Systemic Lupus Erythematosus
"It is important to have frequent and detailed medical evaluations to monitor symptoms and adjust treatment as needed".
DR. EUGENIA ENRÍQUEZ MERAYO
SPECIALIST. RHEUMATOLOGY SERVICE
What is lupus?
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 best known and most visible ones affect the skin and 90% of patients suffer from it. It manifests itself by alternating periods of increased activity or more symptoms (exacerbation) with periods of inactivity (remission). 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 emergence of new biological therapies has opened up new avenues of treatment that will improve patients' quality of life.
Symptoms of lupus
Some of the most common symptoms of lupus are as follows:
General symptoms
Tiredness, weight loss and prolonged fever, which is not due to any infectious process.
Joint and muscle symptoms
90% of lupus patients have joint pain and inflammation (arthritis). The most commonly affected joints are those of the fingers, wrists, elbows, knees and toes. It is common for the patient to notice joint stiffness in the morning.
Skin symptoms
The best known, but not the most common lesion is "butterfly wing erythema", which is a redness and rash on the cheeks and nose. Skin lesions in lupus appear anywhere on the body and are generally not uncomfortable.
Symptoms in the heart and lungs
Lupus inflames the lining of the heart (the pericardium) and lungs (the pleura), resulting in pericarditis and pleuritis. Both processes have similar symptoms: chest pain and sometimes fever.
Kidney symptoms
The most common injury is inflammation (nephritis.) Blood urea levels increase, and protein or blood appears in the urine. Kidney damage is asymptomatic, sometimes manifesting as fatigue or increased blood pressure.
Brain symptoms
It is almost impossible to know how often the brain is affected in lupus.
Symptoms such as infections
The lupus patient is susceptible to infections.
Antiphospholipid syndrome
It is characterised by the appearance of thrombosis, repeated miscarriages and haematological alterations (thrombopenia or haemolytic anaemia), associated with the presence of antiphospholipid antibodies (APA). The best known APA are anticardiolipin antibodies and lupus anticoagulant.
Do you have any of these symptoms?
If you suspect that you have any of the above symptoms,
you should consult a medical specialist for a diagnosis.
What causes lupus?
The cause of this inflammatory reaction is unknown; it is probably the result of a combination of genetic, hormonal (it is a much more common disease in women) and environmental factors (viruses, ultraviolet rays from sunlight, medication).
Who can get lupus?
Lupus usually occurs in people in their 20s and 40s, 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 severely affected.
How is lupus diagnosed?
Lupus erythematosus is difficult to diagnose. Diagnosis is based on the patient's symptoms, physical examination and blood tests.
Blood tests often show lower than normal numbers of leukocytes, lymphocytes and platelets.
Virtually 100% of patients have antinuclear antibodies; when these are negative, lupus is practically ruled out.
There are other autoantibodies that are more specific for lupus, such as the so-called anti-DNA or anti-Sm antibodies, whose presence confirms the diagnosis. The presence of antiphospholipid antibodies also helps to diagnose lupus.
How is lupus treated?
General advice
Medical treatment
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- Lupus patients can lead a normal life from a family, work and social point of view.
- It is advisable to do activities such as walking, swimming or cycling to prevent muscle weakness.
- Regular activities should be alternated with periods of rest to control fatigue.
- Anti-inflammatory drugs. They relieve arthritis pain and may suppress other mild symptoms, such as muscle aches and some pleuritis or pericarditis.
- Corticosteroids. They remain the most important drugs for controlling many of the symptoms of lupus. Virtually all complications of lupus are amenable to successful treatment with corticosteroids.
- Antimalarials. These drugs are used in lupus to treat arthritis, some skin lesions and for pleural and pericardial symptoms.
- Immunosuppressants. The most commonly used are azathioprine and cyclophosphamide. These drugs are only used when there are major complications of the disease, especially in the kidney.
- Antiinflamatorios. Alivian el dolor de la artritis y pueden suprimir otros síntomas leves, como los dolores musculares y algunas pleuritis o pericarditis.
- Corticoides. Siguen siendo los medicamentos más importantes para controlar muchos de los síntomas que aparecen en el lupus. Prácticamente todas las complicaciones de esta enfermedad, son susceptibles de ser tratadas con éxito con los corticoides.
- Antipalúdicos. Estos medicamentos se emplean en el lupus para el tratamiento de la artritis, de algunas lesiones de la piel y para cuando existen síntomas pleurales y pericárdicos.
- Inmunosupresores. Los más utilizados son la azatioprina y la ciclofosfamida. Estos medicamentos se emplean únicamente cuando hay complicaciones importantes de la enfermedad, especialmente en el riñón.
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.
Our team of Lupus experts
