Many patients are interested in: "Systemic lupus erythematosus - what is this disease?", "How exactly does such a disease manifest itself?". Doctors still cannot say exactly why it is developing. If the first signs of lupus occur , you need to see a doctor and conduct comprehensive treatment to prevent dangerous complications.
Pathology refers to diffuse connective tissue disorders or collagenoses. This disease proceeds with damage to all organs where this tissue is present. In addition, the walls of blood vessels are additionally inflamed.
Doctors note that systemic lupus erythematosus has a genetic predisposition that occurs under the influence of various provoking factors.
The history of development
The history of systemic lupus erythematosus can be divided into 3 periods, namely:
- classical;
- neoclassical;
- modern.
It was classified as an autoimmune disease in 1851, and now a variety of diagnostic measures and treatment methods are available to patients. Modern advances in medicine can significantly extend the life of patients.
It is believed that the disease got its name from the fact that the rashes resemble a wolf’s bite, since the lesions on the skin have holes and notches. Systemic lupus erythematosus was first discovered in the Middle Ages. There was no official treatment, and the number of methods aimed at relieving symptoms was limited.
The neoclassical period began in 1851. The French doctor Michel Cazenave was the first to note that this disease mainly develops in adolescents and adults aged 30-39, and also that a distinctive feature is the presence of rashes on the face. In addition, at this time, doctors identified various types of systemic lupus erythematosus, and also identified provocative factors and treatment features.
The modern period began in 1920, and at that time there was a big shift in research regarding the identification of the causes and treatment of the disease. Also, doctors were able to determine exactly how systemic lupus erythematosus affects cardiac, renal and pulmonary tissue.
Disease feature
Systemic lupus erythematosus - what is it? This question is of interest to many people who have characteristic rashes. This is one of the most serious diagnoses, since with untimely treatment, the disease leads to damage to the muscles, joints, organs and blood vessels of a person. However, with the strict implementation of all the recommendations of the doctor, patients manage to lead a full, normal life.
Often this pathology develops in women under 35 years old. In men, systemic lupus erythematosus is diagnosed 10 times less, which is explained by the characteristics of the hormonal background. The causes of the disease are not yet fully understood, however, there are many predisposing factors.
Many doctors are inclined to believe that the development of the disease occurs due to mutations in the genes that are responsible for the functionality of the immune system, which, when exposed to certain factors, is aggressive.
The activity of systemic lupus erythematosus largely depends on the form and degree of the course of the disease. Its course is completely unpredictable and uncontrolled, and is also characterized by periods of exacerbation, alternating with remission.
Forms of the disease
It is important to know not only what kind of systemic lupus erythematosus is this disease, but also what forms are there and what they are characterized by. The discoid form is characterized by the appearance of rashes affecting the cheekbones, face, nose, spreading to the cheeks. The rash in its shape is very reminiscent of a butterfly.
When establishing a diagnosis, such stages of lupus are determined as:
- inconsistent redness with signs of cyanosis;
- the formation of persistent erythematous spots with swelling;
- the presence of bright spots, swelling;
- in discoid elements there is a distinct atrophy and scarring.
In some cases, rashes can go to other areas of the body, in particular, the forehead, scalp, earlobes, trunk, limbs. Certain types of disease can occur non-specifically, namely, purpura, urticaria, and nodules.
Doctors also distinguish such forms of lupus, such as drug and tuberculosis. The last pitchfork of lupus is characterized by the fact that the cause of the disease is Koch's bacillus, which is the causative agent of tuberculosis of any type and contributes to its localization.
Treatment of this form is aimed at eliminating the underlying disease and the consequences of manifestations of lupus. Lupus erythematosus, which occurs when certain drugs are taken, can also be attributed to a separate form, but it has a reversible character and passes after drug withdrawal.
Classification by nature of the course
According to the classification, systemic lupus erythematosus is divided into several specific species, which are divided into:
- symptoms of the onset of the disease;
- the degree of severity of the initial period;
- activity of the pathological process;
- the effect of the use of hormonal agents;
- nature of the course;
- progression speed;
- morphological lesions of the body;
- the duration of the course.
In this regard, several types of course are distinguished, in particular: acute, subacute and constant (chronic). The acute course of the disease is characterized by a sudden onset that the patient cannot even say exactly when the disease overtook him. Pathology is accompanied by a rapid increase in temperature, the development of serositis and polyarthritis. Multiple organ damage and rapid involvement in the pathological process of the nervous and excretory systems leads to a sharp deterioration in well-being. The use of glucocorticosteroids can significantly extend the period of remission.
The subacute course is characterized by a gradual development of the disease, therefore, the skin and joints suffer initially, and then all other organs join the pathological process with each subsequent relapse. The disease develops very slowly, over 5-6 years, and also has a multi-syndromic course.
The constant course of the disease has an imperceptible onset and the presence of one syndrome, while others join a little later, only after a few years. In addition, the disease can become chronic. Knowing that this is a systemic lupus erythematosus, it is possible to timely recognize the presence of violations and conduct treatment.
