Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) - an autoimmune disease that affects the capillaries and connective tissue, thus affecting the entire body.
Systemic lupus erythematosus can begin at any age, there are cases of the disease systemic lupus erythematosus in children (a fifth of all cases), usually after 8 years, but the disease is most commonly begins in women aged 15 to 40 years. Lupus in children occurs more acutely and severely than adults.
The causes of systemic lupus erythematosus
Currently, researchers are inclined to the viral origin theory of disease, as in tissues of patients with systemic lupus erythematosus by microscopic examination revealed some groups of viruses (retroviruses and RNA), and a large amount of blood antibodies thereto. However, not all people fall ill with chronic viral infection and a genetic predisposition. Thus, systemic lupus erythematosus occurs in response to chronic viral infection caused by certain groups of viruses in the presence of hereditary predisposition to the disease.
The symptoms of systemic lupus erythematosus
Systemic lupus erythematosus exhibit a large number of symptoms that is caused by tissue damage almost all the organs and systems. In some cases, symptoms of the disease are limited to only skin symptoms, and then the disease is called discoid lupus erythematosus, but in most cases there are multiple lesions of the internal organs, and then talk about the systemic nature of the disease.
Most regular symptoms of lupus are skin lesions and mucous membranes, muscle-joint system and polyserositis (inflammation of several serous membranes: the pericardium, peritoneum, pleura). Dermatitis, arthritis and polyserositis are so-called diagnostic triad of systemic lupus erythematosus.
Dermatitis, or inflammation of the skin, one of the characteristic symptoms of systemic lupus erythematosus, has many manifestations (In total there are 28 forms of dermatitis in this disease), distinguished by its bright red rash, they are painless, elevated above the normal skin. Characteristic symptom of butterflies - a bright red spots on his cheeks, inflamed connected strip of skin on the bridge of the nose.
Arthritis in SLE affects multiple joints are usually symmetrical. Rheumatoid arthritis distinguishes him severe pain with mild joint damage that is there is a marked discrepancy between sharp pain other signs of inflammation of the joints. Characteristically development flexion contracture of the fingers, "twisted" his fingers. Arthritis is often accompanied by polymyositis - inflammation of muscles, flowing and with severe pain.
Symptoms of lupus can manifest themselves as changes in the cardio-pulmonary system (carditis, pericarditis, pleurisy, pneumonitis), gastrointestinal tract (GI tract disorders of various), liver (hepatitis, lupus), kidneys (lupus nephritis, or lyupus- nephritis), nervous system.
The common symptoms of lupus include persistent fever, fatigue, weight loss, fatigue.
The nature of the flow of systemic lupus erythematosus
Systemic lupus erythematosus may be acute, subacute, and chronic.
- Acute systemic lupus erythematosus. The most malignant form of the disease, characterized by continuously progressive course, a sharp increase and a multiplicity of symptoms, resistance to therapy. In this type often proceeds systemic lupus erythematosus in children.
- Subacute systemic lupus erythematosus. The most common form of the disease. Characterized calmer than in the acute form, over, however, though slow but steady development of symptoms, polisindromnost also present.
- Chronic systemic lupus erythematosus. The most favorable option. It features undulating course, with periods of exacerbation and remission, exacerbation amenable to treatment drugs. This form of the disease can last for decades, it improves the prognosis of systemic lupus erythematosus.
According to the degree of activity of lupus as there are three degrees:
- minimal activity
- Posting Activity
For systemic lupus erythematosus lupus characterized crises, in which the disease activity is maximal. The duration of a crisis can be from one day to two weeks.
Diagnosis of systemic lupus erythematosus
Because of the multiplicity of manifestations diagnosis of systemic lupus erythematosus is a problem, and often with the onset of disease before diagnosis takes a long time. For the diagnosis of systemic lupus erythematosus have been developed several systems of diagnostic features. Currently preferred system developed by the American Association of Rheumatic as more modern. The system includes the following criteria:
- a symptom of a butterfly:
- discoid rash;
- increased sensitivity of the skin to light - rash after sun exposure;
- ulceration of the mucous membranes;
- Arthritis - the defeat of two or more joints;
- kidney disease - a protein in the urine, the cylinders in the urine;
- brain damage, seizures, psychosis;
- reduction in the number of erythrocytes, leukocytes and platelets in clinical blood analysis;
- the appearance in the blood of specific antibodies: anti-DNA antibodies, anti-antibodies see, false positive Wasserman, anticardiolipin antibodies, lupus anticoagulant, a positive test for LE cells;
- Detection levels of antinuclear antibodies (ANA).
Treatment of systemic lupus erythematosus
Systemic lupus erythematosus refers to diseases currently considered incurable. However, treatment of systemic lupus erythematosus is necessary since it is able to remove aggressive disease manifestations make lupus crises rarer and less active, and longer periods of remission.
Treatment of systemic lupus erythematosus is carried out in three areas:
- symptomatic therapy;
- restorative therapy, including lifestyle changes towards more healthy.
Lupus crises removed high-dose hormonal anti-inflammatory drugs, hormonal agents treated as systemic lupus erythematosus in children.
Prediction of systemic lupus erythematosus
Prediction SLE depends not only on the treatment used but largely on the shape of the disease, and the age of the patient. In acute systemic lupus erythematosus prognosis is usually unfavorable. When resistance to therapy, and a high degree of process activity for a year or two may develop complications in the internal organs incompatible with life. In subacute and chronic course of systemic lupus erythematosus prognosis more optimistic.