Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease which occurs as a result of problems with our immune system, where it starts attacking the body's own organs and tissues. The inflammation produced by the lupus affects various systems of the body, such as skin, joints, blood cells, lungs, kidneys, heart and brain. Lupus is a disease which is quite difficult to diagnose, as the signs and symptoms usually resemble other medical conditions. One of the most characteristic sign of lupus is a rash on the face which resembles unfolding of a butterfly's wings over both the cheeks. Some individuals have an inborn tendency towards developing or having lupus; and this can be triggered by certain drugs, infections and even sunlight. There is no proper cure for this disease. The aim of treatment is to control and manage the symptoms.
Causes of Systemic Lupus Erythematosus (SLE)
The exact cause of lupus in not clear. SLE occurs when our immune system starts attacking the healthy tissue in the body. The most likely causes for this are a combination of genetics and environment. Individuals who have an inherited tendency towards lupus can develop this disease when they are exposed to certain triggers in the environment. Some of the factors which trigger lupus are:
- Sunlight exposure can trigger lesions on the skin or it can start an internal response in predisposed people.
- Certain medications, such as antibiotics, blood pressure medications and anti-seizure medications can trigger lupus in some people. Symptoms subside after the offending medicine is stopped.
Risk Factors for Systemic Lupus Erythematosus (SLE)
- Women are at a higher risk for developing lupus.
- Lupus is commonly found in individuals aged between 16 and 40.
- Asians, Hispanics and African Americans are more prone to developing this disease.
Signs and Symptoms of Systemic Lupus Erythematosus (SLE)
- Pain, swelling and stiffness in the joints.
- A rash on the face, shaped like butterfly, is present across the cheeks and the nose.
- Skin rashes or lesions, which appear or worsen upon exposure to the sun.
- Cold weather or stress turns the fingers and toes to blue or white color.
- Pain in the chest
- Dryness in the eyes.
- Disorientation and loss of memory.
Investigations for Systemic Lupus Erythematosus (SLE)
Diagnosing this disease is quite difficult, as the symptoms differ from patient to patient. Symptoms change over the time and can coincide with symptoms from other medical conditions. Various types of tests are needed to arrive at the right diagnosis and these tests include:
- Blood tests and urine tests, such as Complete Blood Count, Erythrocyte Sedimentation Rate are done to measure the red blood cells and to assess the speed at which the RBCs sink at the bottom of the tube in one hour. If the rate is faster than the normal, then it indicates a systemic disease like lupus.
- Blood tests also help in assessing the organs, such as liver and kidneys, as these organs are also affected by lupus.
- Urinalysis is done to check for an increased level of protein or RBCs in the urine.
- ANA (Antinuclear Antibody) test is done for detecting antibodies in the body which are produced by our immune system. Patients suffering from lupus will have a positive ANA test.
- Imaging tests, such as chest x-ray and echocardiogram are done to look at the lungs and the heart.
- Biopsy of kidney is done to find out which treatment is most suitable.
Treatment of Systemic Lupus Erythematosus (SLE)
Treatment depends on the patient's signs and symptoms, as the patient always does not have the same type of symptoms and they vary or flare up with time. So, the doctor needs to adjust the medications and their dosages accordingly. The following medications are commonly used in managing and controlling the symptoms of lupus:
- NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), such as naproxen and ibuprofen help with the fever, pain and swelling. However, patient should be cautioned about the side effects, such as kidney problems, stomach bleeding, and a tendency towards developing heart problems.
- Anti-malarial Drugs, such as hydroxychloroquine also help with managing and alleviating the symptoms of lupus. Side effects include: Stomach upset and retinal damage; though the latter is extremely rare.
- Corticosteroids, such as prednisone help with the inflammation of the lupus; however, there are long-term side effects, such as easy bruisability, weight gain, osteoporosis, diabetes, hypertension and increased vulnerability towards infection.
- Immunosuppressants, such as cyclophosphamide, azathioprine, methotrexate etc. also help with lupus. Side effects are: Increased tendency for developing an infection, damage to the liver, infertility and an increased cancer risk.
Lifestyle Modifications for Systemic Lupus Erythematosus (SLE)
There are simple changes which you can make in your life and which go a long way in preventing flare ups and help you in better management of the symptoms and these lifestyle changes are:
- Always try to get plenty of rest, as persistent fatigue is a common symptom of lupus. So, sleep well at night and try to take as many breaks or naps as you can during the day time.
- Always wear protective clothing and a sunscreen with a SPF of 55 at least when stepping out in the sun; as the ultraviolet rays can trigger a flare up of the symptoms.
- Always try to get some exercise daily, as they reduce the chances of a flare up and cut down on the risk of heart problems. Exercise also greatly helps with depression and overall helps you feel good about yourself.
- Never ever smoke and if you are smoking, quit immediately, as smoking makes you more susceptible to cardiovascular disease and worsens the flare ups of lupus.
- Always follow a healthy diet comprising of vegetables, fruits and whole grains.
- Complementary Medicine, such as DHEA (dehydroepiandrosterone), flaxseed, fish oil and vitamin D are also thought to help with lupus. However, please discuss all this with your doctor before starting anything.