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Lupus Erythematosus – Symptoms

During the state period of lupus erythematosus the following symptoms occur:

– Fever syndrome – constant fever curve uninfluenced of drugs that combat fever and antibiotics, but responsive to glucocorticoids;

– Mucocutaneous manifestations:

  • butterfly erythema (“Vespertilio”): cheek, nose, without nasolabial groove;
  • photosensitivity – face, neck (areas exposed to sun);
  • subacute lesions: erythematous → papules, scaling;
  • discoid lupus. Forms of discoid lupus are characterized by erythema and hyperkeratosis and then atrophy;
  • vasculitic lesions: variable aspects (purpura, erythema, ulceration of fingers, nettle rash);
  • Raynaud’s phenomenon, livedo reticularis;
  • transient or permanent alopecia;
  • mucosal lesions: petechiae, painless ulcer on hard and soft palace, nasal septum, painful or painless.

Bone, joints and muscular manifestations of systemic lupus erythematosus:

  • arthritis (95%) often symmetrical in small joints, elbows, fists and hands, often reversible, sometimes with deformations, morning stiffness (minutes);
  • bone damage: aseptic necrosis of the femoral head (vasculitis, corticosteroids), osteoporosis;
  • myalgia, muscle fatigue.

Polyserositis in systemic lupus erythematosus is represented by an inflammation of the serous membranes of the body with fluid accumulation:

  • pleurisy – (30%) bilateral, small amount of pericardialeffusion;
  • peritonitis: rarely (abdominal pain, vomiting).

In half of cases of lupus erythematosus appears renal manifestations:

  • proteinuria, hematuria, nitrogen retention with hypertension.

Cardiovascular events

  • pericarditis;
  • myocarditis: tachycardia unexplained by fever or anemia;
  • heart failure caused by myocarditis, hypertension;
  • endocarditis, coronary damage (ATS, vasculitis);
  • vasculitis: skin ulcers, purpura, neuritis, arterial and venous thrombosis, recurrent thrombophlebitis;

Symptoms of pulmonary systemic lupus erythematosus:

  • Lupus acute pneumonia with fever, dyspnea, cough, hemoptysis, infiltrates or basal atelectasis (mimics infectious pneumonia);
  • chronic pneumonia: asymptomatic (rarely dyspnoea, cough, cyanosis, rales), but with diffuse inflitrates of lung bases.

Neurological and psychiatric disorders are present in 30% of cases of lupus erythematosus:

  • neurological disorders: convulsions localized / generalized, severe headache, peripheral neuropathy, cranial nerve damage, aseptic lymphocytic meningitis;
  • psychiatric disorders: psychosis, organic brain syndrome.

Ocular manifestations of lupus are less common but also important:

  • retinal capillary vasculitis;
  • keratoconjunctivitis sicca (10% of lupus cases).

Digestive symptoms of lupus are:

  • anorexia, nausea, vomiting, abdominal pain;
  • hepatomegaly, splenomegaly.

Can also occur adenopathy (swollen glands) and discoid lupus.




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