Systemic LUPUS
Erythematosus

• What is Systemic Lupus?
• What is going on in the body?
• What are the signs and symptoms of the disease?
• What are the causes and risks of the disease?
• What can be done to prevent the disease?
• How is the disease diagnosed?
• What is ANA Negative Lupus?
• What are the long-term effects of the disease?
• What are the risks to others?
• What are the treatments for the disease?
• What are the side effects of the treatments?
• What happens after treatment for the disease?
• How is the disease monitored?
  

• Systemic lupus erythematosus, OR SLE, is an autoimmune disorder that affects many parts of the body. An autoimmune disorder is a condition in which the body creates antibodies against its own tissues.
  
  
• Systemic lupus erythematosus, OR SLE, is an autoimmune disorder that affects many parts of the body. An autoimmune disorder is a condition in which the body creates antibodies against its own tissues.
  
  
• A person with SLE produces antibodies against many of his or her own tissues. This autoimmune reaction can damage many parts of the body.
  These include:
  · brain and nervous system
  · digestive system
  · eyes
  · heart
  · joints and muscles
  · kidney
  · lung
  · skin
  
  
• Because SLE affects so many different parts of the body, the disease has many signs and symptoms. These are best listed by organ system.
  
  Signs and symptoms that affect the whole body:
  · fatigue
  · fever
  · loss of appetite
  · nausea
  · weight loss
  
  Signs and symptoms that affect the skin:
  · hives
  · loss of scalp hair
  · red malar rash on the cheeks and bridge of the nose in the shape of a butterfly
  · red, raised rashes in areas exposed to the sun
  · sensitivity to the sun, exhibiting rash, nausea, fever, dizziness and possible joint pain
  · ulcers of the mouth, nose, or vagina (usually painless)
  
  Symptoms and signs that affect the muscles, bones, and joints:
  · arthritis
  · hand deformities
  · joint pains, especially in the hands, wrists, and knees
  · loss of the blood supply to bone, especially hips and shoulders (necrosis)
  · serious infection within a joint
  · muscle pains and weakness
  
  Signs and symptoms of kidney involvement:
  · blood in the urine
  · decrease in kidney function or kidney failure
  · protein in the urine
  · white blood cells in the urine
  
  Signs and symptoms affecting the central nervous system:
  · bleeding in the brain, known as intracerebral hemorrhage
  · headaches, including migraines
  · loss of coordination
  · memory loss, problems with concentration
  · numbness, pain, or a feeling of "pins and needles" in the hands and feet
  · problems with the major nerves in the head and face
  · seizures
  · strokes
  
  Signs and symptoms involving the blood:
  · anemia, which is a low red blood cell count
  · low blood platelet count
  · low white blood cell count
  · problems with both blood clotting and bleeding
  
  Signs and symptoms involving the heart:
  · fluid collection in the sac around the heart, known as pericardial effusion
  · heart attack
  · heart valve problems
  · inflammation and infection in the heart
  · inflammation of the lining of the heart
  
  Signs and symptoms involving the lungs:
  · cough, including coughing up blood
  · fluid in the lung
  · inflammation in the lung
  · inflammation of the lining of the lungs
  · shortness of breath
  
  Signs and symptoms affecting the digestive system:
  · abdominal distress
  · diarrhea
  · enlargement of the liver
  · intestinal perforation due to inflammation of blood vessels
  · loss of appetite
  · nausea and vomiting
  · rectal bleeding caused by ulcerations
  
  Symptoms and signs affecting the eyes:
  · blindness
  · conjunctivitis, which is inflammation of the outer lining of the eye
  · damage to the retina, which may cause visual impairments
  
  
• The exact cause of systemic lupus erythematosus is unknown. It is believed to be an autoimmune disorder. SLE tends to run in families.
  
  Certain medications have been known to cause systemic lupus erythematosus. These include procainamide, hydralazine, isoniazid, and chlorpromazine.
  Events that may trigger the disease include infection, stress, exposure to toxins, and sunlight. due to extreme photosensitivity.
  
