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Systemic Lupus Erythematosus (Treatment Modalities (Treatment can vary…
Systemic Lupus Erythematosus
What is it?
It is a type III hypersensitivity reaction and an autoimmune disease, that has responses to both the innate and humoral systems. It occurs when the body is not able to recognize “self” and in turn begins to attack one’s own organs and tissues. Antigen projecting cells are activated and a cycle begins where B lymphocytes are triggered to develop autoantibodies and T lymphocytes activate, all starting the process of inflammation in organs of the body, which eventually causes permeant damage.
Multi-system alteration in function
The inflammation that is caused by lupus goes on to have serious effects on other parts of the body
Brain & CNS
can attack the nervous system by antibodies binding to nerve cells or blood vessels not allowing them to get energy to function, it also may stop nerve blood flow. This can cause issues from headaches to different serious nephropathies or even strokes or seizers.
Kidneys
- damage to the kidneys is one of the leading causes of mortality in lupus, this usually occurs due to inflammation of the vessels that filter waste within the kidneys. It also can cause inflammation directly to the kidneys, treating them like they are not part of the body.
Heart
- causes inflammation of the heart muscle itself and the arteries, called pericarditis. It also causes increased risk of cardiovascular disease and heart attacks.
Blood and Vessels
- anemia is very common within SLE as well as multiple other etiologies, these alterations can occur due to the bone marrow failure, excessive peripheral cell destruction or certain medications or infections
Lungs
- cause inflammation within the chest cavity lining, called pleurisy. This can be extremely painful, casing shortness of breath and chest pain. It also makes the lungs more susceptible to bleeding and pneumonia.
Other alterations can occur in the endocrine system, GI tract, Musculoskeletal and more. The ones mentioned below tend to be most common
Treatment Modalities
Treatment can vary depending on the individual and their extensiveness of symptoms, desired treatment duration and tolerance of side effects that may occur.
Initial treatment is usually pharmacologic management with NSAIDS, eventually leading to corticosteroids when needed for anti-inflammatory and symptom control.
Immunosuppressant drugs may also be needed in more aggressive cases.
Appropriate drug therapy is very important to manage symptoms and prevent potential damaging side effects. Careful planning and treatment of other issues occurring from the multi-system alterations is crucial.
Clinical Manifesations
Clinical manifestations can look a few different ways but the most common are joint pain and swelling, skin rashes, fatigue, pericardial effusion and pleural effusion. A telling symptom that can appear is a butterfly shaped rash on the face. Anxiety, clinical depression, hair loss and mouth dryness are also possible symptoms.
Diagnosing
SLE is diagnosed by an overall physical exam, noting of symptoms and taking some laboratory values. The physical symptoms of rash, ulcers, pleuritis and proteinuria are very telling in diagnosing. Looking at those, with lab results in anti-DNA antibody and anti-Sm results help a final diagnosis.
What leads to it?
The cause of this is not completely known, it is thought that triggers may be a combination of things. Genetics and familial factors as well as environmental triggers like trauma, stress or certain medications are also thought to be causes for an onset. Women are also more prone to the development of this disease so sex and hormones are also thought to have a part.