Lupus Erythematosus – Symptoms
– 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.
- 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.