Causes of systemic lupus erythematosus. Lupus what kind of disease symptoms photo causes

Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever when the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to give to infants? How can you bring down the temperature in older children? What medicines are the safest?

One of the most serious diseases is systemic lupus erythematosus (SLE). It is characterized by autoimmune inflammation with many other symptoms. This disease is dangerous for its complications. With it, organs of many body systems suffer, but most of all problems occur with the musculoskeletal system and kidneys.

Description of the disease

Lupus develops due to a malfunction of the immune system, in which antibodies are formed that adversely affect healthy cells and tissues. This leads to negative changes in the vessels and connective tissue.

The term "lupus" was once used to refer to red spots that appear on the face. They resembled the bites of wolves or she-wolves, which often attacked people and sought to get to unprotected parts of the body, like the nose or cheeks. Even one of the symptoms of the disease is called "lupus butterfly". Today, the name is associated with the cute word "wolf cub".

Autoimmune disease develops against the background of hormonal disorders. Increased estrogens play an important role, so lupus is most often observed in the fair sex. The disease is usually diagnosed in adolescent girls and young women under 26 years of age.

In men, SLE is more severe, and remissions are rare, but in them the disease occurs 10 times less often, since androgens have a protective effect. Some symptoms may be more pronounced in different sexes. For example, in women, the joints are more affected, and in men, the central nervous system and kidneys.

Lupus can be congenital. Symptoms of SLE appear in children in the first years of life.

The disease develops in waves, with periods of exacerbations and remissions alternating. SLE is characterized by an acute onset, rapid progression, and early spread of the disease process. In children, the symptoms of systemic lupus erythematosus are the same as in adults.

Causes

There is more than one reason for the occurrence and development of lupus. It is caused by the simultaneous or sequential influence of several factors at once. Scientists have been able to identify the main causes of the disease:

The last factor is not included in common causes the occurrence of SLE, but they believe that the relatives of the patient are at risk.

Classification by stages

SLE has a wide range of symptoms. During the illness, exacerbations and remissions occur.

Lupus is classified according to the forms of its course:

The stages of the disease are also distinguished. The minimum is characterized by weak headaches and joint pains, high fever, malaise and the first manifestations of lupus on the skin.

In the moderate phase, the face and body are severely affected, and then the vessels, joints and internal organs. At a pronounced stage, the work of various body systems is disrupted.

Symptoms of the disease

At the onset of SLE, only 20% of patients are bothered by skin lesions. In 60% of patients, symptoms appear later. Some people don't have them at all. Signs of the disease can be seen on the face, neck and shoulders. A rash appears on the back of the nose and cheeks in the form of reddish plaques with peeling, reminiscent of wolf bites in the past. It is called the "lupus butterfly" because it looks like this insect. The patient's skin sensitivity to ultraviolet radiation increases.

Some people with lupus lose their hair in the temple areas and break their nails. Mucous membranes are affected in 25% of cases. Lupus-cheilitis appears, characterized by dense swelling of the lips in the form of grayish scales. On the border, small ulcers of red or pink color may appear. In addition, the oral mucosa is affected.

In lupus, they are affected various systems body:

Common symptoms of lupus in women and men are CNS lesions. The disease is characterized by fatigue, weakness, decreased memory and performance, deterioration of intellectual abilities. A person suffering from an autoimmune disease manifests irritability, depression, headaches, and.

The patient may be less sensitive. Seizures, psychosis and convulsions also develop against the background of lupus.

Diagnostic methods

The diagnosis of lupus can be confirmed by differential diagnosis. It is done because each manifestation speaks of the pathology of a particular organ. For this, a system developed by the American Rheumatological Association of Specialists is used.

The diagnosis of SLE is confirmed with four or more of the following:

After a preliminary diagnosis is made, the patient is referred to a specialist with a narrow focus, for example, to a nephrologist, pulmonologist or cardiologist.

A detailed examination includes a thorough history taking. The doctor needs to learn about all the patient's previous diseases and methods of their treatment.

Methods of treatment

Drug therapy for a patient with SLE is selected individually. Methods of treatment depend on the stage and form of the disease, the symptoms and characteristics of the patient's body.

It will be necessary to hospitalize a person suffering from lupus only in certain cases: a constant temperature above 38 degrees, a decrease, as well as a suspected stroke, heart attack, or severe CNS damage. If they progress Clinical signs disease, then the patient will also be sent for hospitalization.

Treatment of lupus erythematosus includes:

Hormonal creams and ointments eliminate peeling and burning sensations that have arisen in certain areas of the skin.

Special attention given to the patient's immune system. During remission, the patient is treated with immunostimulants in combination with vitamin complexes and physiotherapy procedures.

Comorbidities and complications are also taken into account. Since kidney problems occupy the first place in cases of lethality, they must be constantly monitored in SLE. It is necessary to treat lupus arthritis and heart disease in a timely manner.

Dandelion P acts as a natural chondroprotector that prevents joints from collapsing and restores cartilage tissue. It lowers blood cholesterol levels and cleanses the body of toxins. Dihydroquercetin Plus is used to strengthen the walls of blood vessels. It also eliminates bad cholesterol and improves blood microcirculation.

With lupus, people are prescribed foods that will ease the symptoms of the disease. The patient should give preference to food that can protect the brain, heart and kidneys.

A person diagnosed with lupus must be consumed in sufficient quantities:

Protein will help fight the disease. Doctors recommend eating veal, turkey and other dietary meats and poultry. The diet should include cod, pollock, pink salmon, tuna, squid, low-fat herring. Fish contains omega-3 unsaturated fatty acids, vital for the normal functioning of the brain and heart.

Drink at least 8 glasses of pure water per day. She gets the job done gastrointestinal tract, controls hunger and improves general state.

