Systemic lupus erythematosus term defines a chronic inflammatory multisystemic disease of probably autoimmune etiology, manifested by the production of antinuclear antibodies, which are deposited in tissue and vessels and affects many organs.
Normally, antibodies facilitate recognizing the self in order to destroy foreign cells. In autoimmune diseases like lupus this defense mechanism is aberrant and the antibodies attack our own cells.
Antinuclear antibodies are present in over 95% of cases of lupus disease. The most specific for lupus are anti-ADNS antibodies. In addition there are present anticytoplasm antibodies, anti blood cells, anti circulating factors, anti cardiolypin.
Lupus erythematosus is a rare disease, predominantly in young women, age: 20-40 years. Known as favorable factors for lupus:
– Genetic susceptibility and transmissibility;
– UV radiation and sun exposure;
– Drugs such as hydralazine, procainamide, isoniazid (possibility of reversibility);
– ANA over 95% of patients;
– Specific in SLE are the antibodies antiADNds.
The onset of systemic lupus erythematosus:
– Acute or insidious in young women, after sun exposure, infections, vaccinations, pregnancy;
– Fever / feverish, fatigue, weight loss, anorexia;
– Arthralgia, arthritis (joint pain), skin lesions;
– 1/3 of cases: acute onset with serosity (pleuritis, pericarditis, peritonitis), thrombocytopenic purpura, neuropsychiatric disorders.
The depository of antibodies in organs like in systemic lupus erythematosus disease leads to a process of chronic inflammation:
- Kidney: glomerulonephritis of various types;
- Blood vessels: arterioles, venules, capillaries;
- Joints: exudative synovitis;
- Serous: pleura, pericardium, peritoneum;
- Brain: infarction, hemorrhage;
- Spleen, lymph nodes;
- Heart: myocardium, endocardium, pericardium, coronary vessels;
- Skin: discoid lupus
Treatment for lupus targets:
– General measures to forbid sun exposure and other UV sources, avoiding drugs that may induce SLE, bacterial and viral infections have to be avoided.
– The medicinal treatment consists in lupus in administration of NSAIDs in mild forms, antimalarial drugs of synthesis (rare in mild joint and skin lupus), corticosteroids have to be accompanied by dietary salt restriction (maximum 4 g of salt per day), immunosuppressants, plasmapheresis or monoclonal antibodies anti-CD4 +.
Treatment of complications
– Forms of lupus erythematosus with biological abnormalities and without clinical signs is not treated;
Evolution and prognosis in systemic lupus erythematosus:
SLE is a very serious disease with exacerbations and remissions. Death in lupus occurs more often in renal failure, vascular complications and infections.