  Women account for 80% to 90% of cases of SLE. It is more common in black women than in white women. SLE is also more common in Asian, Hispanic, and Native American women comparative to caucasians.
  
  
• Most cases of systemic lupus erythematosus cannot be prevented. It may be helpful to avoid medications that cause SLE, but not everyone who takes the indicated medications will develop the disease.
  
  
• A complete medical history and physical examination are important tools for diagnosing SLE. Blood tests also play an important role. A blood test called an ANA looks for antibodies that the person has produced against his or her own tissues.
  
  Other tests used to diagnose SLE include the following:
  · CT scan
  · chest X-ray
  · electrocardiogram
  · kidney biopsy
  · MRI scan
  · spinal tap
  
  
• With ANA negative lupus there is a higher incidence of both photosensitive and cutaneous involvement,
  Arthritis and Raynaud's phenomena are common.
  There is a low frequency of both renal and CNS involvement.
  Many patients have a positive rheumatoid factor.
  Prognosis is better than that given to patients who are diagnosed with positive ANAs.
  
  
• SLE is a long-term disease that has a cyclical flare to remission to flare pattern. Persons with SLE often have a significant decrease in the quality of daily life. Many complications of SLE put the person at risk. Many of the medications used to treat the disease also have significant side effects. SLE can be fatal, often as a result of kidney failure, infections, or cardiac issues.
  
  
• There is no evidence that SLE is a contagious disease that can be passed from one person to another. However, it does tend to run in families. Pregnant women with SLE have an increased risk of miscarriages, stillbirths, and premature infants.
  
  
• Although there is no cure for SLE, certain things can help prevent flare-ups. Persons with SLE should avoid any unnecessary stress that can be avoided and intense sun exposure. Liberal use of sunscreens, long-sleeved shirts, and hats are helpful.
  
  Since infections are common, persons with SLE should seek prompt evaluation of fevers. A yearly flu vaccine is recommended. If the spleen is removed, the person should receive the pneumococcal vaccine also. Individuals with cardiac valular problems should also receive antibiotics before any dental procedures.
  
  A number of medications are used to treat SLE, including the following:
  · antimalarial medications, such as chloroquine and plaquenil. These are used to treat skin problems and arthritis and are also helpful with the antiphospholipid syndrome.
  · corticosteroids, such as prednisone and methylprednisolone and for some patients decadron can be helpful.
  These steroid medications reduce the immune system response and help with inflammation systemically.
  · nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and naproxen.
  These medications reduce fever and treat pain.
  · powerful immuno-suppressive/cytotoxic medications, which kill cells (chemo-therapy meds).
  These are used to treat nephritis, and any serious kidney problems as well as other organ involvement and CNS involvement.
  **Individuals with end-stage kidney disease may benefit from kidney dialysis or a kidney transplant.**
  
  
• The medications used to treat lupus have significant side effects. Unfortunately, some of these side effects can mimic the symptoms of the disease itself so you must know your illness well as well as the triggers that set off a flare.
  
  NSAIDs can cause stomach irritation, allergic reaction, and decreased kidney function.
  
  Antimalarial medications can cause rash, muscle weakness, and nerve problems.
  
  Corticosteroids have a host of possible side effects. These include weight gain, high blood pressure, osteoporosis, and increased risk of infection.
  
  The cytotoxic medications can cause problems with the bladder and with blood cell production.
  
  
• Systemic lupus erythematosus is a chronic disease that fluctuates over time. The best way to manage it is by active collaboration between you, the individual and your healthcare providers, including your specialists. You should be your own advocate and learn about your illness and your medications and be a part of the team that looks after you, actively speaking with your doctors and pharmacist and anyone involved in your medical care. Compliance is the key to staying well with lupus.
  
  

• Periodic examinations allow the healthcare provider to monitor the activity of the disease and determine possible complications. A variety of blood tests help in the monitoring of the disease. Any new or worsening symptoms should be reported to your primary healthcare provider who will then send you to the appropriate specialists if necessary.