Some foods will need to be abandoned or limited in your diet:

Fatty meals. Foods that contain a lot of butter or vegetable oil, increases the risk of exacerbations from of cardio-vascular system. Due to fatty foods, cholesterol is deposited in the vessels. It can lead to acute myocardial infarction.
Caffeine. This component is present in large quantities in coffee, tea and some other drinks. Because of caffeine, the mucous membrane of the stomach is irritated, the heart beats more often and the nervous system is overloaded. If you stop drinking cups of drinks with this substance, it will be possible to avoid the occurrence of erosions in the duodenum.
Salt. The food should be limited as it overloads the kidneys and raises blood pressure.

People suffering from lupus erythematosus should avoid alcoholic beverages and cigarettes. They are already harmful on their own, and in combination with drugs can lead to disastrous consequences.

Patient Predictions

The prognosis will be favorable if the disease is detected on early term its development. At the very beginning of the course of lupus, tissues and organs do not undergo severe deformation. A mild rash or arthritis is easily controlled by specialists.

Advanced forms of SLE will require aggressive treatment with large doses of various medical preparations. In this case, it is not always possible to determine what causes more harm to the body: large dosages of drugs or self-medication. pathological process.

Lupus erythematosus cannot be completely cured, but this does not mean that one cannot live happily with it. If timely apply for medical care, can be avoided serious problems. By doing medical advice and the right way of life, the patient will not have to limit himself in many ways.

Complication and progression of the disease is possible if a person has chronic infectious diseases. Frequent vaccinations and colds also have an impact. Therefore, such a patient should take care of his health and avoid factors that adversely affect his body.

Preventive actions

Prevention of SLE will help prevent recurrence of the disease and stop the further progression of pathological processes. Secondary measures contribute to the timely and adequate treatment of lupus.

Patients should regularly undergo dispensary examinations and consult a rheumatologist. Drugs must be taken in the prescribed dosage for a certain period of time.

The state of stable remission can be maintained with hardening, therapeutic exercises and regular walks in the fresh air. The patient must observe the regime of work and rest, avoiding unnecessary psychological and physical stress. full sleep and proper nutrition are important not only for improving the condition of the disease, but also for the normal functioning of the whole organism.

If a person has isolated areas of affected skin, it is necessary to find out if any of his relatives have been diagnosed with the disease. A person with lupus should avoid ultraviolet light and stay away from direct sunlight. In the warm season, you need to use special ointments that can protect the skin from the negative effects of the sun. A person suffering from SLE must give up bad habits that only aggravate his condition.

Systemic lupus erythematosus (SLE) is a severe autoimmune disease in which the human immune system produces antibodies that destroy the DNA of its own healthy cells that form the basis of connective tissue. Connective tissue is everywhere in the body. Therefore, the inflammatory process caused by lupus affects almost all systems and internal organs of a person (skin, blood vessels, joints, brain, lungs, kidneys, heart). The symptoms of lupus are very varied. It can masquerade as other diseases, so in many cases it is difficult to make a correct diagnosis.

A characteristic symptom of lupus is a butterfly-shaped rash on the cheeks and bridge of the nose. In the Middle Ages, it was believed that these manifestations resemble the places of wolf bites, hence the name of the disease. The systemic disease lupus erythematosus is considered incurable, but modern medicine is able to control its symptoms and, with appropriate treatment, to maintain patients and prolong their lives. The disease proceeds with difficult to predict periods of exacerbations and remissions and affects mainly women aged 15 to 45 years.

In the frequency of occurrence of lupus, not only sex, age, but also racial characteristics can be traced. Thus, men get lupus 10 times less often than the fairer sex, the main peak incidence occurs at the age of 15 to 25 years, and according to American researchers, SLE more often affects blacks and Asians.

Children are also susceptible to this disease, in early age SLE is much more severe than in adults and leads to severe damage to the kidneys and heart. We will tell you more about the causes that contribute to the development of the disease, its symptoms and methods of treating the disease.

Systemic lupus erythematosus is a complex multifactorial disease, the exact cause of which is still unknown. Currently, most scientists are inclined to the viral theory of the origin of the disease, according to which the body begins to produce a large number of antibodies to certain groups of viruses.

At the same time, it is noted that not all patients with chronic viral infection develop lupus, but only those who have a genetic predisposition to this disease. Researchers believe that heredity plays an important role, and there are specific genes that increase the body's susceptibility to this pathology.

It is also noted that lupus is not a consequence of immunodeficiency, a type of oncological lesions or contagious infectious disease capable of being transmitted from person to person. In addition to the main cause, there are many concomitant factors that can provoke the development of the disease:

The onset of the disease or the exacerbation of already existing symptoms causes excessive ultraviolet radiation.
Hormonal changes in the body (especially in women in the reproductive or menopausal period).
Infectious and cold diseases.
Bad habits. Smoking can not only provoke the onset of the disease, but also complicate its course due to damage to blood vessels.
Use medicines. The development of lupus symptoms can provoke the use of medications such as antibiotics, hormonal drugs, anti-inflammatory and antifungal drugs, antihypertensive, anticonvulsant and antiarrhythmic drugs.

Sometimes lupus erythematosus develops as a result of adverse environmental factors and interactions with certain metals and insecticides.

The course of the disease can be different:

acute form. It is characterized by a sudden onset and the most severe course. It is characterized by rapid progression, a sharp increase in symptoms and damage to vital organs within 1-2 months. This form of lupus is difficult to treat and can be fatal within 1-2 years.
Subacute form. Most often, the disease occurs in this form, which is characterized by a calmer course and is accompanied by a slow increase in symptoms. From the first manifestations to a detailed picture of the disease with a lesion internal organs takes an average of 1.5 to 3 years.
Chronic form. It is considered the most favorable option in terms of therapy. It is characterized by an undulating nature of the course, periods of remission are replaced by exacerbations that can be treated with drugs. This form of lupus can last for a long time, which improves the prognosis and increases the life expectancy of the patient.

