Systmatic lupus erythematosus
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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The correct spelling is “systemic lupus erythematosus.” However many people mistakenly type in the wrong name. With good reason. It’s difficult to say let alone spell.
Systemic lupus erythematosus or lupus for short is a chronic autoimmune disease where the immune system attacks the host. This attack results in destructive inflammation.
In autoimmune diseases, the immune system gets its signals crossed and attacks the body's own tissues.
Inflammation is the key destructive process that causes the damage in lupus. It is a protective process under normal circumstances. Inflammation helps to eliminate a foreign body or organism (virus, bacteria) and prevent further injury. If inflammation persists and is directed against host tissue, then damage to the tissues can occur. This is why the treatment of lupus is aimed at reducing the inflammation.
The immune system is designed to protect and defend the body from foreign intruders (bacteria, viruses). It contains several different types of cells, some of which function like "the Secret Service" and are constantly on patrol looking for any foreign invaders. When they spot one, they take action, and eliminate the intruder. In lupus, the immune system loses its ability to tell the difference between a foreign intruder and a person's own normal tissues and cells. So, in essence, the "Secret Service" mistakenly identify the person's own normal cells as foreign (antigens), and then eliminate them. Part of their response is to bring antibodies to the site that attach to antigens (anything that the immune system recognizes as non-self or foreign) and form immune complexes. These immune complexes result in inflammation at the site. These immune complexes may travel through the circulation (blood) and lodge in distant tissues and cause inflammation there.
Lupus can occur at any age, and in either sex. Nine out of ten people with lupus are women. During the childbearing years (ages 15-44) lupus strikes women 10-15 times more frequently than men.
People of all races can have lupus; however, African American women have a three times higher incidence (number of new cases) and mortality than Caucasian women. They tend to develop the disease at a younger age and to develop more serious complications. Lupus is also more common in women of Hispanic, Asian, and Native American descent.
Symptoms of lupus vary widely depending on the individual case and the form of lupus present...
• Achy or swollen joints
• Persistent fever over 100 degrees
• Prolonged, extreme fatigue
• Skin rashes, including a butterfly shaped rash across the cheeks and nose
• Pain in the chest on deep breathing
• Excessive protein in the urine
• Sensitivity to sun or ultraviolet light
• Hair loss
• Abnormal blood clotting problems
• Fingers turning white and/or blue in the cold
• Mouth or nose ulcers lasting longer than two weeks
There are four forms of lupus including:
Cutaneous lupus erythematosus affects the skin. There are many different types of cutaneous lupus including:
• Chronic cutaneous LE (CCLE) which is sometimes called discoid.
• Subacute cutaneous LE (SCLE)
• Acute cutaneous LE (ACLE).
Systemic lupus erythematosus (SLE) attacks multiple systems in the body which may include: the skin, joints, lungs, blood, blood vessels, heart, kidneys, liver, brain and the nervous system.
Drug-induced lupus may develop after taking certain prescription medications. Symptoms generally disappear, within weeks to months, after the drug is discontinued.
Neonatal lupus, a fourth type, is a rare condition. It is a condition where the mother passes an abnormal antibody to the infant. The baby has lupus-type symptoms that fade with time.
The majority of people with lupus have lupus alone. Between five and thirty percent of people with lupus report having overlap symptoms characteristic of one or more connective tissue diseases. There are several overlaps that may affect people with lupus including: lupus and rheumatoid arthritis (RA), lupus and myositis, lupus and systemic sclerosis (SSc or scleroderma), lupus and Sjogren's syndrome (SS).
Lupus is not a universally fatal disease. In fact, today with close follow-up and treatment, 80-90% of the people with lupus can expect to have a normal life expectancy. Lupus does vary in intensity and degree, however, and there are people who have a mild case, there are those who have a moderate case and there are some who have a severe case of lupus, which tends to be more difficult to treat and bring under control. For people who have a severe flare-up, there is a greater chance that their lupus may be life-threatening.
Overwhelming infection and kidney failure are the two most common causes of death in people with lupus.
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