Systemic Lupus Erythematosus
"It is important to have frequent and detailed medical evaluations to monitor symptoms and adjust treatment as needed".
DR. Mª JOSÉ CUADRADO LOZANO
DIRECTOR. RHEUMATOLOGY SERVICE
Lupus is a chronic disease in which the patient's immune system attacks different organs and tissues (it can affect the skin, joints, kidneys, lungs, nervous system, etc.) causing damage and inflammation.
Symptoms vary greatly from patient to patient. The most known and visible affect the skin and suffer 90% of patients.
It is manifested by alternating periods of increased activity or more symptoms (exacerbation) with others of inactivity (remission). The attacks can be mild or severe.
As an autoimmune disease, there is no cure, but it can be controlled with drugs that can regulate the immune system and stop inflammation. In addition, the recent irruption of new biological therapies have opened new avenues of treatment that will improve the quality of life of patients.
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What are the symptoms of lupus erythematosus?
Lupus is a disease that can affect several organs:
1. General symptoms: tiredness, weight loss and prolonged fever, which is not due to any infectious process.
2. Joint and muscular symptoms: 90% of lupus patients have pain and inflammation of the joints (arthritis.) Those most affected are those of the fingers, wrists, elbows, knees and feet. It is frequent that the patient notices articular stiffness in the mornings.
3. Skin: The best known lesion, although not the most frequent, is "erythema on butterfly wings", which consists of a redness and rash of the skin on the cheeks and nose. Lupus skin lesions appear anywhere on the body and are generally not uncomfortable.
4. Heart and lungs: Lupus inflames the lining of the heart (the pericardium) and lungs (the pleura), resulting in pericarditis and pleurisy. Both processes have similar symptoms: chest pain and sometimes fever.
5. Kidney: The most frequent lesion is inflammation (nephritis.) Urea increases in the blood, and protein or blood appears in the urine. The injury to the kidney is asymptomatic, sometimes manifesting itself as fatigue or increased blood pressure.
6. Brain: It is practically impossible to know how often the brain is affected in lupus.
7. Infections: The patient with lupus is sensitive to infections.
8. The antiphospholipid syndrome: It is characterized by the appearance of thrombosis, repeated miscarriages and hematological alterations (thrombopenia or hemolytic anemia), associated with the presence of antiphospholipid antibodies (AAF). The best known AAFs are the anti-cardiolipin antibodies and the lupus anticoagulant.
Do you have any of these symptoms?
You may have systemic lupus erythematosus
What are the causes?
The cause of this inflammatory reaction is unknown.
It is probably the result of a combination of genetic tendencies, hormones (it is a much more frequent disease in women) and environmental factors (viruses, ultraviolet rays from sunlight, medications).
Who can suffer from it?
Lupus usually appears in people between the ages of 20 and 40, and is 10 times more common in women than in men.
It is more common among blacks and Asians, who also tend to be more seriously affected.
How is lupus diagnosed?
Lupus erythematosus is difficult to diagnose. The diagnosis is based on the patient's symptoms, physical examination and analysis.
In blood tests, it is common for the number of leukocytes, lymphocytes and platelets to be lower than normal.
Practically 100% of the patients present antinuclear antibodies; when they are negative, the existence of this disease is practically excluded.
There are other autoantibodies more specific to lupus, such as the so-called anti-DNA or anti-Sm antibodies, whose presence allows confirming the diagnosis. The presence of antiphospholipid antibodies also helps to diagnose lupus.
How is systemic lupus erythematosus treated?
- The lupus patient can lead a normal life from a family, work and social point of view.
- Activities such as walking, swimming, or cycling are recommended to prevent muscle weakness.
- Regular activities should be alternated with periods of rest to control fatigue.
- Anti-inflammatory. They relieve the pain of arthritis and can suppress other mild symptoms, such as muscle aches and some pleurisy or pericarditis.
- Corticosteroids. They remain the most important medications for controlling many of the symptoms that appear in lupus. Virtually all of the complications of this disease can be successfully treated with steroids.
- Antimalarial drugs.
These medications are used in lupus for the treatment of arthritis, some skin lesions and when there are pleural and pericardial symptoms.
- Immunosuppressants. The most used are azathioprine and cyclophosphamide. These drugs are used only when there are major complications of the disease, especially in the kidney.
Where do we treat it?
IN NAVARRE AND MADRID
The Rheumatology Service
of the Clínica Universidad de Navarra
The Rheumatology Service has a multidisciplinary team highly specialized in the diagnosis and treatment of rheumatological diseases, from osteoarthritis, arthritis or osteoporosis to autoimmune or inflammatory diseases.
In addition, we have doctors specialized in assisting pregnant women with autoimmune diseases, in order to guarantee the maximum safety of the fetus.
Organized in specialized units
- Inflammatory arthropathies.
- Degenerative arthropathies.
- Microcrystalline arthropathies.
- Bone pathology.
- Systemic autoimmune diseases.
- Autoinflammatory diseases.
Why at the Clinica?
- Valoración integral del paciente.
- Diagnóstico personalizado.
- Tecnología de vanguardia.