Systemic lupus erythematosus (SLE), also called lupus, is a disease that causes inflammation in connective tissue and can damage several organs. It can affect joints, skin, lungs, heart, blood vessels, kidneys, nervous system, and blood cells. Some people also have Raynaud’s phenomenon, which causes spasms in blood vessels, and pain and discoloration in the fingers, toes, ears, and nose.
SLE affects about 1 in 2000 people, five times more women than men; it is most often diagnosed in people 15 to 40 years old. African Americans and people of Asian and Hispanic ancestry get SLE more often than Caucasians.
The cause is unknown, but hereditary and environmental factors may increase the risk of having SLE. SLE isn’t contagious or transmitted from parent to offspring.
The disease is characterized by intervals of active disease (flares) and remissions. Symptoms depend on which organ is involved. The first ones may be fatigue and joint pain, and swelling or stiffness, usually in hands, wrists, and knees. Joint pain can be severe and interfere with activities and work. People may have a rash on sun exposed parts of the body, often the face (cheeks and nose). This is called a butterfly rash. Raynaud’s phenomenon makes fingers change color and become painful when exposed to cold. Some people have pleurisy (inflammation of the lining of lungs), which can make breathing painful, with shortness of breath. Affected kidneys may lead to high blood pressure and kidney failure. SLE may affect memory and mood and cause stress or confusion.
The health care provider makes a diagnosis from a medical history, physical examination, and laboratory tests. X-rays may be done. Laboratory tests include an erythrocyte sedimentation rate (ESR), complete blood cell count (CBC), antinuclear anti-body (ANA), and urinalysis. The ESR measures inflammation. The CBC counts blood cells and platelets. The health care provider may order an anti-DNA test, which is more specific for SLE. The health care provider may suggest seeing a rheumatologist (specialist in joint problems).
Treatment depends on symptoms and which organs are involved. Medicines help reduce inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often given first. The health care provider may also prescribe prednisone, which works quickly. If they don’t help enough, disease-modifying medicines can slow the disease. These include hydroxychloroquine, methotrexate, azathioprine, and cyclophosphamide.
Exercise is important for joint movement and muscle strength.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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