SLE is a disease that appears as a result of a pathology of autoimmune actions in the body involving all organs. Systemic lupus erythematosus (ICD-10 ailment assigned a code - M32) is an unpleasant and dangerous disease. The initial indicator of the disease is a distinctive rash on the skin. This is how systemic lupus erythematosus can be recognized. Recommendations for this ailment will be given below.
The disease is not prevalent and is rare enough, in 2-3 cases for every thousand inhabitants, more often among the fairer sex of childbearing age. The risk group primarily includes people with a genetic predisposition and identical twins.
Causes
The causes of systemic lupus erythematosus are not fully understood. It is believed that the provoking factor is the presence of diseased RNA and retroviruses in the body.
Another genetic risk factor is a genetic predisposition to this disease. In women, this disease occurs 10 times more often than in men, since there is a relationship between the occurrence of systemic lupus erythematosus and the hormonal characteristics of the female body (increased estrogen in the blood).
The risk of the disease in women in the reproductive or menopausal periods increases. Men, in turn, are less likely to develop systemic lupus erythematosus, since male sex hormones androgens have a protective effect on their body.
Factors such as the presence of a bacterial infection, the use of antibiotics, hormonal, anti-inflammatory and antifungal drugs, viral lesions, colds increase the likelihood of systemic lupus erythematosus. Smoking can also cause the disease and complicate its course due to vascular damage.
Symptoms and signs
The first signs and symptoms of SLE in women and men can appear instantly and unexpectedly, but can develop gradually. The main common symptoms are decreased performance, lethargy, weight loss, fever.
From the side of the musculoskeletal system, the following symptoms appear:
- Arthritis occurs in 85% of cases. Often, the joints of the hand and knee joints are most affected.
- When treating with hormonal drugs, osteoporosis may appear.
- Muscle pain, lethargy and fatigue during exercise.
The mucous membranes and skin have the following symptoms of systemic lupus erythematosus (photo below):
- At the heart of everything in patients, this symptom appears late, and may not even manifest itself. Only places that are open to the sun are affected. It appears in the form of red spots with peeling that cover the nose and cheeks.
- Hair loss, but it does not happen often in patients, and even if it happens, then in a certain area.
- More than half of patients exhibit sensitivity to sunlight.
- The mucous membrane suffers. Ulcers in the oral cavity, decreased pigmentation and redness.
Respiratory system. Damage to the respiratory system appears in the bulk of patients. Most often it is:
- pleurisy;
- pneumonia;
- pulmonary hypertension;
- infectious diseases associated with the lungs may also develop.
The cardiovascular system. This disease can adversely affect all heart structures:
- Most often, pericarditis occurs - it is an inflammation of the membranes that cover the heart muscle. The main symptom: dull, constant pain in the chest area.
- Myocarditis is an inflammation of the heart muscle. The main symptom: heart failure, heart rhythm disturbance.
- Heart valves and coronary vessels suffer. It can lead to a heart attack, even at a fairly young age.
The kidneys. Symptoms of SLE with kidney damage are as follows: the protein in the blood decreases sharply and sharply, swelling appears, the protein in the urine becomes larger. Often, this symptom does not appear at the beginning of the disease, but later.
Blood. The color indicator of blood becomes lower than normal, white blood cells in the blood are reduced, rarely, but there is a decrease in platelets in the blood. Also, in most cases, there is an increase in lymph nodes and spleen.
Central nervous system. The effect on the central nervous system is often due to damage to the vessels of the brain. Common symptoms of systemic lupus erythematosus:
- migraine;
- headache;
- damage to brain structures;
- hallucinations;
- cerebral stroke;
- inflammation of the lining of the brain;
- violation of the formation of the membrane of the vessels.
Without symptoms, SLE passes only in rare cases and at the initial stage. At the slightest suspicion of a disease, you should contact the clinic.
