Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects the capillaries and connective tissue, thus affecting the entire body.
Systemic lupus erythematosus can begin at any age, there are frequent cases of systemic lupus erythematosus in children (one fifth of all cases), usually after 8 years, but most often the disease begins in women aged 15 to 40 years. Systemic lupus erythematosus in children is more acute and severe than in adults.
The causes of systemic lupus erythematosus
Currently, researchers are inclined to the viral theory of the origin of the disease, since microscopic examination of some groups of viruses (RNA and retroviruses) is found in the tissues of patients with systemic lupus erythematosus, and in the blood there is a large amount of antibodies to them. However, not all people with a chronic viral infection get sick, but only genetically predisposed ones. Thus, systemic lupus erythematosus occurs in response to a chronic viral infection caused by certain groups of viruses, in the presence of a hereditary tendency to the disease.
Systemic lupus erythematosus symptoms
Systemic lupus erythematosus manifests itself in a large number of symptoms, which is caused by tissue damage to almost all organs and systems. In some cases, the manifestations of the disease are limited exclusively to skin symptoms, and then the disease is called discoid lupus erythematosus, but in most cases there are multiple lesions of internal organs, and then they speak of the systemic nature of the disease.
The most persistent symptoms of systemic lupus erythematosus are damage to the skin and mucous membranes, the musculoskeletal system and polyserositis (inflammation of several serous membranes at once: pericardium, peritoneum, pleura). Dermatitis, arthritis and polyserositis make up the so-called diagnostic triad of systemic lupus erythematosus.
Dermatitis, or skin inflammation, one of the characteristic symptoms of systemic lupus erythematosus, has many manifestations (there are 28 forms of dermatitis in this disease in total), it is distinguished by its bright red color of rashes, their painlessness, and elevation above healthy skin. A symptom of a butterfly is characteristic - bright red spots on the cheeks, connected by an inflamed strip of skin on the bridge of the nose.
Arthritis in systemic lupus erythematosus affects several joints at once, usually symmetrical. It is distinguished from rheumatoid polyarthritis by pronounced pain syndrome in case of mild joint damage, i.e. there is a discrepancy between the expressed sharp pain and other signs of joint inflammation. Characterized by the development of flexion contracture of the fingers, "twisted" fingers. Arthritis is often accompanied by polymyositis - muscle inflammation, which also occurs with severe pain.
Symptoms of systemic lupus erythematosus can manifest themselves as changes in the cardiopulmonary system (carditis, pericarditis, pleurisy, pneumonitis), gastrointestinal tract (various disorders of the gastrointestinal tract), liver (lupus hepatitis), kidney (lupus nephritis, or lupus jade), the nervous system.
Common symptoms of systemic lupus erythematosus include persistent fever, weakness, weight loss, and fatigue.
The nature of the course of systemic lupus erythematosus
Systemic lupus erythematosus can be acute, subacute, and chronic.
- Acute systemic lupus erythematosus. The most malignant form of the disease is characterized by a continuously progressive course, a sharp increase and a plurality of symptoms, and resistance to therapy. Systemic lupus erythematosus in children often occurs in this type.
- Subacute systemic lupus erythematosus. The most common form of the disease. It is characterized by a calmer course than in the acute form, however, although a slow, but steady development of symptoms, polysyndromism is also present.
- Chronic systemic lupus erythematosus. The most favorable option. It differs in a wave-like course, with periods of exacerbation and remission, exacerbations are amenable to drug therapy. This form of the disease can last for decades and improves the prognosis of systemic lupus erythematosus.
According to the degree of activity of the lupus process, three degrees are also distinguished:
- minimal activity
- average activity
- maximum
Systemic lupus erythematosus is characterized by lupus crises, in which the activity of the disease is maximum. The duration of a crisis can range from one day to two weeks.
Diagnostics of the systemic lupus erythematosus
Due to the multiplicity of manifestations, the diagnosis of systemic lupus erythematosus is a problem, and it often takes a long time from the onset of the disease to the diagnosis. Several systems of diagnostic signs have been developed to diagnose systemic lupus erythematosus. The system developed by the American Rheumatic Association is now preferred as being more modern. The system includes the following criteria:
- butterfly symptom:
- discoid rash;
- increased sensitivity of the skin to light - the appearance of a rash after exposure to the sun;
- the formation of ulcers on the mucous membranes;
- arthritis - damage to two or more joints;
- polyserositis;
- kidney damage - protein in the urine, casts in the urine;
- brain damage, convulsions, psychosis;
- a decrease in the number of erythrocytes, leukocytes and platelets in a clinical blood test;
- the appearance of specific antibodies in the blood: anti-DNA antibodies, anti-Cm antibodies, false-positive Wasserman reaction, anticardiolipin antibodies, lupus anticoagulant, positive test for LU cells;
- detection of antinuclear antibodies (ANA) in the blood.
Treatment of systemic lupus erythematosus
Systemic lupus erythematosus refers to diseases that are currently considered incurable. Nevertheless, treatment of systemic lupus erythematosus is necessary, as it can relieve aggressive manifestations of the disease, make lupus crises more rare and less active, and make remission periods longer.
Treatment of systemic lupus erythematosus is carried out in three directions:
- symptomatic therapy;
- immunocorrection;
- restorative therapy, including a change in lifestyle towards a healthier one.
Lupus crises are relieved with high doses of hormonal anti-inflammatory drugs, and systemic lupus erythematosus in children is also treated with hormonal agents.
Systemic lupus erythematosus prognosis
The prognosis of systemic lupus erythematosus depends not only on the treatment used, but largely on the form of the disease, as well as on the patient's age. In the acute form of systemic lupus erythematosus, the prognosis is usually poor. With resistance to therapy and a high degree of activity of the process, complications from the internal organs that are incompatible with life may develop within a year or two. With subacute and chronic course, the prognosis of systemic lupus erythematosus is more optimistic.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
