Systemic lupus erythematosus (SLE), usually called lupus, is a chronic autoimmune disease that can cause inflammation in many parts of the body. It may affect the skin, joints, kidneys, blood, brain, heart, lungs and other tissues.
Lupus varies widely. Some people have mainly skin and joint symptoms, while others develop serious organ involvement. The condition often follows a pattern of flares and quieter periods.
Who Is Affected
Lupus can affect anyone, but it is much more common in women, especially during the childbearing years. NHS inform notes that around 90 percent of SLE cases occur in women and that the condition is more common in people of African, Caribbean or Asian origin than in people of white European origin.
Symptoms
Common symptoms include fatigue, joint pain, swelling, skin rashes, mouth ulcers, fever, hair loss, chest pain caused by inflammation around the lungs or heart, and sensitivity to sunlight.
The well-known butterfly-shaped rash across the cheeks and nose can occur, but not everyone with lupus has it. Raynaud's phenomenon may cause fingers or toes to change colour in response to cold or stress.
More serious disease can involve the kidneys, nervous system, blood counts, lungs or heart. Lupus nephritis is kidney inflammation caused by lupus and can require close monitoring and stronger treatment.
Causes and Triggers
The cause is not fully understood. Lupus appears to involve genetic susceptibility, immune-system dysfunction, hormones and environmental triggers.
Possible triggers include ultraviolet light, infections, some medicines and major physical or emotional stress. A trigger does not act the same way in every person, and many flares have no single obvious cause.
Diagnosis
Diagnosis is based on the pattern of symptoms, examination findings and test results. There is no single test that proves lupus in every case.
Blood tests may include antinuclear antibody testing, anti-double-stranded DNA antibodies, complement levels, full blood count, kidney tests and inflammatory markers. Urine tests are important because kidney inflammation can be present before obvious symptoms develop.
Treatment
Treatment depends on severity and which organs are affected. There is currently no cure, but treatment can reduce symptoms, control inflammation and lower the risk of organ damage.
Common treatments include:
- anti-inflammatory medicines for pain or fever
- hydroxychloroquine for fatigue, rashes, joint pain and flare prevention
- corticosteroids for stronger anti-inflammatory treatment
- immunosuppressants for more active or organ-threatening disease
- biologic medicines for selected patients
People with lupus may also be advised to protect their skin from strong sunlight, manage cardiovascular risk, keep vaccinations up to date where appropriate, and have regular monitoring.
Outlook
The outlook for lupus has improved greatly because of earlier diagnosis, monitoring and better treatment. Many people with lupus have a normal or near-normal life expectancy, but some remain at risk of serious complications, especially when kidneys, heart, lungs or the nervous system are involved.
Long-term care usually needs coordination between rheumatology, primary care and any organ-specific specialists involved.
See Also
References
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