Symptoms

Clinical picture diseases can be different - from minimal symptoms to severe, associated with damage to vital organs. Symptoms of the disease can occur suddenly or develop gradually.

Common symptoms of lupus erythematosus include:

Fatigue (chronic fatigue syndrome)
unexplained fever
Painful joint swelling, muscle pain
Various skin rashes
Pain in chest when breathing deeply
Lack of appetite, weight loss

A characteristic butterfly-shaped rash appears on the cheeks and bridge of the nose. In addition, red rashes can appear on any part of the body: on the chest, arms, shoulders. Other symptoms of lupus include increased sensitivity to sunlight, development of anemia, chest pain, hair loss, and reduced blood flow to the fingers and toes from exposure to cold.

Patients have general weakness, irritability, headaches, insomnia, depression. In some patients, only the joints and skin may be affected, while in others, the disease affects many organs, manifesting itself with severe symptoms. Depending on which organs and systems of the body have been affected, the manifestations of the disease depend.

With the appearance of a characteristic rash, fever, joint pain and severe weakness, it is urgent to seek medical advice, undergo an examination and establish the cause of the ailment. In many patients, the initial symptoms of lupus erythematosus are mild, but it should be understood that this disease is chronic and over time, as the disease progresses, the symptoms will become very serious, which threatens with serious consequences and death.

In most cases, modern medicine is able to control the course of the disease and prevent serious complications caused by damage to internal organs. Adequate drug treatment significantly improves the prognosis and allows you to maintain normal health for a long time. The prognosis for life in systemic lupus is unfavorable, but the latest advances in medicine and the use of modern drugs give a chance to prolong life. Already more than 70% of patients live more than 20 years after primary manifestations diseases.

At the same time, doctors warn that the course of the disease is individual, and if some patients develop SLE slowly, then in other cases, the disease can develop rapidly. Another feature of systemic lupus erythematosus is the unpredictability of exacerbations, which can occur suddenly and spontaneously, which threatens with serious consequences.

Most patients maintain daily physical activity, but in some cases it is necessary to stop active work due to severe weakness, fatigue, joint pain, mental disorders and other symptoms. Life expectancy will largely depend on the degree of damage to vital organs (lungs, heart, kidneys). In the recent past, patients with systemic lupus died at a young age, now the use of modern effective drugs allows you to deal with severe manifestations of the disease and predict a normal life expectancy.

Diagnostics

Systemic lupus erythematosus is characterized by multiple manifestations that are similar to those of other diseases. Therefore, the recognition of the disease is extremely difficult and it may take a long time to make an accurate diagnosis. Scientists have developed 11 main criteria, the presence of which will indicate the development of the disease. Experienced doctors are able to make the correct diagnosis based on only 4 characteristic signs.

Characteristic criteria:

Rash on the face in the shape of a butterfly.
Discoid manifestations - a scaly, coin-like rash on the face, chest, arms, neck, after the disappearance of which scars remain on the skin.
Rashes on the skin that appear under the influence of sunlight (photosensitivity).
The appearance of painless sores on the mucous membranes of the mouth or nose.
Articular pain, swelling and impaired mobility of 2 or more peripheral joints.
Deviations in the analysis of urine, expressed in an increase in protein, kidney cells and red blood cells.
Inflammatory process affecting the mucous membrane surrounding the heart (pericarditis) or lungs (pleurisy).
Disorders nervous system, in which causeless convulsive seizures or psychoses are possible.
A change in the composition of the blood associated with an increase in the number of leukocytes, platelets and erythrocytes.
Immunological disorders that contribute to high autoimmune activity and increase the risk of secondary infection.
The appearance of specific antibodies to the cell nucleus (such autoantibodies act against the nuclei of their own cells, mistaking them for foreign ones).

If present clinical symptoms SLE and analysis for the presence of antibodies are positive, this will unambiguously indicate the presence of the disease and further examination is usually not required. Additionally, examinations can be prescribed to detect damage to the kidneys (biopsy), heart and lungs (CT, MRI).

Therapy of the disease is long and complicated, the main efforts of doctors are aimed at alleviating the symptoms and stopping autoimmune and inflammatory processes. To date, it is impossible to completely recover from lupus, with intensive treatment, remission can be achieved, but it is usually short-lived and is soon replaced by an exacerbation. Of great importance is the moral support of patients and explaining to them the features of therapy and the course of the disease. The patient receives recommendations on diet, reduction of psycho-emotional stress and treatment of concomitant infections.

Drug therapy for systemic lupus erythematosus will depend on the activity of the process and the severity of symptoms, the treatment process should be constantly monitored by a doctor. When the manifestations subside, it is necessary to adjust the treatment regimen, reducing the dose of drugs, with the development of an exacerbation, on the contrary, increase the dosage.

At mild form diseases, to eliminate the symptoms of myalgia, arthritis, non-steroidal anti-inflammatory drugs (NSAIDs) and salicylates are used. It should be borne in mind that long-term use of NVPS can cause damage to the kidneys, stomach and contribute to the development of serous meningitis.

With severe weakness, fatigue, skin lesions, antimalarial drugs (hydroxychloroquine, chloroquine) are used. By-effect from taking these drugs is associated with eye damage (retinopathy, myopathy), so the patient should be examined by an ophthalmologist at least once a year.

The main treatment for lupus remains corticosteroid therapy, which is used even at the initial stage of the disease. Corticosteroids are potent drugs, they have a pronounced anti-inflammatory effect, but their long-term use in high doses provokes serious side effects.

With a small activity of the disease, glucocorticosteroids are prescribed for oral administration in moderate doses, with the gradual withdrawal of the drug to the minimum maintenance dosage. With the activity of the process and severe life-threatening complications, high doses are prescribed to take drugs such as Prednisolone, Dexamethasone, Methylprednisolone. They are taken until the process subsides, usually for 4-10 weeks. With severe exacerbations of the disease good effect gives pulse therapy Methylprednisolone administered intravenously.

