fact that it affects people differently. In addition, its diagnosis is based on a diversity of factors. There are also various laboratory tests that can be carried out to ascertain the presence of SLE. These include compliment levels, CRP results, liver functioning tests, autoantibody tests and creating kinase assay. A suspected patient may also undergo imaging studies for an evaluation of suspected SLE. These imaging studies may include Cardiac MRI, Brain MRI, Chest radiography, joint radiography chest scanning and echocardiography. Among the procedures that may be carried out for such patients, include renal biopsy, lumbar puncture and arthrocentesis (Tsokos, 2011).
Treatment and Management
Despite the fact that lupus patients may only exhibit mild symptoms, the disorder is life-long and may become serious if not managed effectively. However, the symptoms can be affectively controlled in order to prevent serious damage to various body organs. In this perspective, patients should see their doctors on a regular basis for checkup, medication and advice. Moreover, patients are required to obtain prescribed medicines, enough exercises and rest. These are some of the measures to be considered in controlling and managing the symptoms (Bertsias et al, 2011).
SLE management is determined by the severity of the disease and its manifestation within a patient. However, hydroxychloroquine can be used for long-term treatment for most of SLE patients. Various medications that can be used in treating SLE manifestations include Nonbiologic DMARDS such as methotrexate, mycophenolate, cyclosporine, azathioprine, and methotrexate. There are also Biologic DMARDs, which include Belimumab, IV immune globulin, and Belimumab. Other treatment includes Nonsteroidal anti-inflammatory therapies such as naproxen, ibuprofen and diclofenac(Bertsias et al, 2011).
Systemic lupus erythematosus is a serious disorder and once diagnosed, effective measures should be put in place to control it. This is because; it cannot only cause serious damages to the body tissues, but can be fatal. Therefore, both patients and healthcare practitioners should be aware of its signs and symptoms, as well as measures to manage it to avoid the associated consequences.