Systemic lupus erythematosus

February 9, 2013

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Systemic lupus erythematosus   - Systemic autoimmune disease affecting the blood vessels and connective tissue. If the normal state of the body's immune system produces antibodies Which must attack foreign organisms that enter the body, then in systemic lupus in humans, a large number of antibodies to the body's cells, as well as their components. As a consequence, it appears immune complex inflammatory process, the development of which leads to the defeat of a number of systems and organs. With the development of lupus affected heart . skin . kidneys . lungs . joints , and nervous system .

If it affects only the skin is diagnosed discoid lupus . Cutaneous lupus erythematosus expressed obvious signs that are clearly visible even in the photo. If the disease affects the internal organs of a person, in this case, the diagnosis indicates that a person manifests systemic lupus erythematosus . According to medical statistics, the symptoms of lupus both types (and systemic and discoid forms) is about eight times more common in women. This disease lupus can occur in both children and adults, but it is most often an illness affects people of working age - between 20 and 45 years.

Causes

Until now, the reasons are not clearly defined, which cause the disease. Doctors tend to versions that certain value, in this case a hereditary factor, the impact on the human viruses, certain medications, and ultraviolet radiation. Many people with this disease in the past suffered from allergic reactions to foods or medications. If a person has relatives with a history of lupus, the likelihood of illness increases. Wondering whether contagious lupus, should be aware that the disease can not be infected, but he inherited the recessive type, that is, within a few generations. Therefore, treatment of lupus has to take into account the effect of all these factors.

Lupus can trigger the development of dozens of drugs, but the disease appears in about 90% of cases after treatment hydralazine . quinine, and procainamide . phenytoin . isoniazid . Dr. penicillinamine . But after stopping the disease is of such funds on their own.

The disease in women is deteriorating significantly during the month, besides lupus can occur as a result of pregnancy . delivery . Consequently, the experts determined the effect of female sex hormones on the occurrence of lupus.

Lupus   - A kind of manifestation of tuberculosis of the skin, it stimulates expression of Mycobacterium tuberculosis.

Symptoms

If a patient develops discoid lupus, the original skin rash of red color that does not cause a person itching and pain. Rarely discoid lupus in which there is an isolated lesion of the skin becomes systemic lupus, in which already affects the internal organs.

Symptoms manifested in systemic lupus erythematosus may have a variety of combinations. It may hurt the muscles, joints, mouth ulcers appear. Typical for systemic lupus and a rash on the face (on the nose and cheeks), which has the shape of a butterfly. The skin is particularly sensitive to light. Under the influence of the cold disturbed blood flow in the fingers extremities ( Raynaud's syndrome ).

The rash appears on the face in about half of patients with lupus. The characteristic rash in the form of butterflies may be exacerbated if it exposed to direct sunlight.

Most of the patients in the development of SLE symptoms are noted Arthritis . In this case, the arthritis manifested pain, swelling, feeling of stiffness in the joints of the feet and hands, their deformation. Sometimes lupus affected joints so as for rheumatoid arthritis .

It may also occur vasculitis   (inflammation of blood vessels), leading to impaired blood supply to tissues and organs. Sometimes it develops pericarditis   (inflammation of the lining of the heart), and pleurisy   (inflammation of the membranes of the lungs). At the same time the patient notes the emergence of severe pain in the chest that becomes more pronounced when a person changes the position of the body or breathe deeply. Sometimes SLE affects the muscles and heart valves.

The development of the disease may eventually affect the kidneys, the destruction of which is called SLE   lupus nephritis . For a given state is characterized by high blood pressure, protein in the urine. As a consequence, can develop kidney failure, for which a person is vital dialysis or a kidney transplant. The kidneys are affected in about half of patients with systemic lupus erythematosus. With the defeat of the digestive tract there diarrheal phenomenon, in rarer cases, the patient concerned periodic bouts of abdominal pain.

In pathological processes may be involved in lupus and brain ( cerebritis ), Resulting in psychoses , Personality changes, the appearance of seizures, and in severe cases - a coma . After the engagement of the peripheral nervous system nerves lost certain functions, which leads to loss of sensation and muscle weakness defined groups. Peripheral lymph nodes in most patients slightly enlarged and painful on palpation.

Baldness   (hair loss) - as a characteristic phenomenon in the progression of SLE. In addition, there is fragility of nails, a manifestation of bedsores.

Most often, a patient and expresses a common complaint, noting the small display fever , General weakness, loss of appetite. Fever demonstrates resistance to sulfonamides   and antibiotics But marked sensitivity glucocorticoids .

The forms of the disease

Considering the clinical course of the disease, are three variants of the disease: acute . subacute   and chronic   form.

With acute   SLE is celebrated continuously relapsing course of the disease. Numerous symptoms occur early and actively marked resistance to therapy. Patients die within two years after the onset of the disease. The most common subacute   SLE, when symptoms increase relatively slowly, but they are progressing. A person with this form of the disease are living longer than in acute SLE.

Chronic   Form - a benign variant of the disease, which can occur for many years. At the same time, using periodic therapy can achieve long-term remissions. Most often, in this form of affected skin and joints.

Depending on the activity of three different allocated extent. With minimum   activity of the pathological process in the patient noted a slight decrease in weight, normal body temperature, on the skin has a discoid lesion, there is joint syndrome, chronic nephritis, polyneuritis.

