Lupus erythematosus refers to diseases of the connective tissue of a collagenous nature, often manifests as discoid lupus erythematosus, less often observed surface form - Bietta erythema and, in the most rare cases, lupus erythematosus Kaposi-Irganga occurs. With timely initiated treatment and strict adherence to the prophylactic regimen, the prognosis of the disease is favorable. In advanced severe cases, the disease may spread to the internal organs and body systems.
Causes of lupus erythematosus
The cause of the development of cutaneous lupus can be a negative impact of external factors: excessive insolation, frequent hypothermia, the presence of a chronic infection (usually streptococcal), an allergy to drugs or autoallergy in the patient's history. The disease is more often registered in countries with a humid, cool climate and, as a rule, in women of young or middle age.
The viral etiology of cutaneous lupus is confirmed by microscopic studies, and virus-like inclusions are determined in the affected skin areas taken for analysis.
Symptoms of cutaneous lupus
Lupus erythematosus is most often expressed by a triad of symptoms inherent in discoid lupus: erythematous rashes initially appear on the visible skin, and later on these spots develop hyperkeratotic lesions with atrophy patches.
Erythema looks like a pink or reddish speck with clearly defined borders. Then in the center dry grayish-white flakes are formed, which hold tight due to the presence of spiky outgrowths on the lower part, growing into the follicles - follicular hyperkeratosis. When you try to remove them, there are painful sensations.
Foci of atrophy begin to form in their place, and the formation takes on an appearance peculiar to discoid lupus - a smooth scar of white atrophic tissue surrounded by a zone of deep hyperkeratosis and infiltration with a clear red rim. Most often localized on the visible areas of the skin, mainly on the nose and cheeks.
The contoured surface outlines resembles the shape of a butterfly. Rashes can be on the auricles, neck, chest. Often present on the scalp, affect the red border of the lips and oral mucosa with the formation of erosion.
In the superficial variant of lupus erythematosus, Biette's centrifugal erythema, only one of three signs stands out - this is hyperemia. Hyperkeratosis, infiltration and the formation of atrophic foci, as a rule, is not observed. The characteristic location of erythemal spots is the surface of the face with the typical symptom of "lupus butterfly". Multiple rashes all over the body are called disseminated lupus erythematosus.
In this variant of the development of the disease, erythema patches do not have a tendency to grow and infiltrate. They stop growing after they reach a certain size. Foci in a chaotic manner are located on the skin of the face, less often on the skin of the upper chest and back. If a rash appeared on the skin of the hands, then the specks are purple in color with hyperkeratotic atrophic foci.
Kaposi-Irgang's lupus erythematosus is referred to as the rare form of the disease, which often occurs after skin injuries. It is characterized by the presence of one or more independent dense mobile nodes covered with normal skin. Localized most often on the head and hands. In all forms of lupus erythematosus, there is a long-term continuous course of the disease with relapses in spring and summer, that is, with an increase in solar activity.
Treatment of lupus erythematosus
A successful outcome depends on adequate, timely treatment. It is mandatory to conduct complex therapy. Remediation of the identified chronic pathology is recommended. Locally, and only as prescribed by the doctor apply corticosteroid ointment. If the disease is in remission, then outpatient treatment is possible.
Patients should adhere to the prophylactic regimen with special care: it is necessary to spend as little time as possible in the open sun, frost, avoid the cold wind. It is recommended to use sunscreens, umbrellas or wide-brimmed hats in spring and summer. All patients are under lifelong supervision of specialists - a dermatologist and a rheumatologist.
Education: Diploma in "General Medicine" received in 2009 at the Medical Academy. I.M. Sechenov. In 2012, completed a postgraduate course in the specialty "Traumatology and Orthopedics" in the City Clinical Hospital. Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
Schemes of taking medicinal herbs for any female diseases (bases of herbal medicine)
Lupus, as it is perceived in its abbreviated name, is completely defined as systemic lupus erythematosus. And although a significant number of patients with this disease manifest symptoms in a weak expression, lupus itself is incurable, threatening in many cases with exacerbation. Patients can control the characteristic symptoms, as well as prevent the development of certain diseases related to organs, for which purpose they should be regularly examined by a specialist, devoting a considerable amount of time to an active lifestyle and rest, and, of course, taking medications prescribed in a timely manner.
