Systemic lupus erythematosus : causes, clinical features and treatment

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects many parts of the body.

It is characterized by the production of antibodies that attack the body’s own tissues, leading to inflammation and damage to various organs, such as the skin, joints, heart, lungs, kidneys, brain, and nervous system.

Causes of Systemic lupus erythematosus

The exact cause of systemic lupus erythematosus (SLE) is unknown, but it is thought to be a combination of genetic, environmental, and hormonal factors.

Some potential causes and contributing factors include:

• Genetics: SLE is more common in people with a family history of the disease, suggesting a genetic component.
• Environmental triggers: Certain environmental triggers such as sun exposure, infections, stress, and certain medications can trigger or worsen SLE symptoms.
• Hormonal factors: Hormonal changes, such as those that occur during pregnancy, can cause SLE to worsen.
• Immune system dysfunction: SLE is caused by an overactive immune system that attacks healthy tissues in the body. This leads to inflammation, pain, and tissue damage.
• Hormonal imbalances: Hormonal imbalances, such as those caused by low levels of estrogen or testosterone, can contribute to the development of SLE.

It is important to note that the cause of SLE is still not fully understood, and research is ongoing to better understand the underlying mechanisms

Clinical features of Systemic lupus erythematosus

Systematic lupus erythematosus are as follow.

1. Fatigue: One of the most common symptoms of systemic lupus erythematosus is persistent fatigue, which can interfere with daily activities.
2. Joint pain and swelling: Joint pain and swelling are common in lupus patients and can be severe enough to limit mobility.
3. Skin rashes: A characteristic rash called a “butterfly rash” is a common symptom of lupus and can appear on the face and neck.
4. Hair loss: Hair loss is common in lupus patients and can be sudden or gradual.
5. Mouth sores: Sores in the mouth or throat are another common symptom of lupus.
6. Anemia: Lupus can cause anemia, which is a condition characterized by low levels of red blood cells.
7. Sensitivity to sunlight: Lupus patients are often more sensitive to sunlight, and exposure can cause rashes, skin damage, and other symptoms.
8. Neurological symptoms: Lupus can also cause neurological symptoms such as headaches, seizures, and cognitive difficulties.
9. Kidney problems: Lupus can affect the kidneys, leading to inflammation and damage, which can cause swelling, proteinuria, and kidney failure.
10. Fever: Lupus patients often experience fevers without any obvious cause.
11. Chest pain: Chest pain can also be a symptom of lupus, often caused by inflammation of the lining of the heart or lungs

Investigation done in Systemic lupus erythematosus

1. Complete blood count (CBC) to evaluate for anemia, leukopenia, or thrombocytopenia.
2. C-reactive protein (CRP) test to measure inflammation levels.
3. Antinuclear antibody (ANA) test to check for autoimmune disorders.
4. Erythrocyte sedimentation rate (ESR) test to measure the speed at which red blood cells settle at the bottom of a test tube.
5. Complement levels to check the function of the immune system.
6. Kidney function tests, including creatinine and blood urea nitrogen (BUN) levels.
7. Liver function tests, including aspartate transaminase (AST) and alanine transaminase (ALT) levels.
8. Lupus anticoagulant test to check for blood clotting problems.
9. Anti-dsDNA test to check for lupus nephritis, a kidney complication of systemic lupus erythematosus.
10. Chest X-ray or CT scan to check for lung involvement.
11. Electrocardiogram (ECG) to evaluate heart function.
12. Rheumatoid factor (RF) test to rule out rheumatoid arthritis.
13. Urinalysis to check for protein or red blood cell levels in the urine, indicating kidney involvement.
14. Biopsy of affected tissue to confirm diagnosis.

Treatment of Systemic lupus erythematosus

1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These drugs reduce inflammation and relieve pain.
2. Corticosteroids: Prednisone and other corticosteroids can suppress the immune system, reduce inflammation, and control symptoms.
3. Antimalarials: Drugs like hydroxychloroquine and chloroquine can help prevent flare-ups and relieve joint pain and skin rashes.
4. Immunosuppressants: Drugs like azathioprine, methotrexate, and mycophenolate mofetil can suppress the immune system to prevent flare-ups and organ damage.
5. Biologics: Newer drugs like belimumab and rituximab target specific proteins in the immune system to reduce inflammation and prevent flare-ups.
6. Non-Pharmacologic Treatments: Physiotherapy, rehabilitation, and other non-drug treatments can help relieve symptoms, improve mobility, and reduce pain.

It is important to work with a doctor to develop a personalized treatment plan that takes into account the severity and type of symptoms, as well as individual health needs and preferences.