Systemic Lupus Erythematosus – Causes, Symptoms, Diagnosis, And Treatment
What is systemic lupus erythematosus?
Systemic lupus erythematosus (SLE) is a chronic disease that causes inflammation in connective tissues. Connective tissues provide strength and flexibility to structures throughout the body. SLE occurs when the body’s immune system mistakenly attacks healthy tissue. This disease affects the skin, joints, kidneys, brain, and other organs.
SLE is more common in women than men. It may occur at any age. However, it appears most often in people between the ages of 15 and 44.
What causes systemic lupus erythematosus?
Systemic lupus erythematosus (SLE) is caused when the body’s immune system mistakenly attacks healthy tissue. What causes the immune system to mistakenly attack healthy tissue is not known to doctors and other experts.
It is thought that certain drugs may also cause SLE.
The disease affects African Americans and Asians more than people from other races.
What are the symptoms of systemic lupus erythematosus?
Symptoms of SLE vary from person to person. They may come and go. Joint pain and swelling are the common symptoms that occur in everyone with SLE at some point in time. Some affected people develop arthritis. SLE often affects the joints of the fingers, hands, wrists, and knees.
Some people with SLE experience only skin symptoms. This is called discoid lupus.
The following are the other common symptoms of SLE:
- A butterfly rash develops in about half the people with SLE. The rash is mostly seen over the cheeks and bridge of the nose. It can be widespread. It gets worse in sunlight.
- Chest pain when taking a deep breath.
- Fever with no other cause.
- Malaise (general discomfort or ill feeling).
- Hair loss.
- Weight loss.
- Mouth sores.
- Sensitivity to sunlight.
- Swollen lymph nodes.
The following are the other symptoms that may develop depending on which part of the body is affected:
- Brain and Nervous System: Headaches, numbness, tingling, seizures, vision problems, and personality changes
- Digestive Tract: Abdominal pain, nausea, and vomiting
- Heart: Abnormal heart rhythms (arrhythmias)
- Lungs: Coughing up blood and difficulty breathing
- Skin: Patchy skin color and fingers that change color when cold (Raynaud phenomenon)
- Kidneys: Swelling in the legs
How is systemic lupus erythematosus diagnosed?
SLE diagnosis is difficult because it is a multi-system inflammatory disease. To be diagnosed with lupus, 4 out of 11 clinical criteria must be met. Nearly all people with lupus have a positive test for antinuclear antibody (ANA).
The doctor will perform a complete physical exam and review the symptoms. During the exam, a rash, arthritis, or edema in the ankles may be found. The doctor may also hear an abnormal sound called a heart friction rub or pleural friction rub. A nervous system exam may also be done.
The doctor may perform the following tests to diagnose SLE:
- Antinuclear antibody (ANA)
- CBC with differential
- Chest x-ray
- Serum creatinine
The doctor may also perform the following other tests to confirm the diagnosis of SLE:
- ANA panel
- Complement components (C3 and C4)
- Direct Coombs test
- ESR and CRP
- Kidney function tests
- Kidney biopsy
- Liver function tests
- Rheumatoid factor
- Antiphospholipid antibodies and lupus anticoagulant test
- Skin biopsy
How is systemic lupus erythematosus treated?
There is no specific treatment for SLE. The goal of treatment is to control symptoms. Severe symptoms involving the heart, lungs, kidneys, and other organs require treatment from specialists.
Your doctor may recommend following treatment for mild forms of SLE:
- NSAIDs for joint symptoms and pleurisy.
- Low doses of corticosteroids, such as prednisone, for skin and arthritis symptoms.
- Corticosteroid creams for skin rashes.
- Belimumab, a biologic drug, may be helpful in some people,
Your doctor may recommend following treatment for more severe SLE:
- High-dose corticosteroids.
- Immunosuppressive drugs (drugs which suppress the immune system). These medicines are used if you do not get better with corticosteroids, or to reduce the need for corticosteroids.
- Blood thinners, such as Coumadin, for clotting disorders.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.