Lupus: symptoms of the disease
The main symptoms that occur with lupus are severe fatigue and the appearance of a skin rash, in addition, there is also pain in the joints. In the case of progression of the disease, this kind of lesions that affect the functioning and general condition of the heart, kidneys, nervous system, blood and lungs become topical.
The symptoms that manifest themselves in lupus directly depend on which organs are affected by it, as well as on what degree of damage to them is characteristic of the specific moment of their manifestation. Consider the main of these symptoms.
- Weakness. Almost all patients diagnosed with lupus argue that they have to experience fatigue in varying degrees of its manifestation. And even if we are talking about a weak lupus, its symptoms make significant adjustments to the habitual way of life for the patient, interfering with vigorous activity and playing sports. If fatigue is noted sufficiently strong in its manifestation, then here we are talking about it as a sign indicating that the symptoms are soon exacerbated.
- Pain in muscles, joints. Most patients who have been diagnosed with lupus have to experience pain in their joints from time to time (i.e. arthritis). At the same time, more than 70% of their total number claims that pain arising in muscles was the first manifestation of the disease. As for the joints, they may be subject to redness, they also swell up and become slightly warm. Some of the cases indicate a feeling of stillness in the morning time of day. With lupus, arthritis occurs predominantly in the wrists, as well as in the hands, knees, ankles, and elbows.
- Skin diseases. The prevailing majority of lupus patients also faces a skin rash. Systemic lupus erythematosus, whose symptoms indicate a possible involvement in this disease, precisely due to this manifestation, it is possible to diagnose the disease. On the nose and cheeks, in addition to the characteristic rash, red painful spots often appear in the arms, back, neck, lips and even in the mouth. Also, the rash may be violet bumpy or red and dry, while also concentrating on the face, scalp, neck, chest and arms.
- Increased sensitivity to light. In particular, ultraviolet (solarium, sun) contributes to the aggravation of the rash, while simultaneously provoking the exacerbation of the remaining symptoms characteristic of lupus. Particularly sensitive to such exposure to ultraviolet people are fair-haired and white-skinned.
- Disorders of the nervous system. Often lupus is accompanied by diseases associated with the work of the nervous system. These include headaches and depression, anxiety, etc. The actual, although less common, manifestation is memory impairment.
- Various heart diseases. Many of the patients suffering from lupus also face this type of disease. Thus, inflammation often occurs in the region of the pericardial sac (otherwise defined as pericarditis). This, in turn, can provoke acute pain in the center of the left side of the chest. Further, such pain can spread to the back and neck, as well as to the shoulders and arms.
- Mental disorders. Lupus is also accompanied by mental disorders, for example, they may consist in a constant and unmotivated anxiety or expressed in the form of depression. These symptoms are caused, both by the disease itself and by drugs against it, and stress plays a role in their appearance, accompanying many different chronic diseases.
- Temperature change. Often lupus is manifested with such one of its symptoms as low temperature, which also in some cases allows you to diagnose the disease.
- Weight change. Lupus exacerbations are usually accompanied by rapid weight loss.
- Hair loss Hair loss in the case of lupus is a manifestation of a temporary nature. Loss occurs either in small pieces, or evenly along the entire head.
- Inflammation of the lymph nodes. During exacerbation of symptoms typical of lupus, patients often experience swollen lymph nodes.
- Raynaud's phenomenon (or vibro-illness). In some cases, this disease is associated with lupus, and small vessels are affected, along which blood flows to the soft tissues and to the skin beneath them in the toes and hands. Due to this process, they acquire a white, red or bluish tint. In addition, the affected areas experience numbness and tingling with a simultaneous increase in their temperature.
- Inflammatory processes in the blood vessels of the skin (or cutaneous vasculitis). Lupus erythematosus, the symptoms of which we have listed, can also be accompanied by inflammation of the blood vessels and their bleeding, which, in turn, provokes the formation of red or blue spots of various sizes on the skin, as well as in the nail plates.
- Swelling of the feet, palms. Some lupus patients experience kidney disease that is provoked by it. This becomes an obstacle to the removal of fluid from the body. Accordingly, the accumulation of excess fluid can lead to swelling of the feet and palms.
