A disease of the chronic autoimmune disorder systemic lupus erythematosus affects about 60,000 patients in Germany today. One observes an increasing accumulation of lupus in the population in the last 50 years. Women have this autoimmune disease ten times more frequently than men. In lupus erythematosus, chronic inflammation mainly affects blood vessels, joints or organs such as the kidneys. Systemic lupus erythematosus cannot be completely cured.
What is systemic lupus erythematosus?
Lupus erythematosus, or lupus for short, is a disease of varying severity that belongs to the autoimmune diseases or connective tissue inflammations and collagenoses. A striking feature of lupus is often an intense redness that can affect certain areas of the skin. It is caused by chronic inflammation of the blood vessels. Most notable in lupus erythematosus is the so-called “butterfly erythema,” which can spread in a butterfly shape down the side of the nose on the face. The initial symptoms of systemic lupus erythematosus may initially be varied and relatively nonspecific. SLE progresses chronically, necessitating prolonged treatment. In addition to systemic lupus, there is also lupus that affects only the skin. To confirm the diagnosis, systemic lupus must result in several concurrent leading symptoms and antibodies in the blood. Systemic lupus erythematosus is also abbreviated with the letters SLE.
Causes
The cause of lupus erythematosus or systemic lupus is thought to be a chronic autoimmune disease. In its course, the body’s own defenses are disturbed and misdirected. However, the causes of the autoimmune disorder itself are still largely unknown. The disease is called systemic lupus erythematosus because all systems in the body can actually be damaged by chronic inflammatory processes. This happens mainly if the disease of SLE is not diagnosed and treated in time. Systemic lupus erythematosus is classified as an inflammatory rheumatic disease. In SLE, it is mainly the cell nuclei that are attacked, which contain the genetic material. It is not yet known whether lupus erythematosus develops for hereditary or hormonal reasons or as a result of an infection. The fact that women are more often affected makes hormonal contributors to SLE likely. In some cases, lupus occurred after taking a contraceptive. Hereditary causes of lupus erythematosus are also possible. Indeed, lupus erythematosus occurs in twins and is clustered in some families. The association between lupus erythematosus and survived infectious diseases is also being investigated as a possible cause of SLE. It is likely that the causation of systemic lupus depends on numerous factors.
Symptoms, complaints, and signs
Nonspecific symptoms of systemic lupus erythematosus include fever, general feeling of weakness, and weight loss; enlarged lymph nodes are usually noticed. Frequently, SLE manifests itself through joint inflammation, predominantly in the hand – it is not uncommon for the tendon sheaths to be affected as well. Skin changes occur in about fifty percent of SLE patients: Characteristic is the so-called butterfly erythema, which appears in the form of a symmetrical reddening of the cheeks to the bridge of the nose. Rashes may also occur on other parts of the body and are exacerbated by sun exposure. Swollen legs and eyelids or dark discolored urine may indicate kidney involvement. In about one third of those affected, inflammation of the pleura or pericardium occurs, which is manifested by respiratory chest pain. In about ten percent of cases, systemic lupus erythematosus affects the nervous system and can cause neurological symptoms such as sensory disturbances, headaches, visual disturbances and seizures; psychological impairments such as personality changes, memory disorders and depression are also possible. Rarely, SLE causes a disorder of blood clotting with a tendency to thrombosis, embolism, infarction, and pregnancy complications.Peritonitis is manifested by abdominal pain, nausea, and vomiting; myocarditis may cause cardiac arrhythmias or heart failure associated with exercise-induced shortness of breath. Muscle pain and weakness may indicate skeletal muscle inflammation.
Disease progression
In lupus, the body’s immune system turns against the organism of the affected person. The antibodies produced as a result of this disease can trigger inflammatory reactions throughout the body. This circumstance can make lupus life-threatening. Thanks to a disease of lupus even whole organ systems can be damaged. In its course, systemic lupus erythematosus can cause chronic inflammation of various organs, joints or connective tissue. The course of the disease can be mild, moderate or dramatic. Lupus erythematosus can even lead to death if it is not treated. This is also true if treatment is not effective or leads to complications. Thanks to good medical care, systemic lupus can be survived in 90 percent of cases today. However, an increase in the incidence of lupus has been observed for years. Among the most commonly affected patients with lupus erythematosus are women.