Diagnostics
To establish an accurate diagnosis of systemic lupus erythematosus , it is necessary to undergo a comprehensive examination. If there is a likelihood of this disease, first of all the patient consults a rheumatologist. The doctor prescribes:
- general blood test (for this disease, an increased ESR is characteristic, platelets, leukocytes, red blood cells are reduced);
- urine (hematuria, proteinuria is observed);
- ECG (pericardial friction noise);
- Ultrasound of the abdominal organs (kidneys - glomerular capillary fibrinoid, hyaline thrombi);
- radiography of bones and joints (epiphyseal osteoporosis, most often brushes);
- radiography of the lungs;
- antinuclear factor analysis.
At the doctor’s appointment, an examination is carried out on the basis of diagnostic criteria for systemic lupus erythematosus according to V. A. Nasonova:
- Temperature over 37.5 degrees for several days.
- "Butterfly" - a rash on the cheekbones and in the nasolabial area.
- Photosensitivity - a rash that occurs due to skin contact with sunlight.
- Mucosal ulcers of the oral cavity.
- Dramatic weight loss in a short time.
- Hair loss.
- Fatigue during physical exertion.
After the examination, the patient goes for a consultation with such specialists as a psychiatrist, neurologist, nephrologist, optometrist. And only after completing the full range of diagnostics can you correctly diagnose.
Lupus erythematosus during pregnancy
Lupus erythematosus is a chronic autoimmune disease characterized by pathologies of the connective tissues and vascular system. In this case, pathological processes occur in the organs and systems of the body, which are subjected to additional stress during pregnancy and childbirth (musculoskeletal system, genitourinary system, respiratory and cardiovascular systems, skin integument, blood vessels).
It is especially important to pay attention to this problem, since women of childbearing age are subject to lupus erythematosus, which is facilitated by the hormonal background and the menstrual cycle.
Symptoms of lupus erythematosus in pregnant women are characterized by such mild phenomena as:
- weight loss;
- increased swelling;
- joint pain;
- fatigue
- general weakness;
- reaction to ultraviolet.
These manifestations may intensify during the period of exacerbation and not be observed during the period of remission. Of course, ideally, a woman who has been diagnosed with lupus erythematosus should consult with a specialist regarding pregnancy risks and threats before planning pregnancy.
The presence of systemic lupus erythematosus (a symptom photo is presented in the article) in some cases can lead to such pathologies of pregnancy and childbirth:
- in pregnant women with kidney damage (nephritis), there may be an increase in protein in the urine and an increase in blood pressure;
- miscarriage (spontaneous abortion);
- treatment of lupus erythematosus with special drugs can lead to premature birth and the birth of a premature baby;
- fetal developmental disorders;
- the appearance of blood clots in the placenta.
You can try to avoid such negative factors if, together with the doctor, you plan to conceive and become pregnant for the period of remission of lupus erythematosus. A pregnant woman with a diagnosis of "systemic lupus erythematosus" should be examined by a rheumatologist (at least three consultations at different times), the development of the fetus should be controlled with the help of modern studies such as ultrasound, fetal monitoring, dopplerometry. Regular blood sampling is also important.
The use of drugs for lupus erythematosus during pregnancy is carried out taking into account their influence on the development of the fetus and the course of pregnancy. Today, lupus erythematosus is not a sentence for a woman who wants to have children. Subject to the recommendations of the doctor, careful monitoring of the pregnancy there is every chance to endure and give birth to a healthy baby.
Lupus erythematosus in children
Systemic lupus erythematosus in children is an autoimmune inflammation in which immunity produces antibodies that affect the DNA of its own normal cells. As a result of lupus erythematosus, specific systemic changes in the body as a whole occur.
This disease, which is not possible to cure, is often affected by girls at puberty. Only 5% of cases are boys. Systemic lupus erythematosus in children is difficult to determine, since its manifestation is very similar to other ailments inherent in children.
Causes of SLE in children
Theories, for what reason such a disease appears in children, are many. The disease has not yet been fully investigated, since no one can indicate its specific causes. Nevertheless, a large number of doctors are inclined to believe that this violation is caused by some kind of virus or a certain infection.