- Anemia. Anemia, as you may know, is a condition characterized by a decrease in the amount of hemoglobin in the blood cells, due to which oxygen is transported. Many people who have certain chronic diseases experience anemia over time, which is caused, respectively, by a decrease in the level of red blood cells.
Systemic lupus erythematosus: symptoms requiring elimination
Treatment of lupus should be started as soon as possible - this will help to avoid damage to organs that are irreversible in their consequences. As for the main drugs used in the treatment of lupus, these include anti-inflammatory drugs and corticosteroids, as well as tools whose action is aimed at suppressing the activity characteristic of the immune system. Meanwhile, about half of the total number of patients diagnosed with systemic lupus erythematosus cannot be treated using standard methods for them.
For this reason, therapy with stem cells is prescribed. It lies in their collection from the patient, after which therapy is carried out aimed at suppressing the immune system, which completely destroys it. Further, in order to restore the immune system, stem cells are introduced into the bloodstream that were previously seized. As a rule, the effectiveness of this method is achieved with a refractory and severe course of the disease, and it is recommended even in the most difficult, if not to say, hopeless cases.
With regard to the diagnosis of the disease, in the event of those or other listed symptoms with suspected him should consult a rheumatologist.
Why does lupus erythematosus occur: the main causes of the disease
There is no specific reason for the occurrence of systemic lupus erythematosus, and physicians still cannot give a clear answer to the question of what exactly provokes the development of the disease. Of course, there are several theories of the development of lupus erythematosus, such as genetic predisposition or a serious hormonal failure, but more often the practice shows that the disease is caused by a combination of predisposing factors.
The most common causes of systemic lupus erythematosus include:
- Hereditary predisposition - if there were cases of systemic lupus erythematosus in the genus, then there is a high probability that the child will have the disease,
- Bacterial-viral theory - according to studies, all patients with systemic lupus erythematosus had Epstein-Barr virus, so scientists do not rule out the relationship of this disease with this virus,
- Hormonal theory - when lupus erythematosus is detected in women and girls during puberty, an increase in the level of the hormone estrogen was noted. If hormonal disruption occurred before the first signs of the disease appeared, then it is likely that systemic lupus erythematosus was triggered by an increase in the body's estrogen,
- Ultraviolet irradiation - a relationship is noted between the development of systemic lupus erythematosus and prolonged human exposure to direct sunlight. Open sunshine, which is directed to the skin for a long time, can provoke mutation processes and the development of connective tissue diseases in the future.
Who is most susceptible to the development of lupus erythematosus: risk groups
There is a category of people who have a high proportion of the probability of becoming ill with systemic lupus erythematosus, as a rule, they have one or several conditions:
- immunodeficiency syndrome
- chronic infectious diseases in the body,
- dermatitis of various etiologies,
- frequent colds
- systemic diseases
- drastic hormonal changes,
- abuse of sunbathing, frequent visits to the solarium,
- diseases of the organs of the endocrine system,
- pregnancy and recovery period after childbirth,
- alcohol abuse.
Pathogenesis of lupus erythematosus (disease development mechanism)
How does systemic lupus erythematosus develop in a healthy person? Under the influence of certain factors and reduced function of the immune system in the body fails, which begins to produce antibodies against the "native" cells of the body. That is, tissues and organs begin to be perceived by the body as alien objects and a self-destruct program is launched.
This body reaction is pathogenic in nature, causing the development of the inflammatory process and the inhibition of healthy cells in various ways. Most often the blood vessels and connective tissue are affected. The pathological process leads to a violation of the integrity of the skin, a change in its appearance and a decrease in blood circulation in the lesion. With the progression of the disease affects the internal organs and systems of the whole organism.
How is lupus erythematosus: symptoms
Symptoms of systemic lupus erythematosus depends on the area of the lesion and the severity of the disease. Common symptoms of pathology are:
- weakness, lethargy, malaise,
- fever, chills, fever,
- exacerbation of all chronic diseases,
- the appearance of red flaky spots on the skin.
At the initial stage of the development of the pathological process, lupus erythematosus occurs with mild symptomatology, outbreaks of outbreaks are characteristic of the disease, which soon pass on their own, and remission occurs. This is the most dangerous, because the patient believes that everything has passed and often does not even seek medical help, and at this time the internal organs and tissues are affected. With repeated exposure to the body of irritating factors, lupus erythematosus flashes with a new force, only it flows harder and lesions of blood vessels and tissues are also more pronounced.