The doctor needs to monitor the development side effects and their prevention, since long-term treatment and the use of large doses of glucocorticoids may develop osteoporosis, bone necrosis, diabetes, arterial hypertension, infectious complications.

In combination with hormone therapy Cytostatic drugs are used to reduce the frequency and severity of exacerbations and reduce the dose of glucocorticoids. Cytostatic drugs (Cyclophosphamide, Azathioprine, Methotrexate) are prescribed in case of severe lesions of the central nervous system and renal failure.

With the development of complications, antibacterial, antifungal (with candidiasis) drugs are used. With the development of diabetes, a diet is prescribed, insulin preparations are administered. When a tuberculosis infection is attached, they are treated with anti-tuberculosis drugs, with damage to the gastrointestinal tract, a course of anti-ulcer therapy is carried out. Patients with severe complications, accompanied by damage to vital organs, undergo plasmapheresis procedures and use program hemodialysis.

Systemic disease lupus erythematosus It is a serious illness leading to disability and threatening death. But still, modern medicine successfully fights the manifestations of the disease and is able to achieve periods of remission, during which the patient can live a normal life. SLE patients must strictly adhere to all the recommendations of the attending physician, inform him of all changes in their condition and avoid negative factors that can aggravate the course of the disease.

Folk remedies

Nature is rich in natural substances that can support and restore the body by suppressing the inflammatory process.

Remember that before starting treatment with folk recipes you need to consult a doctor, this will save you from unwanted complications.

Systemic lupus erythematosus or SLE belongs to a group of systemic autoimmune diseases with an unknown etiological factor. The disease develops as a result of genetically determined failures of immune regulation, which determine the formation of organ-nonspecific antibodies to antigens of cell nuclei and lead to the development of the so-called immune inflammation in organ tissues.

This disease is otherwise called a multisystem inflammatory disease, since almost all organs and systems are affected: joints, skin, kidneys, brain, etc.

The risk group for developing SLE includes young women who are childbearing age, especially the Negroid race - about 70% of SLE cases are diagnosed in this population group. However, SLE can develop at absolutely any age, even in the neonatal period. Among the child population, the disease is most common in the age group of 14-18 years, and girls are more often ill. About the causes of lupus erythematosus, symptoms and treatment of the disease, our article.

Reasons for the development of SLE

The true causes of SLE development have not yet been established. There are several theories of the development of systemic lupus erythematosus, which are controversial and have both confirming and refuting factors:

genetic theory. According to this theory, the disease is genetically determined. However, the specific gene that triggers the development of SLE has not yet been discovered.
virus theory. It was revealed that Epstein-Barr virus is often found in patients suffering from SLE.
Bacterial theory. It has been proven that the DNA of a number of bacteria can stimulate the synthesis of antinuclear autoantibodies.
hormonal theory. Women with SLE often have elevated level hormones prolactin and estrogen. There is also a frequent primary manifestation of SLE during pregnancy or after childbirth, when female body undergoes huge hormonal changes.
The action of physical factors. It is known that ultraviolet radiation can trigger the synthesis of autoantibodies by skin cells (in people predisposed to SLE).

None of the theories described above can explain the cause of the development of the disease with one hundred percent accuracy. As a result, SLE is spoken of as a polyetiological disease, i.e. having multiple causes.

Types of hard currency

The disease is classified according to the stages of the course of the disease:

acute form when lupus erythematosus occurs, the symptoms are characterized by a sudden and sharp manifestation: a significant rise in temperature up to febrile indicators, rapid damage to several organs, high immunological activity.

Subacute form characterized by the frequency of exacerbations, however, with a lesser degree of symptomatology than in the acute course of SLE. Organ damage develops during the first 12 months of the disease.

Chronic form characterized by a long-term manifestation of one or more symptoms. The combination of SLE with antiphospholipid syndrome is especially characteristic in chronic form illness.

The pathogenesis of SLE or what happens in the body

Under the influence of a certain causative factor or when they are combined in conditions of immune system dysfunction, DNA “exposure” occurs different cells. These cells are perceived by the body as foreign or antigens. The body immediately begins to produce special proteins-antibodies that are specific to these cells and protect against them. As a result of the interaction of antibodies and antigens, immune complexes are formed that are fixed in certain organs.

This process leads to the development of an immune inflammatory response and cell damage. Connective tissue cells are most often affected, so SLE disease is referred to as a disease of this particular tissue of the body. Connective tissue is widely represented in all organs and systems, so almost the entire body is involved in the pathological lupus process.

Immune complexes, when fixed on the vascular walls, can provoke thrombosis. Circulating antibodies are toxic and lead to anemia and thrombocytopenia.

Discovery of scientists

One of two latest research, according to scientists, a mechanism was discovered that controls the aggression of the human body against its own tissues and cells. This opens up new opportunities for the development of additional diagnostic techniques and will allow the development of effective directions for the treatment of SLE.

This discovery came as the American Drug Administration was about to announce a decision on the use of biological preparation"Benlysta". This new drug"Benlysta" (USA), is now approved for use in the treatment of lupus erythematosus.

The essence of the discovery is as follows.

In SLE, the body produces antibodies against its own DNA, called antinuclear antibodies (ANA). Thus, a blood test for ANA in a patient with suspected SLE will allow a correct interpretation of the diagnosis.

The main mystery of SLE was the mechanism by which cell DNA gets out. In 2004, it was found that the explosive death of neutrophil cells leads to the release of their contents, including nuclear DNA, outward in the form of threads, between which pathogenic viruses, fungi and bacteria are easily entangled. At healthy people such neutrophil traps easily disintegrate in the intercellular space. In people with SLE, the antimicrobial proteins LL37 and HNP do not allow the remnants of nuclear DNA to break down.

