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more about Lupus

Systemic lupus erythematosus

  • 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.

  • 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)

  • 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.

  • 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).

  • 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

  • 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.

  • Rheumatoid arthritis
  • Acquired Immune Deficiency Syndrome (AIDS)
  • Wegener's granulomatosis
  • Scleroderma
  • Polymyositis/dermatomyositis

  • Medication-induced lupus:
  • Certain medications can cause a lupus-like syndrome.
  • The most common medications are chlorpromazine, hydralazine, isoniazid, methyldopa, procainamide, dilantin, and quinidine.

more about Lupus

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