Local clinical symptoms of lupus erythematosus
As already mentioned, the symptoms of lupus erythematosus depend on the location of the pathological process:
- the skin on the cheeks, under the eyes and on the bridge of the nose a small red rash appears, which merges together and forms a continuous scaly red spot. In shape, these spots are very much like butterfly wings. The reddening is located on both sides of the cheeks symmetrically to each other and under the influence of ultraviolet rays begin to peel off, microscopic cracks appear, which subsequently scar and leave scars on the skin,
- mucous membranes - against the background of the progression of lupus erythematosus in the mouth and nose painful sores are formed, which can be single and small or reach large sizes and merge with each other. Sores in the mouth and nose interfere with normal breathing, food intake, communication and cause pain and discomfort,
- musculoskeletal system - the patient develops clinical signs of arthritis. Most often, due to the progression of lupus erythematosus, the joints of the extremities become inflamed, but they do not exhibit structural changes and destructive disorders. A swelling in the area of the inflamed joints is clearly visible, the patient complains of pain, the small joints are most often affected - the phalanges of the toes and hands,
- respiratory organs — the lung tissue is affected, with the result that the patient often develop pleurisy, pneumonia, which not only disrupts health, but also endangers life,
- the cardiovascular system - the connective tissue grows inside the heart as the lupus erythematosus progresses and the connective tissue grows, which does not carry any contractile function. As a result of this complication, mitral valve fusion may occur with atrial valves, which threatens the patient with the development of coronary heart disease, acute heart failure, and heart attack. Against the background of all the changes taking place, the patient has inflammatory processes in the heart muscle and the pericardial bag,
- kidneys and urinary organs - often there are nephritis, pyelonephritis, chronic renal failure gradually develops. These conditions threaten the patient’s life and can be fatal.
- nervous system - depending on the severity of lupus erythematosus, damage to the central nervous system in a patient can manifest as unbearable headaches, neuroses and neuropathies, ischemic stroke.
Depending on the severity of the symptoms of the disease, systemic lupus erythematosus has several stages:
- acute stage - at this stage of development, lupus erythematosus progresses sharply, the patient's general condition worsens, he complains of constant fatigue, temperature rise up to 39-40 degrees, fever, pain and aching muscles. The clinical picture is developing rapidly, already in 1 month the disease covers all organs and tissues of the body. The prognosis for acute lupus erythematosus is not comforting and often the patient’s life expectancy does not exceed 2 years,
- subacute stage - the rate of progression of the disease and the severity of clinical symptoms is not the same as in the acute stage and from the time of the disease until the onset of symptoms may take more than 1 year. At this stage, the disease is often replaced by periods of exacerbations and persistent remission, the prognosis is generally favorable and the patient’s condition directly depends on the adequacy of the treatment prescribed,
- chronic form - the disease has a sluggish form of the course, the clinical symptoms are mild, the internal organs are practically not affected and the body as a whole functions normally. Despite the relatively mild lupus erythematosus, it is impossible to cure the disease at this stage, the only thing that can be done is to alleviate the severity of the symptoms with the help of medications at the time of exacerbation.
Methods of diagnosis of lupus erythematosus
To confirm the diagnosis of lupus erythematosus conduct differential diagnostics. This is necessary because each symptom of the disease signals the pathology of a particular organ. For diagnosis, doctors use a system developed by the American Rheumatological Association of Specialists. The main rule to confirm the diagnosis of "systemic lupus erythematosus" is the presence in the patient of 4 or more of the 11 symptoms listed, which collected the main manifestations of the pathology:
- erythema on the face in the form of butterfly wings - characterized by the formation of symmetric red scaly spots in the cheeks and cheekbones. On the surface of the spots microscopic microcracks are formed, which are subsequently replaced by cicatricial changes,
- discoid eruptions on the skin - red asymmetric patches in the form of plaques appear on the surface of the skin, scaly, which crack and are replaced by scars,
- photosensitivity - pigmentation on the skin, which is enhanced by direct sunlight or artificial ultraviolet illumination,
- ulceration - painful small and large ulcers form on the mucous membranes of the mouth and nose, which interfere with breathing, eating, talking, and are accompanied by severe pain,
- symptoms of arthritis - inflammatory processes develop in small joints, however, there is no deformation and stiffness of movements, as in polyarthritis,
- serous inflammation - damage to the lung tissue and heart tissue. The patient often has pleurisy and pericarditis,
- on the part of the urinary system - frequent pyelonephritis, pielity, the appearance of protein in the urine, the progression of renal failure,
- from the side of the central nervous system - irritability, psycho-emotional over-stimulation, psychosis, hysterical seizures for no apparent reason,
- circulatory system - reducing the number of platelets and lymphocytes in the blood, changing the composition of the blood,
- the immune system - false positive Wasserman (test for syphilis), the detection of antibody titers and antigens in the blood,
- an increase in antinuclear antibodies without apparent reason.