These proteins and DNA residues together are able to activate plasmacytoid dendritic cells, which in turn produce proteins (interferon) that support the immune response. Interferon forces neutrophils to release even more trap threads, supporting an endless pathological process.

Thus, according to scientists, the pathogenesis of lupus erythematosus lies in the cycle of neutrophil cell death and chronic tissue inflammation. This discovery is important for both diagnosis and treatment of SLE. If one of these proteins can become a marker of SLE, this will greatly simplify the diagnosis.

Another interesting fact. Among 118 patients participating in another study aimed at detecting vitamin D deficiency in patients with connective tissue diseases. Among 67 patients with autoimmune diseases (rheumatoid arthritis, lupus erythematosus), vitamin D deficiency was found in 52%, among 51 patients with pulmonary fibrosis of a different nature — in 20%. This confirms the need and effectiveness of adding vitamin D courses to the treatment of autoimmune diseases.

Symptoms

Symptoms of the disease depend on the stages of development of the pathological process.
With acute initial manifestation lupus erythematosus suddenly occurs:

fever up to 39-39 C
weakness
fatigue
joint pain

Patients can often accurately indicate the start date clinical manifestations The symptoms are so severe. After 1-2 months, a clear lesion of vital organs is formed. If the disease progresses further, then in a year or two the patients die.

For subacute the first symptoms are less pronounced, the pathological process develops more slowly - organ damage occurs gradually, within 1-1.5 years.

In chronic course for several years, one or more symptoms are constantly manifested. Exacerbation of the disease is rare, the work of vital organs is not disturbed.

Basically, the initial manifestations of SLE do not have specificity, they easily pass with treatment with anti-inflammatory drugs, or on their own. Remission is distinguished by the duration of the course. Sooner or later, an exacerbation of the disease occurs, most often in the autumn-summer periods due to an increase in solar radiation, while the condition of the skin of patients deteriorates sharply. Over time, symptoms of organ damage occur.

Skin, nails and hairline

Involvement in the pathological process of the skin is the most common symptoms of lupus erythematosus in women, the occurrence of which is associated with some causal factor: prolonged exposure to sunlight, exposure to frost, psycho-emotional shock (see,).

Very characteristic of SLE is reddening of the skin near the nose and cheeks, shaped like the wings of a butterfly insect. In addition to the face, erythema appears on open areas of the skin - upper limbs, décolleté. Erythema is prone to peripheral growth.

In discoid lupus erythematosus, skin erythema changes inflammatory edema. This area gradually thickens and after some time atrophies with the formation of a scar. Foci of discoid lupus are found in different parts of the body, which indicates the dissemination of the process.

Another symptom of SLE is capillaritis, which is manifested by redness, swelling and numerous hemorrhages in the form of small dots localized on the fingertips, soles and palms.

Hair damage in SLE is manifested by gradual partial or complete baldness (see). During the period of exacerbation, a change in the structure of the nails is characteristic, often leading to atrophy of the periungual ridge.

Alopecia areata, or generalized, and urticaria are the most characteristic symptoms of SLE. In addition to skin manifestations, patients are worried about headaches, joint pain, changes in kidney and heart function, mood swings from euphoria to aggression.

mucous membranes

The mucous membranes of the mouth and nose suffer more often: redness appears, erosions (enanthemas) form on the mucous membrane and small ulcers in the mouth (see,). With the formation of cracks, erosion and ulceration of the red border of the lips, lupus-cheilitis occurs. The lesions become in the form of dense bluish-red plaques that are painful when eating, prone to ulceration, have clear boundaries and are sometimes covered with pityriasis scales.

Musculoskeletal system

Up to 90% of SLE patients have joint damage. Small joints suffer, more often fingers (see). The pathological process spreads symmetrically, leading to pain and stiffness in the joints. Aseptic bone necrosis often develops. In addition to the joints of the hand, the hip and knee joints suffer, which leads to their functional insufficiency. If the ligamentous apparatus is involved in the process, then contractures of a non-permanent nature develop, and in severe SLE, dislocations and subluxations develop.

Respiratory system

The lungs are most often affected with the development of bilateral pleurisy, acute lupus pneumonitis and pulmonary hemorrhages. The last two pathologies are life-threatening.

The cardiovascular system

In the prevailing majority of cases, Libman-Sachs endocarditis develops with involvement in the pathological lupus process. mitral valve. The valve leaflets grow together, and stenosing heart disease is formed. In the case of pericarditis, the layers of the pericardium become thicker. provokes pain syndrome in the chest area, an increase in the size of the heart. Small and medium-sized vessels often suffer (including the vital coronary arteries and vessels of the brain), as a result of which patients often die due to cerebral stroke and coronary artery disease.

Nervous system

Neurological symptoms are varied, ranging from migraine to transient ischemic attacks and strokes. Epileptic seizures, cerebral ataxia, chorea are possible. Peripheral neuropathy develops in a fifth of the diseased, in which inflammation is considered a very unfavorable phenomenon. optic nerve leading to loss of vision.

Kidneys. The severe course of SLE leads to the formation of various types of lupus nephritis.

When lupus erythematosus is diagnosed in children, signs initially appear in the form of joint damage (flying arthralgia, acute and subacute periarthritis) without progression, as well as typical skin lesions like an erythematous rash, anemia appears. SLE should be differentiated from .

Differential Diagnosis

Chronic lupus erythematosus is differentiated from lichen planus, tuberculous leukoplakia and lupus, early rheumatoid arthritis, Sjögren's syndrome (see photophobia). With the defeat of the red border of the lips, chronic SLE is differentiated from the abrasive precancerous cheilitis of Manganotti and actinic cheilitis.

Since the defeat of internal organs is always similar in course to various infectious processes, SLE is differentiated from, syphilis, mononucleosis (), HIV infection (see), etc.