Complications
Systemic lupus erythematosus can cause complications throughout the body – serious consequences are possible, especially if the brain or kidneys are inflamed. For example, chronic kidney failure can occur, as a result of which the patient must be connected to a dialysis machine. In the case of inflammation of the brain, neurological symptoms may occur – such as gait disorders or other deficits. In the further course, the antipholipid syndrome can lead to an activation of the blood clotting system. This increases the risk of thrombosis, embolism or arterial occlusion. If pregnant women are affected, there is an increased risk of miscarriage. Similar complications can occur with systemic lupus erythematosus. Drug-induced lupus erythematosus is associated with involvement of the joints, pleura, and occasionally the pericardium. After discontinuation of the triggering drug, the symptoms usually disappear. Treatment of the disease also carries risks. The prescribed antimalarials are always associated with side effects and interactions. Typically, headaches and pain in the limbs occur, as well as temporary gastrointestinal complaints. Prolonged use increases the risk of retinal damage. Similar risks come from painkillers, cholesterol-lowering drugs and other preparations.
When should you see a doctor?
Affected individuals rely on medical treatment from a doctor for SLE. Since self-healing cannot occur in this disease and the symptoms worsen if left untreated, an examination with subsequent treatment must be performed in any case. This is the only way to prevent the development of further complications. A doctor should be consulted for SLE if the affected person suffers from inflammation of the joints. There is fever and a general feeling of illness. It is not uncommon for patients to also suffer from swollen legs or severe limitations in movement. Pain in the chest or heart can also indicate SLE and should be examined by a doctor. Furthermore, vision problems or severe abdominal pain also often point to this disease and need to be investigated if they do not go away on their own. SLE can be diagnosed by a pediatrician or by a general practitioner. Further treatment usually requires a visit to a specialist, as this depends on the exact symptoms.
Treatment and therapy
Treatment of systemic lupus erythematosus is usually undertaken by the rheumatologist. A thorough history, blood tests, and a clinical examination may confirm the suspicion of lupus. The therapy of systemic lupus erithematosus is mainly carried out with drugs suppressing the immune system. Lupus erithematosus is therefore often treated with cortisone preparations.
Prevention
Prevention of lupus erythematosus is not, in fact, possible. To prevent lupus erythematosus, the best one can do is avoid strong UV radiation. If one is already suffering from sytemic lupus erythematosus, one should avoid sun exposure and long sunbathing sessions.
Aftercare
As a result of therapy, the cause of the disease is untreated. Systemic lupus erythematosus (SLE) does not heal. Based on the clinical findings, the only way to assess for follow-up is whether the disease progresses slowly (chronic progressive course) or is relapsing. The main tasks of follow-up care are monitoring the course of the disease, reviewing the medication and identifying and treating any new symptoms. This requires regular checks of the “large” blood count. During the follow-up examinations, the attending physician is dependent on a detailed description by the patient of the general state of health and the symptoms. This is because no laboratory values are recognized in medicine by which the activity of SLE can be reliably assessed. If necessary, the inflammatory activity can reduce by itself. Basically, however, SLE increases in severity and number of symptoms. Clinical visits may then be required to reassess the necessary medication. However, even newly added symptoms will not be curable, but can only be alleviated with medication. The patient must learn to cope with SLE in everyday life. As a first approach, a cure treatment is recommended. This does not apply to drug-induced SLE. Follow-up examinations can be omitted as soon as the patient regains good general health with the discontinuation of the triggering drug.
Here’s what you can do yourself
Sufferers are advised to lead as healthy a lifestyle as possible. This includes physical activity as well as abstaining from alcohol, nicotine, and too much coffee. A change in diet helps to alleviate symptoms. For example, a wholefood diet that avoids egg and dairy products and includes foods that are as low in fat as possible has a favorable effect on the disease. Olive oil is also recommended because it contains an abundance of the fatty acid omega 9, which helps to reduce inflammation, which is fundamental in this clinical picture. In the case of joint or muscle complaints, wraps soaked in herbal decoctions can have a soothing effect. Medicinal herbs are also used to improve symptoms. These include mainly: angelica, garlic, ginger, marjoram, lemongrass, black pepper, lemon, basil, lemon balm and juniper. Additionally, a healthy digestive tract is fundamental in sufferers, as many patients suffer from significant nutrient deficiencies. It is therefore particularly important to guarantee correct nutrient intake. Probiotics can be used to promote a healthy and strong intestinal flora, which also helps to prevent inflammation. Massages are also part of the recommended symptom treatment. These noticeably help relieve inflammation, detoxify the body and reduce stress.
