If lupus affected skin, heart,lungs, kidneys, joints and nervous system. If only the skin is affected, this condition is called discoid lupus erythematosus. If the process involves the internal organs, the disease known as systemic lupus erythematosus, or SLE.
Both types of lupus is 8 times more common in women than in men. The disease can begin at any age, but most often it occurs between 20 and 45 years.
The cause of lupus is unknown. Obviously, playing a role heredity, viruses, ultraviolet radiation and certain drugs. It is expected that the immune system in patients with lupus erythematosus are genetically more susceptible to the effects of external factors, such as viruses and ultraviolet radiation.
Lupus can cause several tens ofdrugs, but more than 90% of the drug lupus develops after taking six drugs: hydralazine (a drug for the treatment of hypertension), quinine, and procainamide (used to treat arrhythmias), phenytoin (treatment of epilepsy), isoniazid (tuberculosis treatment), Dr. penicillinamine (rheumatoid arthritis). Drug erythematosus, fortunately, quite rare and passes on their own after stopping treatment.
It is known that some women for lupusworsens during menstruation. This phenomenon, as well as the predominance of women among the cases shows that female sex hormones play a role in the development of lupus.
Discoid lupus: with discoid lupus rash is red, does not cause pain or itching. In 5-10% of cases of discoid lupus (an isolated lesion of the skin) is transformed into a system (internal organ damage).
In SLE there are different combinationssymptoms. The most frequent complaints: fatigue, low-grade fever, loss of appetite, muscle aches and joint pain, mouth ulcers, rash on the face (in the form of a "butterfly"), increased skin sensitivity to light, inflammation of the lung membrane (pleurisy) and heart (pericarditis) , circulatory disorders of the fingers and toes exposed to the cold (so-called Raynaud's phenomenon).
The rash on the face. It develops in about half of patients with lupuserythematosus. It occurs on the nose and under the eyes - the so-called "butterfly". This rash is painless, does not cause itching, may be exacerbated by exposure to sunlight.
Arthritis. It develops sooner or later mostpatients. Arthritis Lupus is characterized by swelling, pain, stiffness and deformation of the joints of the hands and feet. In some cases, joint damage in SLE resembles joint damage in rheumatoid arthritis. Sometimes there inflammation and pain in the muscles (myositis).
vasculitisOr inflammation of blood vessels. It leads to disruption of the blood supply to various organs and tissues.
Pleurisy and pericarditis. Inflammation of the membranes of the lungs and heart,respectively. It causes severe pain in the chest that increases with deep breathing, coughing and changes in body position. Meets heart muscle disease (carditis) and heart valves (endocarditis).
Nephritis. In SLE commonly affects the kidneys, this complicationIt called lupus nephritis. When nephritis protein appears in the urine, increased blood pressure. Lupus nephritis can lead to kidney failure, requiring a kidney transplant or dialysis (connection to the device "artificial kidney") to maintain the patient's life.
Changes psyche. Because of the involvement in the pathological process in the brainSLE patients may experience personality changes, psychosis, convulsions and even coma. The defeat of the brain called cerebritis. The pathological process in the peripheral nervous system can lead to loss of individual nerves functions - it causes weakness of certain muscle groups, numbness and loss of sensation in the places that "serve" the affected nerves.
Alopecia. Many patients with lupus hair fall out, this process is called alopecia, its activity often coincides with the overall activity of the disease.
Patients with lupus may experience the mosta variety of symptoms, so to ease rheumatic diagnostki American Association of eleven diagnostic criteria have been developed - typical symptoms of lupus. If you have four or more criteria for the diagnosis of lupus is considered "very likely." In some patients, not all criteria are shown at once, while others - for the time of disease are observed only criterion 2-3.
The criteria of the American Association of rheumatic:
In addition to these eleven criteria used for diagnosis and some other tests, such as erythrocyte sedimentation rate, biochemical tests, biopsy tissue, etc.