Of course, these 11 parameters are rather indirect and can be observed in any other pathology. As for lupus erythematosus, the final diagnosis can only be made if the patient has 4 or more signs from the list. First, a preliminary diagnosis or lupus erythematosus is questionable, after which the patient is referred for a detailed, focused examination.
A huge role in the diagnosis given to careful collection of anamnesis, including genetic features. The doctor must find out exactly what the patient had been ill with in the last year and how the disease was treated.
Treatment of lupus erythematosus
Drug therapy to a patient with systemic lupus erythematosus is selected individually, depending on the course of the disease, stage, severity of symptoms and characteristics of the organism.
Hospitalization of the patient is necessary if he has one or more clinical manifestations of lupus erythematosus:
- for a long time, the body temperature is above 38 degrees and does not get off with antipyretic drugs,
- suspected heart attack, stroke, pneumonia, severe damage to the central nervous system,
- depression of the patient’s mind
- the rapid decline of leukocytes in the blood,
- sharp progression of clinical signs of systemic lupus erythematosus.
If necessary, the patient is referred to narrow specialists - to a nephrologist for kidney damage, to a cardiologist for heart diseases, to a pulmonologist for pneumonia and pleurisy.
Standard general therapy for systemic lupus erythematosus includes:
- hormone therapy - prescribe Prednisolone, Cyclophosphamide during a sharp exacerbation of the disease. Depending on the severity of the clinical picture and the severity of the disease, a single use of hormonal drugs or their use for several days is prescribed,
- Diclofenac - drug injections are prescribed when signs of inflammation of small joints appear,
- Ibuprofen or Paracetamol-based antipyretic drugs - prescribed for a body temperature above 38 degrees.
To eliminate flaking, soaking and burning skin in the area of damage and red spots, the doctor selects the patient with special ointments and creams, which include hormonal agents.
Particular attention is paid to maintaining the patient's immune system. During the period of remission of lupus erythematosus, immunostimulants, vitamin complexes, and physiotherapeutic procedures are prescribed. It is possible to use immunostimulating agents only during the period of subsiding of the acute clinical signs of the disease, otherwise the condition of the patient may deteriorate sharply.
Lupus erythematosus is not a sentence, since even with such a disease you can live happily ever after. The key point of a favorable prognosis of the disease is timely seeking medical help, making the correct diagnosis and following all the recommendations of the doctor.
The risk of developing complications and progression of lupus erythematosus is much higher if the patient has chronic infectious diseases, he vaccinates or often suffers from colds. Given these data, such patients should carefully take care of their health and in every way avoid the influence of negative trends on the body.
What is lupus erythematosus
This is an autoimmune pathology in which kidneys, blood vessels, connective tissues and other organs and systems are affected. If, in the normal state, the human body produces antibodies capable of attacking foreign organisms that fall outside, then in the presence of a disease, the body produces a large number of antibodies to the cells of the body and their components. As a result, an immune complex inflammatory process is formed, the development of which leads to the dysfunction of various elements of the body. Systemic lupus affects internal and external organs, including:
The etiology of systemic lupus is still unclear. Doctors suggest that the cause of the disease is viruses (RNA, etc.). In addition, a risk factor for the development of pathology is a hereditary predisposition to it. Women suffer from lupus erythematosus about 10 times more often than men, which is explained by the peculiarities of their hormonal system (there is a high concentration of estrogen in the blood). The reason for which the disease manifests itself less frequently in men is the protective effect that androgens (male sex hormones) have. Increase the risk of SLE can:
- bacterial infection
- viral lesion.