Treatment of lupus erythematosus

Treatment is selected individually for a particular patient. A complex of therapeutic measures is carried out on an outpatient basis.

Indications for hospitalization are:

persistent hyperthermia for no apparent reason
life-threatening conditions: malignant renal failure, acute pneumonitis or bleeding from the lungs
neurological complications
severe thrombocytopenia, a significant decrease in red blood cells and blood lymphocytes
lack of effectiveness from outpatient treatment

Systemic lupus erythematosus in the acute period is treated with hormonal drugs (prednisolone, corticosteroid ointments, see) and cytostatics (cyclophosphamide) according to the scheme. Non-steroidal anti-inflammatory drugs (etc. see) are indicated in the presence of hyperthermia and the development of damage to the musculoskeletal system.

When the process is localized in a particular organ, a narrow specialist is consulted and appropriate corrective therapy is prescribed.

People with SLE should avoid direct sunlight. Exposed areas of the skin should be lubricated with a protective cream from UV rays.

Immunosuppressive therapy with own stem cells is very effective, especially in severe cases. In most cases, autoimmune aggression stops and the patient's condition stabilizes.

Compliance is of paramount importance healthy lifestyle life, rejection of bad habits, feasible exercise stress, rational nutrition and psychological comfort.

Forecast and prevention

It should be noted that a complete cure for SLE is impossible to achieve.

Prognosis for life with adequate and timely treatment favorable. About 90% of patients survive 5 years or more after the onset of the disease. The prognosis is unfavorable with an early onset of the disease, high activity process, the development of lupus nephritis, the addition of infection. The prognosis for life is unfavorable in the development of SLE in males.

Due to the unknown etiology, there is no primary prevention of SLE. To prevent exacerbations, direct insolation should be avoided and the skin should be protected as much as possible (clothing, sunscreen, etc.).

Prevention of exacerbations of SLE in children is the organization of home schooling, the prevention of infections and strengthening the immune system. Vaccination can be carried out only in the period of absolute remission. The introduction of gamma globulin is possible only if there are absolute indications.

Content

This disease is accompanied by a malfunction of the immune system, resulting in inflammation of muscles, other tissues and organs. Lupus erythematosus occurs with periods of remission and exacerbation, while the development of the disease is difficult to predict; in the course of progression and the appearance of new symptoms, the disease leads to the formation of insufficiency of one or more organs.

What is lupus erythematosus

This is an autoimmune pathology in which the kidneys, blood vessels, connective tissues and other organs and systems are affected. If, in a normal state, the human body produces antibodies that can attack foreign organisms that enter from the outside, then in the presence of a disease, the body produces a large number of antibodies to the cells of the body and their components. As a result, an immunocomplex inflammatory process is formed, the development of which leads to dysfunction of various elements of the body. Systemic lupus affects internal and external organs, including:

lungs;
kidneys;
skin;
heart;
joints;
nervous system.

Causes

The etiology of systemic lupus is still unclear. Doctors suggest that viruses (RNA, etc.) are the cause of the development of the disease. In addition, a risk factor for the development of pathology is a hereditary predisposition to it. Women suffer from lupus erythematosus about 10 times more often than men, which is explained by the peculiarities of their hormonal system (there is a high concentration of estrogen in the blood). The reason why the disease is less common in men is the protective effect that androgens (male sex hormones) have. The risk of SLE can be increased by:

bacterial infection;
taking medications;
viral defeat.

Development mechanism

A normally functioning immune system produces substances to fight the antigens of any infection. In systemic lupus, antibodies purposefully destroy the body's own cells, while they cause an absolute disorganization of the connective tissue. As a rule, patients show fibroid changes, but other cells are susceptible to mucoid swelling. In the affected structural units of the skin, the core is destroyed.

In addition to damage to skin cells, plasma and lymphoid particles, histiocytes, and neutrophils begin to accumulate in the walls of blood vessels. Immune cells settle around the destroyed nucleus, which is called the “rosette” phenomenon. Under the influence of aggressive complexes of antigens and antibodies, lysosome enzymes are released, which stimulate inflammation and lead to connective tissue damage. Destruction products form new antigens with antibodies (autoantibodies). As a result of chronic inflammation, tissue sclerosis occurs.

Forms of the disease

Depending on the severity of symptoms of pathology, systemic disease has a certain classification. The clinical varieties of systemic lupus erythematosus include:

Sharp form. At this stage, the disease progresses sharply, and the general condition of the patient worsens, while he complains of constant fatigue, high temperature (up to 40 degrees), pain, fever and muscle aches. The symptomatology of the disease develops rapidly, and in a month it affects all human tissues and organs. Forecast at acute form SLE is not comforting: often the life expectancy of a patient with such a diagnosis does not exceed 2 years.
Subacute form. It can take more than a year from the onset of the disease to the onset of symptoms. This type of disease is characterized by frequent alternation of periods of exacerbation and remission. The prognosis is favorable, and the patient's condition depends on the treatment chosen by the doctor.
Chronic. The disease proceeds sluggishly, the signs are mild, the internal organs are practically not damaged, so the body functions normally. Despite the mild course of the pathology, it is virtually impossible to cure it at this stage. The only thing that can be done is to alleviate the condition of a person with the help of medications during an exacerbation of SLE.

Should be distinguished skin diseases related to lupus erythematosus, but not systemic and not having a generalized lesion. These pathologies include:

discoid lupus (a red rash on the face, head or other parts of the body that rises slightly above the skin);
drug-induced lupus (inflammation of the joints, rash, heat, pain in the sternum associated with taking drugs; after their withdrawal, the symptoms disappear);
neonatal lupus (rarely expressed, affects newborns if mothers have diseases of the immune system; the disease is accompanied by abnormalities of the liver, skin rash, pathologies of the heart).

How does lupus manifest?

