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Systemic Lupus Erythematosus

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  • This is an autoimmune disease (the body's immune system mistakenly attacks itself).  The disease is also called, "SLE", or "lupus."  Almost every organ in the body is susceptible to this disease.
  • It affects the joints (causes arthritis) in 90% of those affected 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 (coughing up blood, in severe cases)
  • Palpitations
  • Abdominal pain
  • Psychosis
  • Seizures
  • Depression
  • Kidney failure (leg swelling)

  • Anti-nuclear antibody is usually positive (though not specific)
  • Anti-double stranded DNA and Sm are specific for lupus (but not as sensitive)
  • Antiphospholipid antibodies may occur.  These increase the risk of blood clots and Miscarriages.
  • Certain medications can cause a lupus-like syndrome.
  • The most common medications are chlorpromazine, hydralazine, Isoniazid, methyldopa, procainamide, Dilantin and quinidine.

  • 85% female predominance; this predominance is 3:1 in prepubertal patients.
  • Generally occurs in the age group 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.

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