A normally functioning immune system produces substances to combat the antigens of any infections. With systemic lupus, antibodies purposefully destroy their own cells in the body, while they cause absolute disruption of the connective tissue. As a rule, patients show fibroid changes, but other cells are susceptible to mucoid swelling. In the affected structural units of the skin, the nucleus is destroyed.
In addition to damage to skin cells, plasma and lymphoid particles, histiocytes, and neutrophils begin to accumulate in the walls of blood vessels. Immune cells settle around the destroyed nucleus, which is called the "rosette" phenomenon. Under the influence of aggressive complexes of antigens and antibodies, lysosomal enzymes are released, which stimulate inflammation and lead to damage to the connective tissue. New antigens with antibodies (autoantibodies) are formed from the degradation products. As a result of chronic inflammation, tissue sclerosis occurs.
Forms of the disease
Depending on the severity of the symptoms of pathology, systemic disease has a certain classification. The clinical varieties of systemic lupus erythematosus include:
- Acute form. At this stage, the disease progresses sharply, and the patient’s general condition worsens, while he complains of constant fatigue, high temperature (up to 40 degrees), pain, fever and muscle aches. Symptomatology of the disease is developing rapidly, and within a month it affects all tissues and organs of a person. The prognosis for acute SLE is not comforting: often the patient’s life expectancy with such a diagnosis does not exceed 2 years.
- Subacute form. From the moment of onset of the disease and before the onset of symptoms may take more than a year. For this type of disease characteristic frequent change of periods of exacerbation and remission. The prognosis is favorable, and the patient's condition depends on the treatment chosen by the doctor.
- Chronic. The disease is sluggish, signs are weak, the internal organs are practically intact, so the body functions normally. Despite the mild course of pathology, it is practically impossible to cure it at this stage. The only thing that can be done is to alleviate the condition of a person with the help of medications for exacerbating SLE.
It is necessary to distinguish skin diseases related to lupus erythematosus, but not systemic and not having a generalized lesion. These pathologies include:
- discoid lupus (red rash on the face, head or other parts of the body, slightly elevated above the skin),
- drug lupus (inflammation of the joints, rash, high fever, sternum pain associated with taking drugs, after their withdrawal symptoms go away),
- neonatal lupus (rarely expressed, affects the newborn when the mother has a disease of the immune system, the disease is accompanied by abnormalities of the liver, skin rash, heart disease).
How does lupus manifest
The main symptoms that manifest themselves in SLE include severe fatigue, skin rashes, and pain in the joints. With the progression of pathology, problems with the work of the heart, nervous system, kidneys, lungs, and blood vessels become topical. The clinical picture of the disease in each case is individual, because it depends on which organs are affected and what degree of damage they have.
Tissue damage at the onset of the disease occurs in about a quarter of patients, in 60-70% of patients with SLE, skin syndrome is noticeable later, and in others it does not occur at all. As a rule, areas of the body that are open to the sun are typical for the localization of a lesion - a face (a butterfly-shaped area: nose, cheeks), shoulders, neck. The lesions are similar to erythema (erythematosus), as they have the appearance of red scaly patches. Along the edges of the lesions are dilated capillaries and areas with an excess / lack of pigment.
In addition to the face and other parts of the body exposed to the sun, the systemic lupus affects the scalp. As a rule, this manifestation is localized in the temporal region, while the hair falls out on a limited area of the head (local alopecia). In 30-60% of patients with SLE, there is a noticeable increased sensitivity to sunlight (photosensitization).
Very often, lupus erythematosus affects the kidneys: about half of the patients show damage to the renal apparatus. A frequent symptom of this is the presence of protein in the urine, cylinders and red blood cells, as a rule, are not detected at the beginning of the disease. The main signs that SLE has affected the kidneys are:
- membranous nephritis,
- proliferative glomerulonephritis.
In the joints
Rheumatoid arthritis is often diagnosed with lupus: in 9 out of 10 cases it is non-deforming and non-erosive. Most often, the disease affects the knee joints, fingers, wrists. In addition, patients with SLE sometimes develop osteoporosis (decrease in bone density). Often, patients complain of muscle pain and muscle weakness. Immune inflammation is treated with hormonal drugs (corticosteroids).
