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Systemic lupus erythematosus
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- This is an autoimmune disease (the body's immune system mistakenly attacks itself). Almost every organ in the body is susceptible to this disease.
- It affects the joints (causes arthritis) in 90% of those infected with the disease.
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- Joint pain, stiffness or swelling
- Fever
- Weight loss
- Fatigue
- "Butterfly rash" -- red rash on the cheeks
- Skin lesions
- Sensitive to light
- Eye inflammation/redness
- Vision problems
- Shortness of breath
- Cough (severe cases with blood)
- Palpitations
- Abdominal pain
- Psychosis
- Seizures
- Depression
- Kidney failure (leg swelling)
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- Anti-nuclear antibody is usually positive (though not specific)
- Anti-double stranded DNA antibodies
and anti-Sm antibodies are relatively specific for lupus (but not as sensitive)
- Antiphospholipid antibodies may occur. These increase the risk of blood clots and miscarriages.
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- 85% female predominance; this predominance is 3:1 in prepubertal patients.
- Generally occurs from 15 to 50 years of age
- Most commonly found in African-Americans, Asians, Native Americans and Hispanics
- Familial (genetic) factors -- common genetic markers for SLE are the genes for HLA-B8, DR2 and DR3. There may be other markers for this disease (complement deficiencies and polymorphisms of the Fc gene).
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- No specific therapy
- Mild -- supportive only
- Anti-inflammatories, e.g., ibuprofen
- Hydroxychloroquine (person should be monitored for retinal damage by an ophthalmologist)
- Corticosteroids (e.g., prednisone) for more severe cases.
- Cyclophosphamide, chlorambucil or azathioprine may be considered for cases resistant to prednisone.
- If antiphospholipid antibodies are present and clotting occurs in arterial or venous systems, then Coumadin is prescribed.
- Dialysis and renal transplantation
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- Spontaneous exacerbations and remissions
- The 5-year survival rate is 90% or higher, but the disease may still progress in many patients.
- Patients can die from kidney failure, central nervous system complications, infections, heart failure, or lung failure.
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- Rheumatoid arthritis
- Acquired Immune Deficiency Syndrome (AIDS)
- Wegener's granulomatosis
- Scleroderma
- Polymyositis/dermatomyositis
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Medication-induced lupus:
- Certain medications can cause a lupus-like syndrome.
- The most common medications are chlorpromazine,
hydralazine, isoniazid, methyldopa, procainamide, dilantin,
and quinidine.
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