|
What is Systemic Lupus Erythematosus?
Systemic Lupus Erythematosus, known more widely as lupus
or SLE, is an autoimmune disorder which causes inflammation in the
small blood vessels in the body's connective tissues, which are
the main constituents of tendons, ligaments and cartilage. Less
serious symptoms can occur affecting the skin and joints. Sometimes
this inflammation can cause abnormalities in the function and structure
of vital organs such as kidney, heart, brain or lungs.
Apart from the systemic form of lupus there are other types; discoid
lupus erythematosus (DLE) and subacute cutaneous lupus (SCLE) involve
skin rashes and sun sensitivity. A drug-induced lupus can develop
as a reaction to certain medications but this goes away when the
drug is not taken.
Lupus is neither infectious nor contagious.
What are the symptoms?
Symptoms of lupus are many and varied. Rashes and flu-like symptoms
such as fatigue, joint pain, weakness, lack of energy, anaemia and
loss of appetite and weight are common.
Lupus is very much an individual disease as problems can vary greatly
in different patients. Most patients form arthritis type pain in
the joints with other common problems being fevers, swollen glands
or sometimes hair loss. Sunlight plays an important role in causing
lupus symptoms to flare and all patients are advised to be extremely
wary of sun exposure.
Who gets Lupus?
Lupus most commonly affects women (9:1 female: male) and because
it can often appear during child-bearing years this may pose other
problems as there is a higher risk of miscarriage and an increased
risk of lupus flare after the delivery. However, as a rule, pregnancy
in lupus is usually uncomplicated - there is no increased risk of
flares during pregnancy and very little chance of the baby also
having lupus.
The cause and consequences
The cause of lupus is not known, though genetic and environmental
factors are known to be relevant. Research scientists are almost
certain that SLE involves malfunction of the immune system. In SLE
the immune system seems to be overacting, sometimes attacking the
body tissue as though it were a foreign invader like a virus. One
of the consequences is that substances not cleaned away by sanitation
cells clog up the kidneys. This is why the kidneys are a primary
concern in SLE.
Diagnosis
For a lupus diagnosis a person must have at least four of the following
at some time or other over a period of time:
1. Malar rash (rash on the cheeks)
2. Discoid rash (red scaly patches)
3. Sensitivity to sunlight
4. Mouth ulcers
5. Arthritis pain or swollen joints
6. Pleuritis
7. Protein in the urine
8. Seizure, convulsions or psychosis (not drug-induced)
9. Low red or white blood count, decrease of lymphocytes
in the blood or decrease in the platelets
10. Presence of LE cells, antibody to DNA or Sm or false-positive
test for syphilis
11. Positive test for anti-nuclear antibody.
Treatment
Treatment of lupus is according to its severity and whether eyes
are affected. Regular clinical and test monitoring will indicate
the level of activity and need for subsequent treatment. Through
regular medical monitoring disease flares can be detected early
and treatment adjusted. Lupus patients are advised to stay indoors
during the brightest part of the day and to wear long sleeves and
broad brimmed hats with regular application of 30+ sunblock.
Non-steroidal anti-inflammatory drugs are often used to treat arthritis
and pleurisy, but can cause gastritis and stomach ulcers and must
be used carefully.
Cortico-steroid drugs are widely used in treating lupus, including
the use of topical creams for rashes. Oral cortico-steroids are
very effective in controlling active lupus. The dose should be carefully
monitored to minimize the side effects that can include weight gain,
bruising, osteoporosis, diabetes and cataracts. Topical creams and
low doses of tablets have fewer side effects.
Anti-malarials such as Plaquenil are useful in treating lupus rash
and sometimes arthritis. There is a low risk of eye problems with
anti-malarials, so regular eye checks are strongly advised.
Immuno-suppressive drugs (the type used to prevent organ rejection
in transplant patients) are used to treat those with severe diseases,
especially kidney problems. They are also used in cases where cortico-steroids
are ineffective.
Because of the improvements in diagnostic tests and more effective
treatments, most lupus patients can expect to have a normal or near
normal life span, though changes in life style may be necessary.
Lupus patients can be more prone to vascular disease resulting in
coronary artery disease or strokes. To keep this risk low, lupus
patients should have a balanced, low-cholesterol diet and maintain
appropriate body weight through diet and exercise.
This information is part of the information sheet written by Lesley
Campbell for Arthritis SA.
The information presented is not intended to replace the medical
advice of your doctor or health care provider. Arthritis SA recommends
that you consult your doctor about specific medical conditions.
Other information and resources available
from Arthritis SA
Lupus Fact Sheet
• Email advisors@arthritissa.org.au
(please include your postal address in email)
Lupus, Scleroderma and Sjögren's SA
Support Group
Click here "Branches & Support
Groups" > "Lupus, Scleroderma, Sjögren's SA"
for further information
Telephone Advisory Service
9.30am - 3.30pm, Mon - Fri
8379 5711 or country free call on 1800 011 041
Library
Lupus: A Wolf in Sheep's Clothing by Keren Hardy, 1985
Lupus, Handbook for Women by Robin Dibner and Carol Colman,
1994
Borrowing privileges extend to members only
Book Sales
Learning and living with Scleroderma and Lupus
For price and order details please contact Arthritis SA
• 8379 5711 or country free call on 1800 011 041
• Email info@arthritissa.org.au
(please include your name and business hours phone number in email)
Moving Towards Wellness Course
6 weeks x 2.5 hours
click here "Self Management
Courses" for further information
|