On the mucous
The disease manifests itself in the oral mucosa and nasopharynx in the form of ulcers, which do not cause painful sensations. The defeat of the mucous membranes is fixed in 1 of 4 cases. For this is characteristic:
- reduction of pigmentation, red border of the lips (cheilitis),
- ulceration of the mouth / nose, petechial hemorrhages.
Lupus erythematosus can affect all the structures of the heart, including the endocardium, pericardium and myocardium, coronary vessels, valves. However, damage to the outer membrane of the organ occurs more frequently. Diseases that may result from SLE:
- pericarditis (inflammation of the serous membranes of the heart muscle, manifested by dull pains in the chest),
- myocarditis (inflammation of the heart muscle, accompanied by rhythm disturbances, nerve impulses, acute / chronic organ failure),
- valvular dysfunction,
- damage to the coronary vessels (may develop at an early age in patients with SLE),
- damage to the inner side of the vessels (this increases the risk of atherosclerosis),
- damage to the lymphatic vessels (manifested by thrombosis of the extremities and internal organs, panniculitis - subcutaneous painful nodes, and reticularis - blue spots forming the grid pattern).
On the nervous system
Doctors suggest that the failure of the central nervous system is caused by damage to the brain vessels and the formation of antibodies to neurons - cells that are responsible for the nutrition and protection of the body, as well as to immune cells (lymphocytes. The key signs that the disease struck the nervous structures of the brain - this :
- psychosis, paranoia, hallucinations,
- migraine headaches,
- Parkinson's disease, chorea,
- depression, irritability,
- brain stroke,
- polyneuritis, mononeuritis, aseptic type meningitis,
- neuropathy, myelopathy, etc.
A systemic disease has an extensive list of symptoms, with periods of remission and complications. The onset of pathology can be lightning or gradual. The symptoms of lupus depend on the form of the disease, and since it belongs to the multiorgan category of pathologies, the clinical symptoms can be varied. Non-severe forms of SLE are limited only to damage to the skin or joints, more severe types of the disease are accompanied by other manifestations. The characteristic symptoms of the disease include the following:
- swollen eyes, joints of the lower limbs,
- muscle / joint pain
- swollen lymph nodes
- fatigue, weakness,
- red, similar to allergic rashes on the face,
- unreasonable fever,
- Blue fingers, hands, feet after stress, contact with cold,
- soreness when breathing in
- sensitivity to sunlight.
Early symptoms include temperature, which fluctuates within the limits of 38039 degrees and can last for several months. After that, the patient has other signs of SLE, including:
- arthrosis of small / large joints (can independently pass, and then reappear with greater intensity),
- a rash in the shape of a butterfly on the face, rashes appear on the shoulders, chest,
- inflammation of the cervical, axillary lymph nodes,
- in case of severe lesions of the body, internal organs suffer - kidneys, liver, heart, which is reflected in the violation of their work.
At an early age, lupus erythematosus is manifested by numerous symptoms, progressively affecting various organs of the child. In this case, doctors can not predict which system will fail next. The primary signs of pathology may resemble the usual allergies or dermatitis, such pathogenesis of the disease causes difficulties in diagnosis. Symptoms of SLE in children can be:
- skin thinning, photosensitivity,
- fever, accompanied by profuse perspiration, chills,
- allergic rashes,
- dermatitis, usually first localized on the cheeks, nose (it has the form of warty rash, blisters, edema, etc.),
- joint pain
- brittle nails,
- necrosis at the fingertips, palms,
- alopecia, up to complete hair loss,
- mental disorders (nervousness, moodiness, etc.),
- stomatitis that is not treatable.
To establish the diagnosis, doctors use a system developed by American rheumatologists. To confirm that a patient has lupus erythematosus, the patient must have at least 4 of the 11 listed symptoms:
- erythema on the face in the shape of butterfly wings,
- photosensitivity (pigmentation on the face, aggravated by sunlight or UV radiation),
- discoid skin rash (asymmetrical red patches that peel and crack, with areas of hyperkeratosis have jagged edges),
- symptoms of arthritis,
- ulceration of the mucous membranes of the mouth, nose,
- disorders of the central nervous system - psychosis, irritability, hysteria without a cause, neurological diseases, etc.,
- serous inflammation
- frequent pyelonephritis, protein in the urine, the development of renal failure,
- false positive analysis of Wasserman, detection of titers of antigens and antibodies in the blood,
- reduction of platelets and lymphocytes in the blood, changing its composition,
- unreasonable increase in antinuclear antibodies.
