Systemic Lupus Erythematosus (SLE)
DISEASE DEFINITION
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys, blood vessels and other organs and tissues. The exact cause of lupus is not known, but a combination of genetic, environmental and hormonal factors is believed.
SYMPTOMS
People with SLE may experience a variety of symptoms that include:
- fatigue and malaise
- skin rashes, fevers
- pain or swelling in the joints
Other symptoms can include:
- sun sensitivity
- oral ulcers, arthritis
- lung problems
- heart problems
- kidney problems (lupus nephritis) leading to proteinuria and impaired kidney function, seizures, psychosis, and blood cell and immunological abnormalities
Among some adults, having a period of SLE symptoms called flares may happen every so often, sometimes even years apart, and go away at other times called remission. However, other adults may experience SLE flares more frequently throughout their life.
DIAGNOSIS
Diagnosis is typically based on a combination of symptoms, physical examination, blood tests, and sometimes, a biopsy of affected tissue. SLE may be difficult to diagnose because its early signs and symptoms are not specific and can look like signs and symptoms of other diseases. It's important to note that SLE can be a complex and variable disease therefore the diagnosis may take time and more observations, more information about symptoms and test results might be necessary.
Generelly rheumatologists and nephorlogists specialize in diagnosing and treating patients with SLE, however other specialists should also be involved in the treatment process. Some specific criteria as well in the case of lupus nephritis the result of kidney biopsy are used to classify SLE.
TREATMENT
Lupus is a chronic condition, and long-term management is crucial to improving quality of life and preventing flares. The goal of treatment for SLE is typically to control symptoms, reduce inflammation, prevent organ damage, and improve the patient's quality of life. The treatment of SLE involves a combination of medications and lifestyle adjustments. The specific treatment varies depending on the severity of the disease and the organ involment. The common components of the treatment are:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
These medications, such as ibuprofen and naproxen, help relieve pain, inflammation, and joint stiffness associated with SLE.
Antimalarial Drugs
Hydroxychloroquine (Plaquenil) is commonly prescribed to treat skin rashes, joint pain, and fatigue in people with lupus. It can also help reduce disease activity and prevent flares.
Corticosteroids
These anti-inflammatory drugs, such as prednisone, are used to control severe symptoms during flares. Long-term use of high-dose steroids may have many side effects and should be avoided.
Immunosuppressive Drugs
For people with more severe or organ threatening SLE, medications like azathioprine, mycophenolate mofetil, or cyclophosphamide may be used to suppress the immune system and reduce inflammation.
Biologic Therapies
Some biologic drugs, such as belimumab (Benlysta), target specific components of the immune system and reduce disease activity.
Lifestyle Modifications
Patients with SLE can benefit from lifestyle changes to manage their condition. Those include getting regular exercise, maintaining a balanced diet, managing stress, getting adequate sleep, and protecting the skin from sunlight to prevent flares.
Sun Protection
Sun exposure can trigger or worsen symptoms of SLE, so it's crucial to use sunscreen, wear protective clothing, and avoid prolonged sun exposure.
Regular Monitoring
People with lupus should have regular check-ups with their healthcare provider to monitor disease activity, adjust medications as needed, and address any emerging complications.
Supportive Care
Depending on the individual's symptoms and needs, other healthcare professionals such as dermatologists, nephrologists (kidney specialists), ophthalmologists and cardiologists may be involved in the care team.