The effect of drugs on the state of the immune system is also not overlooked. As practice shows, they are the trigger mechanism of lupus erythematosus in children with high sensitivity to various factors from the outside. The provocateurs of the disease (not the cause) are:
- sun exposure;
- hypothermia;
- stress;
- fatigue;
- injuries, both psychological and physical.
These circumstances are very significant at the time when hormonal changes in the body occur, its physiological allergization. A huge role in the appearance of this disease is heredity. The “family” cases of the disease, as well as the cases of rheumatism, arteritis and other pathologies of a diffuse nature that are very often noted among the relatives, speak about the nature of the disease of a genetic nature.
Effects
Systemic lupus erythematosus is a disease of the immune system and connective tissue. It is characterized by a negative reaction of the immune system to the connective tissue of human capillaries.
Violation of autoimmune processes is localized in almost all organ systems, such as:
- skin integument;
- kidneys
- heart;
- blood;
- cortex;
- lungs.
The first sign and symptom of SLE is the appearance of a small red rash on the face. The coverage area resembles a butterfly with spread wings. Today, global treatment for SLE is ineffective, however, monitoring your health can reduce the negative effects of symptoms to a minimum.
The main complications
The main secondary negative phenomena of symptoms of SLE disease include:
- Kidney disorders.
- Mental health disorders (delirium, hallucinations, memory impairment).
- Circulatory diseases (anemia, vasculitis).
- Respiratory disorders (pleural inflammation).
- Disorders of the heart and blood vessels (heart attacks, pericarditis, myocarditis).
- Severe pregnancy in women (increased likelihood of miscarriage by 30%).
- Oncological diseases.
Drug treatment
Etiotropic therapy is permissible only in cases where the disease factor is known, i.e., with the pharmaceutical LE syndrome. Already after the cancellation of the provoking medication, the symptoms disappear for a couple of months. In all other situations, it is recommended to beware of drugs that can lead to the development of LE cells and exacerbation of the disease. Anti-inflammatory drugs: salicylates and phenylbutazone - do not have independent significance.
Corticoids. Due to the diverse effects on the body in specific situations, they provide a decisive effect. The main indications for their use:
- A relatively simple course of the disease, in which it is possible to exclude immunosuppressants: the daily dose should not be higher than 10 mg of prednisolone.
- The acute period of the disease, since immunosuppressants do not start working instantly. In these cases, take large doses (100 mg of prednisolone or more), most often combining therapy with immunosuppressive substances. With the onset of remission, the dose of these substances is reduced, and therapy is continued until the process stabilizes. In severe cases, methylprednisolone is used repeatedly in a dose of 1 g.
- Specific medical manifestations of the disease. On the one hand, because of the threat of the development of irreversible changes in the kidneys, one should immediately start active therapy, and on the other hand, the use of immunosuppressants is associated with the risk of a number of complications, for this reason corticosteroids are preferred.
Antimalarial drugs. Most often prescribed hingamine. Its initial portion reaches 300-500 mg. After the onset of improvement, the dose is reduced to a maintenance dose (100-200 mg) and used for a couple of months. The medication is more effective in dermatological than in visceral forms of the disease. Due to possible complications, hingamine is constantly combined with corticoids, the doses of which are also reduced to support over time.
Immunosuppressive treatment. Opinions on the value of this method differ. Some authors believe that suppression should not be general, but intentionally affect an impaired element of immunoregulation. In principle, immunosuppressants should be prescribed only at a time when therapy with the above medications has become ineffective, especially with damage to the kidneys, central nervous system, serous membranes or the heart. On the one hand, one should not rush using these substances, and on the other hand, only their timely exposure can eliminate progressive damage to organs (kidneys).
Alternative treatment
Treatment of systemic lupus erythematosus (SLE) with traditional medicine provides funds for both external use and for oral administration. Most used herbs:
- Birch buds;
- horse chestnut flowers;
- tarragon;
- dioica nettle leaves;
- mistletoe;
- burdock roots;
- celandine;
- white willow bark.