The specialist makes the final diagnosis only if there are four or more signs from the above list. When the verdict is in question, the patient is directed to a narrow, detailed examination. A large role in the diagnosis of SLE, the doctor assigns anamnesis and the study of genetic factors. The doctor must find out what diseases the patient had during the last year of life and how they were treated.
SLE is a chronic-type disease in which complete cure of the patient is impossible. The objectives of therapy are to reduce the activity of the pathological process, restore and preserve the functional capabilities of the affected system / organs, prevent exacerbations to achieve a longer life expectancy for patients and improve its quality of life. Treatment of lupus involves the mandatory intake of medicines, which the doctor prescribes for each patient individually, depending on the characteristics of the organism and the stage of the disease.
Patients are hospitalized in cases where they have one or more of the following clinical manifestations of the ailment:
- suspected stroke, heart attack, severe damage to the central nervous system, pneumonia,
- a temperature rise above 38 degrees for a long time (fever cannot be eliminated with the help of antipyretic agents),
- depression of consciousness
- a sharp decrease in leukocytes in the blood,
- rapid progression of disease symptoms.
When the need arises, the patient is referred to specialists such as a cardiologist, nephrologist or pulmonologist. Standard treatment for SLE includes:
- hormonal therapy (prescribed drugs of the glucocorticoid group, for example, Prednisolone, Cyclophosphamide, etc.),
- anti-inflammatory medications (usually Diclofenac in ampoules),
- antipyretic drugs (based on paracetamol or ibuprofen).
To relieve burning, peeling of the skin, the doctor prescribes hormone-based creams and ointments to the patient. Special attention during the treatment of lupus erythematosus is paid to maintaining the patient's immunity. During remission, the patient is prescribed complex vitamins, immunostimulants, and physiotherapeutic manipulations. Drugs that stimulate the work of the immune system such as azathioprine are taken only during a lull of illness, otherwise the patient’s condition may deteriorate sharply.
Treatment must begin in the hospital as soon as possible. The therapeutic course should be long and constant (without interruptions). During the active phase of the pathology, glucocorticoids are given to the patient in large doses, starting with 60 mg of Prednisolone and increasing over 3 months by an additional 35 mg. Reduce the volume of the drug slowly, moving to pills. After individually assigned maintenance dose of the drug (5-10 mg).
To prevent a violation of mineral metabolism, simultaneously with hormone therapy, potassium preparations are prescribed (Panangin, potassium acetate solution, etc.). After completion of the acute phase of the disease, complex treatment with corticosteroids is carried out in reduced or maintenance doses. In addition, the patient takes aminoquinoline drugs (1 tablet of Delagin or Plaquenil).
The earlier the treatment is started, the greater the chances of the patient to avoid irreversible effects in the body. Therapy of chronic pathology necessarily includes the use of anti-inflammatory drugs, drugs that suppress the activity of the immune system (immunosuppressants) and corticosteroid hormonal drugs. However, only half of patients achieve success in treatment. In the absence of positive dynamics, stem cell therapy is carried out. As a rule, autoimmune aggression is then absent.
What is dangerous lupus erythematosus
Some patients with such a diagnosis develop severe complications - the work of the heart, kidneys, lungs, other organs and systems is disturbed. The most dangerous form of the disease is systemic, which damages even the placenta during pregnancy, as a result of which it leads to stunting of the fetus or its death. Autoantibodies are able to penetrate the placenta and cause neonatal (congenital) disease in the newborn. In this case, the baby appears skin syndrome, which passes after 2-3 months.
How many live with lupus erythematosus
Thanks to modern medicines, patients can live for more than 20 years after the diagnosis of the disease. The process of pathology development proceeds at different speeds: in some people the symptoms increase the intensity gradually, in others it increases rapidly. Most patients continue to live their usual way of life, but with a severe course of the disease, the ability to work is lost due to severe joint pain, high fatigue, and CNS disorders. The duration and quality of life for SLE depends on the severity of symptoms of multiple organ failure.