Systemic lupus erythematosus, also called SLE or lupus, is a chronic disorder that can cause inflammation, pain and tissue damage throughout the body. SLE is an autoimmune disease in which a person’s immune system attacks its own tissues as though they were foreign substances. This disease is very common in females and affects a significant number of Anguillian women.

What is SLE?
SLE is a multisystem autoimmune disease where the body’s tissues are attacked by it own immune system. The immune system is a very complex system that is designed to fight infectious agents and other foreign invaders. One of the mechanisms that the immune system uses to fight infections is the production of antibodies. Individuals with SLE produce abnormal antibodies in their blood that target the body’s own tissues. SLE can affect any area of the body causing disease of the skin, heart, lungs, kidneys, joints and the nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus. SLE is more common in women then men (about 8-10 times). The disease can occur in all ages but commonly begins from age 20 to 45 years.

What causes SLE?
The exact cause of SLE is not known. There appears to be no single cause and many researchers believe that a combination of factors affect the immune system and trigger a reaction that causes SLE. Viruses, inherited genes, ultraviolet light, infections, hormones and drugs have all be implicated as a causative factor for SLE.

What are some of the symptoms of SLE?
The symptoms of SLE may vary depending on the organ that is involved. Common symptoms include the following:
• Fatigue
• Skin rash – rash on face “butterfly” rash
• Muscle aches
• Arthritis -swollen tender joints
• Low - grade fever
• Ulcers of the mouth and nose
• Unusual sensitivity to sunlight (photosensitivity)
• Kidney abnormalities
• Seizures
• Chest pain
• Hair loss (alopecia)

How is SLE diagnosed?
It can take a long time to make the diagnosis as there is no single definitive test for SLE. A diagnosis is based on a combination of signs, symptoms and blood tests.

How is SLE treated?
There is no permanent cure for SLE. The goal of treatment is to relieve symptoms and protect organs by decreasing inflammation and or the level of autoimmune activity in the body. You can control mild to moderate symptoms with proper self-care such as appropriate rest, exercise, avoiding sun exposure and intermittent anti-inflammatory medications. If you have more serious symptoms, especially if it involves vital organs, your doctor may prescribe corticosteroids or other medications that suppress the immune system.

How can patients with SLE help prevent disease activity?
Most patients with SLE can live a fully active, healthy life. In a few cases the symptoms can become very severe and can be potentially very serious. Periodic increases in disease activity, also called flares, can be managed with various medications. As ultraviolet light can cause and worsen flares, individuals with SLE should avoid sun exposure. Sunscreens and clothing covering the extremities can be helpful.
Abruptly stopping mediations, especially corticosteroids, can cause flares and should be avoided. Patients with SLE should be under close supervision by their doctor and communication with their doctor is crucial for optimum care.

SLE and pregnancy
Patients with SLE who become pregnant are considered “high risk” pregnancies and should be under the care of an experienced and qualified obstetrician. These women have an increased risk of miscarriages and flares during pregnancy. Lupus antibodies can be transferred from the mother to the fetus and result in lupus illness in the newborn. There may be problems in the newborn’s heart as well.
New research has shown that the oral contraceptive pill does NOT increase the rate of flares in SLE, but the PILL should be avoided in women who have phospholipid antibodies or who are at an increased risk of blood clotting.

Conclusion
SLE is a multisystem inflammatory disease of unknown aetiology. It is characterized by an overproduction of autoantibodies. This disease can affect any organ with varying effects. Organs commonly affected are the kidneys, heart, lungs, brain and skin. Individuals with symptoms suggestive of SLE should consult with their doctor for a full evaluation. The outlook for individuals with SLE is improving with the development of new tests and treatments. Patients are now more knowledgeable about their condition and can closely monitor their symptoms and also communicate with their doctor resulting in improved care.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

| Printer-friendly page | Send this article to a friend |

World News