Disease in children and pregnant women
Many are interested in how the doctor determines that this is a systemic lupus erythematosus, and whether it can occur in childhood. This disease is quite common in young children and adolescents. Often girls get sick, their pathology is found about 3 times more often than boys.
The causes of the disease, the nature of the course, symptoms and therapeutic measures are practically no different from adult therapy. Quite often, such concepts as systemic lupus erythematosus and pregnancy are interconnected. During the bearing of the child, this disease may occur for the first time or its exacerbation may develop. However, it is possible that during pregnancy, a woman's well-being may improve.
Due to the high level of development of medicine, artificial termination of pregnancy is not carried out now, if suddenly a woman has this diagnosis. However, pregnancy management by gynecologists and rheumatologists is required. In some cases, complications in the form of thrombosis, bleeding and fetal death may occur during gestation.
Causes of occurrence
When the first signs of pathology occur, many ask themselves questions: "So what kind of disease is systemic lupus erythematosus?", "For what reasons does it arise?" and "How is the treatment given?" So far, it has not been possible to answer the question of why it occurs, since the disease has no specific causes.
This is an autoimmune disease, which is accompanied by the production of specific antibodies to their own tissues and cells. This is due to genetic abnormalities, that is, it can be said that the disease has a hereditary predisposition.
In the origin of the disease, the presence of infection in the body is of no small importance, while the appearance of pathogens is completely unimportant, since the main point is the deterioration of immunity and the production of antibodies. At the site of introduction of the pathogen, favorable conditions are created for the formation of specific immunoglobulins. Among other provoking factors, it is necessary to distinguish such as:
- prolonged exposure to the sun;
- abortion and childbirth;
- fluctuations in hormonal levels;
- stress;
- psycho-emotional overstrain;
- taking certain medications.
The combination of all these causes contributes to the onset of this disease, which can occur in a variety of forms, on which the clinical picture largely depends.
Main symptoms
The first symptoms of systemic lupus erythematosus in adults are considered such as:
- joint damage;
- skin rashes;
- temperature rise;
- feeling of fatigue, severe weakness;
- losing weight.
The onset of the disease is characterized by very acute manifestations, and signs are characteristic of it:
- polyarthritis;
- jade;
- fever
- skin lesions;
- polyserositis.
The clinic of systemic lupus erythematosus, proceeding in a chronic form, is mainly limited for a long time to the presence of only one syndrome, for example:
- arthritis;
- Raynaud's syndrome;
- discoid lupus.
However, after about 10 years, as a result of the progression of the pathology, other organs are also affected. With the development of functional organ failure, the patient may die.
The clinic of systemic lupus erythematosus with skin lesions is similar to the signs of the dioxide form of the disease. In the presence of articular syndrome, almost all patients note the presence of migratory pain, as well as limited mobility in the joints. Sometimes these symptoms are added to these symptoms, such as:
- atrophic muscle change;
- muscle inflammation;
- deformation of the fingers;
- muscle pain;
- bone soreness.
Serositis is an inflammation of the serous membranes that occurs against the background of systemic lupus erythematosus. It includes such manifestations as:
- dermatitis;
- inflammation of the pericardium;
- arthritis;
- peritonitis;
- pleurisy.
Serositis has a tendency to relapse, while forming adhesions and scars in the pericardium and pleura. Among the main symptoms, it is necessary to highlight the presence of pain, noise during friction of the pleura and peritoneum.
The defeat of the cardiovascular system is not limited to pericarditis. Large vessels, myocardium are affected. In this case, there is pain in the heart, tachycardia, shortness of breath, low blood pressure. The inflammatory process can also affect the respiratory, digestive, kidneys, liver, and nervous system. Kidney damage in systemic lupus erythematosus is observed in about half of patients, the disease is accompanied by the development of pyelonephritis, nephrotic syndrome, nephritis. In some cases, the disease can begin with a pathology that resembles the nephropathy of pregnant women.
These are only the main signs of systemic lupus erythematosus, as it can have many other manifestations, so if you feel unwell and have rashes, you need to visit a doctor for diagnosis and treatment.
Diagnostics
Noticing the first manifestations of systemic lupus erythematosus, you need to visit a doctor for a comprehensive diagnosis and treatment. The diagnosis is established on the basis of a detailed medical history, examination data and analyzes. The complex of diagnostic measures includes such laboratory methods as:
- blood analysis;
- liver test;
- Analysis of urine.
Among the additional research methods, radiography, echocardiography, tomography, and joint puncture are used. If there is a suspicion of a pathological change in the kidneys, a biopsy is prescribed.
Treatment feature
Therapy of systemic lupus erythematosus is prescribed purely individually. A dermatologist determines the main type of therapeutic effect, which in the shortest possible time allows you to eliminate the characteristic manifestations of the disease.
