Systemic lupus erythematosus (SLE)
Causes and risk factors
This systemic disease most often affects women of childbearing age (from 20 to 40 years), and in this age group, the ratio of cases among women and men is 9 to 1. It affects between 40 and 50 people per 100,000. This is not a hereditary disease, but there is a family predisposition to the development of autoimmune diseases.
The real cause is unknown. It is likely that the disease develops due to the influence of not fully identified genetic factors, which, however, should be supplemented with environmental factors.
In rare cases, the disease can be triggered by medications.
Exposure to sunlight often causes symptoms.
The higher incidence of diseases in patients of childbearing age suggests that hormonal factors also play an important role.
Which are the symptoms?
Manifestations can be multiple and very versatile:
- arthritis and joint pain (sometimes accompanied by stiffness, swelling or puffiness;
- light fatigue and tiredness;
- skin rash on the face, often affecting the zygomatic region and the bridge of the nose (the so-called “butterfly” type erythema);
- trauma to the mucous membrane of the mouth or nose;
- paradoxical reactions to sunlight (photosensitivity);
- neurological changes (epileptic seizures, psychomotor agitation, delirium and other manifestations of organic psychosis);
- hematological changes, such as hemolytic anemia and autoimmune thrombocytopenia;
- cold changes in the blood circulation of the fingers and toes (Raynaud’s phenomenon);
- severe hair loss (often by spots with inflammation of the underlying tissues);
- serositis (pleurisy and pericarditis);
- chest pain with pleurisy and pericarditis;
- lesions of the oral mucosa and skin;
- hemolytic anemia and autoimmune thrombocytopenia;
- sudden appearance of signs of nephritis.
The presence of antinuclear antibodies (ANA), a decrease in white blood cells (leukopenia) and an increase in inflammatory indicators (in particular ESR) are also characteristic features.
How is it diagnosed?
The diagnosis is made clinically and is based on anamnesis, the results of laboratory and instrumental studies. A kidney biopsy is useful for diagnosis if there are signs of damage at this level, and a magnetic resonance imaging of the brain if neurological changes are detected.
How is it treated?
Regular clinical monitoring is important, especially in patients who have the disease in acute stages or who experience spontaneous remission. In addition, the therapy should be gradually adapted to the conditions of the individual patient.
The main means of treatment is cortisone-based therapy. Depending on the clinical picture, other drugs may be used (hydroxychloroquine, azathioprine, cyclophosphamide).