The main symptoms of SLE include severe fatigue, skin rash, and joint pain. With the progression of the pathology, problems with the work of the heart, nervous system, kidneys, lungs, and blood vessels become relevant. The clinical picture of the disease in each case is individual, since it depends on which organs are affected and what degree of damage they have.

On the skin

Tissue damage at the onset of the disease appears in about a quarter of patients, in 60-70% of patients with SLE the skin syndrome is noticeable later, and in the rest it does not occur at all. As a rule, for the localization of the lesion, areas of the body open to the sun are characteristic - the face (a butterfly-shaped area: nose, cheeks), shoulders, neck. The lesions are similar to erythematosus in that they appear as red, scaly plaques. Along the edges of the rashes are dilated capillaries and areas with an excess / lack of pigment.

In addition to the face and other sun-exposed areas of the body, systemic lupus affects hairy part heads. As a rule, this manifestation is localized in the temporal region, while the hair falls out in a limited area of the head (local alopecia). In 30-60% of SLE patients, increased sensitivity to sunlight (photosensitivity) is noticeable.

in the kidneys

Very often, lupus erythematosus affects the kidneys: in about half of the patients, damage to the renal apparatus is determined. A frequent symptom of this is the presence of protein in the urine, casts and erythrocytes, as a rule, are not detected at the onset of the disease. The main signs that SLE has affected the kidneys are:

membranous nephritis;
proliferative glomerulonephritis.

in the joints

Rheumatoid arthritis is often diagnosed with lupus: in 9 out of 10 cases it is non-deforming and non-erosive. More often the disease affects the knee joints, fingers, wrists. In addition, patients with SLE sometimes develop osteoporosis (decrease in bone density). Patients often complain of muscle pain and muscle weakness. Immune inflammation is treated with hormonal drugs (corticosteroids).

On mucous membranes

The disease manifests itself in the mucosa oral cavity and nasopharynx in the form of ulcers that do not cause pain. Mucosal lesions are recorded in 1 out of 4 cases. This is typical for:

decreased pigmentation, red border of the lips (cheilitis);
ulceration of the mouth/nose, punctate hemorrhages.

On vessels

Lupus erythematosus can affect all structures of the heart, including the endocardium, pericardium and myocardium, coronary vessels, valves. However, damage to the outer shell of the organ occurs more often. Diseases that can result from SLE:

pericarditis (inflammation of the serous membranes of the heart muscle, manifested dull pains in the chest area);
myocarditis (inflammation of the heart muscle, accompanied by a violation of the rhythm, conduction nerve impulse, acute / chronic organ failure);
heart valve dysfunction;
damage to the coronary vessels (may develop at an early age in patients with SLE);
damage to the inner side of the vessels (in this case, the risk of developing atherosclerosis increases);
damage to the lymphatic vessels (manifested by thrombosis of the limbs and internal organs, panniculitis - subcutaneous painful nodes, livedo reticularis - blue spots that form a grid pattern).

On the nervous system

Doctors suggest that the failure of the central nervous system is caused by damage to the cerebral vessels and the formation of antibodies to neurons - cells that are responsible for nourishing and protecting the organ, as well as to immune cells (lymphocytes. Key signs that the disease has affected the nervous structures of the brain are :

psychoses, paranoia, hallucinations;
migraine, headaches;
Parkinson's disease, chorea;
depression, irritability;
brain stroke;
polyneuritis, mononeuritis, aseptic type meningitis;
encephalopathy;
neuropathy, myelopathy, etc.

Symptoms

Systemic disease has an extensive list of symptoms, while it is characterized by periods of remission and complications. The onset of pathology can be lightning fast or gradual. Signs of lupus depend on the form of the disease, and since it belongs to the category of multiple organ pathologies, the clinical symptoms can be varied. Non-severe forms of SLE are limited only to damage to the skin or joints, more severe types of the disease are accompanied by other manifestations. TO characteristic symptoms ailments include:

swollen eyes, joints of the lower extremities;
muscle/joint pain;
enlarged lymph nodes;
hyperemia;
increased fatigue, weakness;
red, similar to allergic, rashes on the face;
causeless fever;
blue fingers, hands, feet after stress, contact with cold;
alopecia;
soreness when inhaling (indicates damage to the lining of the lungs);
sensitivity to sunlight.

First signs

Early symptoms include a temperature that fluctuates around 38039 degrees and can last for several months. After that, the patient develops other signs of SLE, including:

arthrosis of small / large joints (may pass on its own, and then reappear with greater intensity);
a butterfly-shaped rash on the face, rashes appear on the shoulders, chest;
inflammation of the cervical, axillary lymph nodes;
in case of severe damage to the body, internal organs suffer - kidneys, liver, heart, which is expressed in a violation of their work.

In children

At an early age, lupus erythematosus manifests itself with numerous symptoms, progressively affecting various organs child. At the same time, doctors cannot predict which system will fail next. Primary signs of pathology may resemble ordinary allergies or dermatitis; This pathogenesis of the disease causes difficulties in diagnosis. Symptoms of SLE in children can include:

dystrophy;
skin thinning, photosensitivity;
fever, accompanied by profuse sweating, chills;
allergic rashes;
dermatitis, as a rule, first localized on the cheeks, bridge of the nose (looks like warty rashes, vesicles, edema, etc.);
joint pain;
fragility of nails;
necrosis on the fingertips, palms;
alopecia, up to complete baldness;
convulsions;
mental disorders (nervousness, capriciousness, etc.);
stomatitis, not amenable to treatment.

