Pathophysiology - Systemic Lupus Erythematosus

Contents

Introduction        

Signs and Symptoms        

Causes        

Risk Factors        

Diagnostic Tests        

Treatment        

References        

Introduction

The immune system is responsible for fighting off dangerous infections and bacteria in order to keep your body healthy. When healthy, it protects the body by making antibodies (blood proteins) that attack foreign germs and cancers. With lupus, the immune system misfires and instead of producing protective antibodies, an autoimmune disease begins and makes “autoantibodies,” which attack the patient’s own tissues. As the attack goes on, other immune cells join the fight which leads to inflammation and abnormal blood vessels (vasculitis). These antibodies then end up in cells in organs, where they damage those tissues. SLE may affect various parts of the body but most often affects the skin, joints, blood, and kidneys. Systemic Lupus Erythematosus is a chronic disease that can have phases of worsening or mild symptoms (flares) that alternate with periods of no symptoms (remission).

Discoid (Cutaneous) Lupus Erythematosus (chronic skin condition of sores with inflammation and scarring favoring the face, ears and scalp. It is also a type of lupus that is confined to the skin and does not affect other parts of the body, about 10% of people with this type of lupus go on to develop SLE), Drug-Induced Lupus (is a temporary and mild form of lupus caused by certain prescription medications), and Neonatal Lupus (rare autoimmune disease that is present can cause skin rashes, anemia or liver problems and symptoms usually go away after a few months and does not cause permanent damage but usually go on to developing a heart disease), are different types of Lupus but Systemic Lupus Erythematosus is the most common type of lupus; which is why when patients talk about having Lupus they are referring to SLE.

Signs and Symptoms

No two cases of SLE are exactly alike and it is difficult to diagnose because it shares the many of same symptoms with other diseases. Signs and symptoms of SLE may slowly develop over months or even year or it could suddenly appear overnight. Some of the common symptoms that SLE share with other diseases are severe fatigue, painful or swollen joints, headaches, loss of appetite, weight loss, fever, bruising, chest pains, dry eyes, mouth ulcers, or hair loss. Some of the more serious symptoms include anemia, blood-clotting problems, and Raynaud’s Phenomenon (painful, pale or purple fingers or toes triggered by cold or stress). The most unique symptom of SLE is a skin rash on the face that extends over the bridge of the nose and cheeks known as a malar rash or better known as a “butterfly rash”.

Causes

The cause of this autoimmune disease is unknown but it is believed that the combination of genetics and your environment may contribute to SLE. Exposure to the sun’s harmful rays may bring on lupus skin lesions or it could trigger an internal response for people prone to SLE. Lupus could also be triggered by certain types of anti-seizure medications, blood pressure medications, or antibiotics. Infections could also initiate SLE or even cause a relapse of the disease. There is no evidence of one gene being the major trigger of SLE but researchers have shown that there may be about 20- 100 different genetic factors that make a person vulnerable to Lupus.

Risk Factors

Researches show that SLE is more common in women and they believe that hormones may be an explanation as to why 90% of SLE patients are women. Women who have chronic SLE have less flare ups after menopause and are 2.5 times more susceptible to SLE. Although 15% of SLE patient’s symptoms occur before they reach age 18, most patients develop SLE between ages 15 and 40. Systemic Lupus Erythematosus affects people of all ethnic background but is shown that majority of SLE patients are of African-American, Hispanic, and Asian descent. You also want to keep an eye out for a family history of SLE because you will be 20 times more prone to SLE than someone who does not have a family history of SLE.