Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus can manifest in different ways: skin rashes, joint pain, prolonged fatigue, fever, hair loss. With a wave-like course, symptoms sometimes weaken and then return. Due to the variety of manifestations, patients do not always immediately consult a rheumatologist, which can increase the risk of complications.

At the «Oxford Medical» medical center, you can receive a consultation from an experienced specialist and undergo the necessary examinations to establish an accurate diagnosis and select treatment. Make an appointment at a time convenient for you by phone or through the online appointment form on the website.

Systemic lupus erythematosus — is a chronic autoimmune disease in which the immune system mistakenly reacts to the body’s own cells and tissues. As a result, long-term inflammation occurs, which can affect the function of different organs and systems.

As National Institute of Arthritis and Musculoskeletal and Skin Diseases explains, lupus can affect different parts of the body and cause inflammation or tissue damage. Therefore, systemic lupus erythematosus has a different course in different patients: in one person, rashes and joint pain predominate, in another — damage to the kidneys, heart, lungs, nervous system, or blood cells.

The feature of SLE — is a wave-like course. Periods of relative improvement can be replaced by exacerbations, when symptoms return or intensify. The disease is not contagious and is not transmitted from person to person, but it requires regular monitoring in order to notice the activity of the process in time and prevent complications.

The exact cause of the development of SLE has not been definitively established. The disease is associated with a disruption of the immune system, but usually develops not because of one factor, but because of a combination of hereditary predisposition, external influences, and features of hormonal regulation.

Possible factors in the development of SLE include:

• hereditary predisposition to autoimmune diseases;
• hormonal changes;
• previous infections;
• severe or prolonged stress;
• some medications;
• smoking.

In people with a predisposition to autoimmune diseases, certain factors can provoke exacerbation or intensification of symptoms. In particular, excessive sun exposure, smoking, infections, severe stress can worsen the course of SLE.

One of the characteristic manifestations may be a rash on the face in the shape of a «butterfly» — on the cheeks and bridge of the nose. Patients may also notice increased rashes after being in the sun, chest pain during a deep breath, swelling, a change in the color of the fingers in the cold, a prolonged low-grade fever, and increased hair loss, sometimes — up to alopecia.

Doctors of «Oxford Medical» note: systemic red lupus can affect not only the skin and joints, but also the cardiovascular system. Some patients experience chest pain, inflammation of the membranes of the heart, and attacks of arrhythmia. With such symptoms, it is important to assess not only rheumatological manifestations, but also the condition of the heart.

Diagnosis begins with a consultation with a rheumatologist. The doctor clarifies complaints, the duration of symptoms, the presence of rashes, joint pain, hair loss, changes in general well-being, as well as a family history of autoimmune diseases.

To clarify the diagnosis, the following may be prescribed:

• general blood and urine tests;
• biochemical tests to assess kidney and liver function;
• tests for antinuclear antibodies and other autoantibodies;
• tests to assess complement levels and inflammation markers;
• ECG or echocardiography in case of symptoms from the heart;
• ultrasound of the abdominal organs according to indications.

SLE has many possible manifestations, so the doctor evaluates not one separate indicator, but a combination of symptoms, test results, and instrumental examinations. In some cases, monitoring over time is necessary, since manifestations of the disease may appear gradually.

Treatment tactics depend on the activity of the disease. The main goal of therapy is to reduce inflammation, control exacerbations, and maintain quality of life.

With such a disease as systemic lupus erythematosus, treatment may include:

• nonsteroidal anti-inflammatory drugs — to reduce pain, swelling, temperature, and inflammation of the joints;
• glucocorticosteroids — in case of active inflammation, pronounced symptoms, or damage to internal organs;
• hydroxychloroquine and other drugs for basic control of SLE — to reduce skin and joint manifestations, maintain remission, and reduce the risk of exacerbations;
• immunosuppressive drugs — to reduce excessive activity of the immune system;
• concomitant therapy — to control high blood pressure, anemia, thromboses, kidney damage, or other complications.

According to the recommendations of EULAR, treatment of SLE should be individual and aimed at achieving remission or low disease activity, preventing exacerbations, and reducing the risk of organ damage.

Doctors of «Oxford Medical» recommend not changing the dosage of medications on your own and not stopping therapy after improvement in well-being. In SLE, periods of remission may be replaced by exacerbations, so treatment should take place under the supervision of a rheumatologist.

Complications of SLE depend on the activity of the disease and on which organs are involved in the autoimmune process. With a milder course, skin and joint manifestations may predominate, but with high activity, the disease can affect the kidneys, heart, lungs, blood vessels, nervous system, hematopoiesis, and digestive tract.

Possible complications of SLE:

• lupus nephritis and impaired kidney function;
• inflammation of the membranes of the heart or lungs;
• thromboses and other vascular complications;
• anemia, decreased leukocytes or platelets;
• damage to the nervous system;
• disorders of the digestive system: abdominal pain, nausea, decreased appetite, or diarrhea.

Systemic lupus requires long-term control even during periods of improvement. Regular monitoring helps to notice an exacerbation in time, assess the risk of complications, and adjust therapy before the disease leads to persistent organ damage.

The total price of treatment depends on the activity of the disease, the necessary scope of diagnostics, and the individually selected therapy program. In some cases, a consultation with a rheumatologist, basic tests, and scheduled monitoring are sufficient, in others — additional examinations and systemic medication therapy are needed.

You can preliminarily familiarize yourself with prices for medical services here. The doctor will guide you in more detail regarding treatment options and cost during the consultation. At the «Oxford Medical» clinic, you can undergo a consultation with a rheumatologist, laboratory diagnostics, and receive individual recommendations. To make an appointment, contact the contact center or use the online appointment form on the website.

The information is for informational purposes and does not replace a doctor's consultation.

Sources:

National Institute of Arthritis and Musculoskeletal and Skin Diseases

European Alliance of Associations for Rheumatology

US National Library of Medicine