Curing SLE quite impossible. The goal of treatment - to alleviate the symptoms, protect organs and tissues of the body's own immune system, reduce inflammation and autoimmune process.
Nonsteroidal anti-inflammatory drugs (NSAIDs)reduce inflammation and pain in muscles, joints and other tissues. The NSAID group includes aspirin, ibuprofen, naproxen, Voltaren, sulindac and other side effects of NSAIDs:. Irritation of the stomach, the development of gastritis and ulcers (so these drugs should be taken after a meal), reduced blood clotting.
Corticosteroids have strongeranti-inflammatory effects than NSAIDs. Corticosteroids can be administered in tablet, administered by injection into the joints or intravenously. Unfortunately, the corticosteroids have many serious side effects, especially when used for a long time at high doses.
The most common side effects are: obesity, osteoporosis, infections, diabetes, cataracts, necrosis of the large joints, increased blood pressure. To reduce the severity and frequency of side effects of steroids are trying to assign in minimal doses.
Hydroxychloroquine (Plaquenil) - antimalarialdrug which is particularly effective in SLE patients with weakness, skin lesions and joints. Hydroxychloroquine reduces the frequency of thrombosis, especially with the availability of so-called antiphospholipid syndrome. Side effects: diarrhea, indigestion, eye pigment changes (so treatment should be carried out under the supervision of an ophthalmologist).
Immunosuppressants - drugs that inhibitimmune system. These drugs are used in severe lupus, when the disease affects the internal organs. By Immunosuppressive include methotrexate, azathioprine, cyclophosphamide, chlorambucil, and cyclosporin.
All of these drugs can cause a drop in the number oferythrocytes, leukocytes and blood platelets, leading to anemia, frequent infections and bleeding. There are other side effects, for example, methotrexate is toxic to the liver, and cyclosporin - to the kidneys. Immunosuppressants can be used only under the strict supervision of a rheumatologist, with regular analyzes of the surrender.
SLE - a serious disease that affects manyorgans that can lead to invadilizatsii and even death. Nevertheless, it is important to understand that patients with SLE can live a normal active life, especially during the remission. A flare-up should be docked with medication.
Ultraviolet radiation can causeexacerbation or worsen its course of disease, so patients with lupus should avoid sun exposure, if necessary - to use clothes with long sleeves and sunscreen.
Patients should be careful to take prescribed medication and in any case not to interrupt sharply corticosteroids - this could provoke an aggravation.
Patients with SLE, especially if they are taking corticosteroids or immunosuppressive agents are at increased risk of infection, so patients should be immediately reported to your doctor about any increase in temperature.
One of the conditions for the successful treatment of SLE -permanent contact between the patient and the doctor. The doctor needs to know about changes in the state of health of the patient, the appearance of new symptoms, side effects of drugs, etc.
Pregnancy in a patient with SLE referred to"High risk" category. All pregnant patients should be seen by a rheumatologist and an obstetrician, since the risk of miscarriage in these patients is very high, especially in the presence of so-called phospholipid antibodies (cardiolipin antibodies, lupus anticoagulant).
Phospholipid antibodies induce propensity tothrombosis, so that patients are often prescribed aspirin (sometimes together with heparin) to "thin out" the blood. Some experts also prescribe special indications immunoglobulin
Volchanochye antibodies can be transmitted from motherto the child, as a result of developing "lupus newborns", characterized by a reduction of red blood cells, platelets and white blood cells in the blood of the child, the appearance of skin rash. Some newborns arises heart block (violation of electrical impulses to the heart) - in such cases, the cardiologist consultation.
neonatal lupus occurs more frequently ifMother detected anti Ro (SS - A) and anti-La (SS - B) antibodies - the risk of developing lupus infant in case is 5% and the risk of heart block - 2%. Usually newborns passes erythematosus after about 6 months, when maternal antibodies in the body of the child destroyed.