Adults are prescribed antimalarial drugs, the dosage and duration of use of which is selected individually. During the treatment, the doctor constantly monitors the patient’s well-being. The safest drugs are selected for the treatment of children and pregnant women, and an adjustment is also made during the treatment process.
It should be noted that it is impossible to achieve a complete cure, but with the right therapy and constant monitoring, it is possible to reduce symptoms and normalize the patient’s well-being.
Therapeutic treatment
To reduce the symptoms of systemic lupus erythematosus, treatment should be started immediately when any stage of the disease is detected. With an integrated approach, you can get a good result. The therapeutic method involves the use of physiotherapeutic techniques that enhance the effects of drugs.
You can apply the method of magnetotherapy, radiation at minimum dosages, which will be effective to stop the ongoing pathological process. You also need to normalize the time of work and rest.
Drug therapy
The main goal of treating systemic lupus erythematosus with drugs is to suppress the outbreak of an autoimmune reaction of the body. Patients are prescribed drugs such as:
- glucocorticosteroids;
- cytostatics;
- anti-inflammatory drugs.
Glucocorticosteroids help eliminate inflammation and reduce the activity of the immune system. For treatment, a drug such as Prednisolone is prescribed. Without hormone therapy, life expectancy is very low.
Cytostatics are prescribed in combination with glucocorticosteroids. They are used if hormones are not effective enough. Cytostatics are also aimed at reducing immunity. Among the main indications for the appointment of these drugs, it is necessary to highlight such as:
- high activity of the disease and its rapid progression;
- involvement in the pathological process of the kidneys;
- low effectiveness of hormone therapy.
Often, Azathioprine or Cyclophosphamide are prescribed for treatment. Among the main criteria for treatment with cytostatics can be identified such as:
- elimination of dependence on hormones;
- persistent remission;
- decrease in the intensity of symptoms;
- decreased activity of the disease.
Anti-inflammatory drugs are prescribed to reduce joint symptoms. Often, patients are prescribed Indomethacin, Diclofenac tablets. Treatment continues until the temperature normalizes and pain in the joints disappears. Plasmapheresis can be prescribed as additional methods of conducting therapy. During the procedure, metabolic products, as well as compounds that provoke inflammation, are removed from the patient’s blood.
Power Features
Be sure to follow a special diet that will help fight lupus and protect internal organs from damage. You need to limit fatty foods, caffeinated drinks, alcohol and salt. It is recommended to consume a lot of fresh vegetables and fruits, foods high in calcium. Dairy products will help prevent the development of osteoporosis, which often occurs while taking glucocorticosteroids. In addition, it is better to drink drugs with milk so that they irritate the mucous membrane less.
A sufficient amount of protein should be present in the diet, as it helps the body fight the disease. That is why it is recommended to eat lean meat and fish. Seafood contains a lot of omega-3 fatty acids, as they are required for the normal functioning of the heart and brain. Drinking regimen is very important, you should try to use at least 8 glasses of pure mineral water per day. This will help normalize general well-being, control hunger and improve the functioning of the stomach and intestines.
Possible complications
Systemic lupus erythematosus often provokes very serious complications, especially if you do not pay attention to the presence of a problem in time. Some of them lead to disability, while others lead to the death of the patient. At first glance, these are just rashes on the body, but they can lead to very deplorable consequences. The main complications include conditions such as:
- hypertension
- atherosclerosis;
- vasculitis;
- liver damage.
The incubation period can last a long time, which is the main danger in such a disease.If systemic lupus erythematosus occurs in pregnant women, then it often leads to premature birth or miscarriage. Among the complications, it is necessary to highlight the change in the emotional state of the patient.
Changes in mood are often observed in women, and men are much easier to tolerate this disease. Complications in emotional terms include:
- epileptic seizures;
- depression;
- neurosis.
Since this is a rather rare disease, the causes of which are not fully understood, when the first signs appear, it is necessary to carry out complex treatment and avoid provoking factors. This will avoid the development of complications.
Forecast and Prevention
With systemic lupus erythematosus, the prognosis for the patient's life largely depends on the form and characteristics of the course of the disease. Only with the dosage form of treatment can the prognosis be favorable. The discoid type of the disease can be cured in about 40% of cases.
With a generalized form of systemic lupus erythematosus, the prognosis for life is not so favorable. With early diagnosis and the correct treatment, remission occurs in about 90% of cases, which can significantly extend life and improve its quality. However, with early damage to the internal organs, the prognosis becomes unfavorable.
It is necessary to carry out prophylaxis, as this will prevent the progression of pathology. The preventive complex includes:
- timely, comprehensive therapy;
- regular visits to the doctor;
- strict adherence to the dosage of the drug;
- strict observance of the daily routine;
- dieting.
In case of skin lesions, the use of sunscreens is required before going out. In infectious diseases, strict adherence to bed rest, desensitizing and antibacterial therapy are indicated. As a preventive measure, it is also advisable to perform a comprehensive examination of the closest relatives of the patient with lupus.