With average   activity body temperature does not exceed 38 degrees, moderate body weight is lost, the skin appears exudative erythema, there is also a dry pericarditis, subacute polyarthritis, chronic pneumonia, diffuse gomerulonefrit, entsefalonevrit.

With maximum   SLE activity body temperature can exceed the mark of 38, a person loses much of its weight, the skin on the face is affected in the form of a "butterfly", says arthritis, pulmonary vasculitis, nephrotic syndrome, entsefalomieloradikulonevrit.

When systemic lupus erythematosus occur lupus crises Who are at the highest manifestations of lupus activity process. Crises are characteristic for any of the disease, when the manifestation of change noticeably laboratory parameters, swept aside obschetroficheskie disorders, activation of symptoms.

Lupus

This kind of lupus is a form of lupus. Its causative agent - Mycobacterium tuberculosis. In this disease primarily affects the skin of the face. Sometimes the damage spreads to the skin of the upper lip, oral mucosa.

Initially, the patient has a specific tuberculosis bump, reddish or yellow-red, having a diameter of 1-3 mm. Such bumps are located on the skin of the affected groups, and after their destruction ulcers remain swollen edges. Later loss affects the mucous membrane of the mouth, broken bone in the interdental septa. As a result, the teeth become loose and fall out. Lips swollen patient, covered saniopurulent crusts, cracks appear on them. Increases and becomes denser regional lymph nodes. Often, pockets of lupus may be complicated by the addition of a secondary infection. Approximately 10% of lupus ulcers ozlokachestvlyayutsya.

In the process of diagnosis used vitropression and conduct research probe.

Medication used for the treatment of drugs and high doses vitamin D2 . Sometimes X-ray irradiation is practiced, phototherapy. In some cases, it is advisable to delete tuberculosis foci surgically.

Diagnostics

Given the fact that patients with lupus there is a very wide range of symptoms, we developed special criteria that are used in the diagnostic process. If you have four or more symptoms of the eleven listed, you can talk about the probability of the diagnosis "lupus."

Evaluated the following symptoms: rash on the face in the form of "butterfly"; discoid rash (red skin, which later may appear scars); high sensitivity (rash after sun exposure); sores on mucous membranes of the nose, mouth and throat; kidney disease; arthritis; pleurisy / pericarditis; brain damage; changes in laboratory parameters (reducing the number of leukocytes erythrocytes, blood platelets, the presence of specific antibodies to a false positive reaction syphilis ).

Also taken into account the results of biochemical analyzes, Biopsy   tissues.

Treatment

Unfortunately, it is impossible to cure lupus. Therefore, treatment is chosen so as to reduce symptoms, to suspend the inflammatory and autoimmune processes.

With the NSAIDs can reduce inflammation, as well as to reduce pain. However, preparations of this group Propafenone can cause irritation of the stomach, and, as a consequence, gastritis   and ulcer . In addition, it reduces blood clotting.

A more pronounced anti-inflammatory effect of corticosteroids have products-. However, prolonged use of large doses also provoke serious side effects. The patient may develop diabetes . osteoporosis . obesity Appear Cataract , Notes necrosis of large joints , Increased arterial pressure .

High efficiency effects in SLE patients with lesions of the skin and has a weak drug hydroxychloroquine ( Plaquenil ).

In the complex treatment also includes drugs that inhibit the activity of human immune system. Such agents are effective for severe disease develops when expressed visceral. But the reception of these funds leads to anemia, susceptibility to infection, as well as bleeding. Some of these drugs adversely affect the liver, kidneys. Therefore, immunosuppressive agents may be used only under the close supervision of a physician-rheumatologist.

In general, the treatment of SLE should serve several purposes. First of all, it is important to stop the autoimmune conflict in the body to restore normal adrenal function. In addition, it is necessary to carry out the impact on the brain center to balance the sympathetic and parasympathetic nervous system.

Treatment of the disease is carried out courses: on average it takes six months of continuous therapy. Its duration depends on the activity of disease, its duration and gravity of the number involved in the pathological process of organs and tissues.

If the patient develops nephrotic syndrome, treatment for a longer time, and recovery - more complicated. The result of treatment depends on how the patient is ready to implement all the recommendations of the doctor and to assist him in the treatment.

SLE is a serious illness that leads to disability and even death. Yet People with lupus can lead a normal life, especially in the period of remission. SLE patients have to avoid the factors that can adversely affect the course of the disease, aggravating it. They can not stay in the sun for a long time, in the summer is to wear long-sleeved clothing and apply sunscreen.

Be sure to take all medications that are prescribed by a doctor, and avoid abrupt withdrawal of corticosteroids, as such actions may lead to a serious aggravation of the disease. Patients whose treatment is conducted with use of corticosteroids or agents suppress the immune system are more susceptible to infection. Consequently, the temperature of the growth he must immediately inform the doctor. In addition, the expert should conduct ongoing monitoring of the patient and be aware of any changes in his condition.

Pregnant women with systemic lupus erythematosus are in the category of special risk. Over the period of a woman carrying a child must observe not only the gynecologist, and a rheumatologist. Such women are at high risk of abortion, the propensity to thrombosis . Most pregnant women with SLE prescribe aspirin for the purpose of blood thinners and immunoglobulin .

The antibodies of lupus can be transmitted from mother to newborn, as a result, appears the so-called "neonatal lupus". The infant appears a skin rash, reduced blood levels erythrocyte . leukocytes . Platelet . Sometimes a child may be heart block. As a rule, to the age of six months newborn baby erythematosus cured, because the mother's antibodies are destroyed.