All plants relieve inflammation, have wound healing and diuretic characteristics. They also enrich the body with the missing trace elements and vitamins.
Some recipes are recognized in folk medicine as the most effective for SLE. For example, compresses with tincture of celandine are recommended for external use. They are applied directly to the sore spot. In order to prepare the tincture, you will need alcohol (0.5 l) and celandine (fresh, 100 grams). Celandine is poured with alcohol and infused for 7 days. After that, it is necessary to strain the tincture and send it to a dark place for storage. Celandine is also effective as an ointment. To make it, you need pork fat and celandine juice itself (10: 1 ratio). It is necessary to add celandine juice to the melted fat. Stir until smooth and cool. Affected areas should be treated with ointment 3 p. in a day.
In addition to celandine, ointment with the addition of tarragon is often used in CKD. As a rule, interior fat is taken for it, which is also melted in a steam bath, and tarragon is added in dry form (5: 1 ratio). After connection, the mixture is placed in the oven for 5-6 hours, maintaining a low temperature (up to 30 degrees). At the end, everything is filtered, and after cooling, put in the refrigerator, where the ointment can be stored for 2-3 months.
Compresses and ointments have a beneficial effect on the skin manifestations of the disease. In turn, means for oral administration increase the protective reaction of the whole organism and maintain overall well-being at a good level, for example, it can be an infusion of mistletoe or a decoction of white willow.
For an infusion of mistletoe, it is important that its leaves are pre-harvested in the cold season. They must be washed, dried and ground well. Dried raw materials are poured with water (2 tsp. Per 1 glass of water), brought to a boil, and then insisted for about half an hour. The finished infusion is filtered, distributed into three doses and taken after meals.
If a decoction of white willow was chosen for the treatment of SLE, then only its dried bark should be brewed. For 500 ml of boiling water, 1 tbsp is taken. a spoonful of raw materials. After which the composition again needs to be boiled, make the fire weak and boil for 25 minutes. After the broth is removed from the fire, it is placed for 5 hours in a warm place. Take the finished drug is necessary 3 p. 100 ml per day.
Food
With systemic lupus erythematosus, the regulation of consumed foods helps to greatly improve the effectiveness of treatment. An organism weakened by illness and repeated medication will be better able to cope with its functions if you adhere to certain nutritional rules.
The strictness of dieting and control over food intake largely depend on the degree of the disease. First of all, it is necessary to eliminate smoked dishes, canned food from the diet and minimize salt intake. These products only provoke metabolic disorders. Among the possible undesirable effects of SLE, there is the likelihood of developing diabetes.
If you follow a diet, it is recommended to stop eating sweets, switch to a sweetener. If it is not possible to refuse sweets, honey can be used as a sweetener. Given that nonsteroidal drugs for inflammation and hormonal therapy can cause gastrointestinal irritation, build up fluid in the body and increase appetite, food should be sparing. This implies a rejection of fatty foods and a decrease in carbohydrates.
Also, foods such as fatty fish and meat have hepatotoxic effects on the liver. Therefore, it is advisable to start eating lean meat, lean fish when diagnosing SLE. Avoiding many problems with the intestines will help taking bifidopreparations and dairy products. Most of all useful milk protein in cottage cheese and kefir. Fiber-containing foods (buckwheat, wheat, pearl barley and whole grain bread) have a beneficial effect on the functioning of the gastrointestinal tract.
With systemic lupus erythematosus, clinical recommendations include the use of chicken eggs, all fruits and vegetables (suitable both raw and stewed, and boiled). Do not forget about the proper drinking regimen. The body needs to get enough fluid with systemic lupus erythematosus, but its volume should not overload the kidneys.
The use of any alcohol is prohibited, as it causes an exacerbation of the disease. It should be noted that SLE occurs in each person purely individually, and in each case of exacerbation and remission, the severity of recommendations regarding nutrition can vary.