Diagnostics

To establish a diagnosis, doctors use a system developed by American rheumatologists. To confirm that a patient has lupus erythematosus, the patient must have at least 4 of the 11 listed symptoms:

erythema on the face in the form of butterfly wings;
photosensitivity (pigmentation on the face that increases when exposed to sunlight or UV radiation);
discoid skin rash (asymmetric red plaques that peel and crack, while areas of hyperkeratosis have jagged edges);
symptoms of arthritis;
the formation of ulcers on the mucous membranes of the mouth, nose;
disturbances in the work of the central nervous system - psychosis, irritability, tantrums for no reason, neurological pathologies, etc .;
serous inflammation;
frequent pyelonephritis, the appearance of protein in the urine, the development of renal failure;
false-positive Wasserman analysis, detection of antigen and antibody titers in the blood;
reduction of platelets and lymphocytes in the blood, a change in its composition;
causeless increase in antinuclear antibodies.

The specialist makes the final diagnosis only if there are four or more signs from the above list. When the verdict is in doubt, the patient is referred for a narrowly focused detailed examination. When making a diagnosis of SLE, the doctor assigns an important role to the collection of anamnesis and the study of genetic factors. The doctor must find out what diseases the patient had during last year life and how they were treated.

Treatment

SLE is a chronic type of disease in which it is impossible to completely cure the patient. The goals of therapy are to reduce the activity of the pathological process, restore and preserve the functionality of the affected system/organs, prevent exacerbations in order to achieve a longer life expectancy for patients and improve its quality of life. Treatment of lupus involves the mandatory intake of medications, which the doctor prescribes to each patient individually, depending on the characteristics of the organism and the stage of the disease.

Patients are hospitalized in cases where they have one or more of the following clinical manifestations of the disease:

suspected stroke, heart attack, severe CNS damage, pneumonia;
an increase in temperature above 38 degrees for a long time (fever cannot be eliminated with antipyretics);
oppression of consciousness;
a sharp decrease in leukocytes in the blood;
rapid progression of symptoms.

If necessary, the patient is referred to such specialists as a cardiologist, nephrologist or pulmonologist. Standard treatment for SLE includes:

hormone therapy (drugs of the glucocorticoid group are prescribed, for example, Prednisolone, Cyclophosphamide, etc.);
anti-inflammatory drugs (usually Diclofenac in ampoules);
antipyretics (based on Paracetamol or Ibuprofen).

To relieve burning, peeling of the skin, the doctor prescribes creams and ointments based on hormonal agents to the patient. Particular attention during the treatment of lupus erythematosus is paid to maintaining the patient's immunity. During remission, the patient is prescribed complex vitamins, immunostimulants, physiotherapeutic manipulations. Drugs that stimulate the immune system, such as Azathioprine, are taken only during the calm period of the disease, otherwise the patient's condition may deteriorate sharply.

Acute lupus

Treatment should begin in the hospital as soon as possible. The therapeutic course should be long and constant (without interruptions). During the active phase of the pathology, the patient is given high doses of glucocorticoids, starting with 60 mg of Prednisolone and increasing by another 35 mg over 3 months. Reduce the volume of the drug slowly, switching to tablets. After that, a maintenance dose of the drug (5-10 mg) is individually prescribed.

To prevent a violation of mineral metabolism, potassium preparations are prescribed simultaneously with hormonal therapy (Panangin, potassium acetate solution, etc.). After the completion of the acute phase of the disease, complex treatment with corticosteroids in reduced or maintenance doses is carried out. In addition, the patient takes aminoquinoline drugs (1 tablet of Delagin or Plaquenil).

Chronic

The earlier treatment is started, the more chances the patient has to avoid irreversible consequences in the body. Therapy of chronic pathology necessarily includes the use of anti-inflammatory drugs, drugs that suppress the activity of the immune system (immunosuppressants) and corticosteroids. hormonal drugs. However, only half of the patients achieve success in treatment. In the absence of positive dynamics, stem cell therapy is carried out. As a rule, autoimmune aggression is absent after that.

Why is lupus erythematosus dangerous?

Some patients with this diagnosis develop severe complications - disruption of the heart, kidneys, lungs, and other organs and systems. most dangerous form The disease is systemic, which even damages the placenta during pregnancy, as a result of which it leads to fetal growth retardation or death. Autoantibodies can cross the placenta and cause neonatal (congenital) disease in the newborn. At the same time, the baby develops a skin syndrome, which disappears after 2-3 months.

How long do people live with lupus erythematosus

Thanks to modern medicines, patients can live more than 20 years after diagnosing the disease. The process of development of pathology proceeds with different speed: in some people, the symptoms increase in intensity gradually, in others it increases quickly. Most patients continue to lead a normal life, but with a severe course of the disease, disability is lost due to severe joint pain, high fatigue, and CNS disorders. The duration and quality of life in SLE depends on the severity of symptoms of multiple organ failure.

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Systemic lupus erythematosus is a chronic autoimmune disease characterized by damage to the connective tissue and blood vessels and, as a result, the involvement of almost all organs and systems of the body in the pathological process.

In the development of systemic lupus erythematosus, hormonal disorders play a certain role, in particular, an increase in the amount of estrogen. This explains the fact that the disease is more often recorded in young women and adolescent girls. According to some data, viral infections and chemical intoxication play an important role in the occurrence of pathology.

This disease is related to autoimmune diseases. Its essence lies in the fact that the immune system begins to produce antibodies to some kind of irritant. They adversely affect healthy cells, as they damage their DNA structure. Thus, due to antibodies, a negative change in the connective tissue and blood vessels occurs.

Causes

What causes contribute to the development of systemic lupus erythematosus, and what is this disease? The etiology of the disease is unknown. In its development, a role is assumed viral infection, as well as genetic, endocrine and metabolic factors.

In patients and their relatives, lymphocytotoxic antibodies and antibodies to double-stranded RNA are found, which are markers of persistent viral infection. In the endothelium of the capillaries of damaged tissues (kidneys, skin), virus-like inclusions are detected; the virus was identified in experimental models.

SLE occurs predominantly in young (20-30 years old) women, but cases of the disease are not uncommon in adolescents and older people (over 40-50 years old). Among the sick, only 10% of men are noted, but the disease is more severe in them than in women. Provoking factors are often insolation, drug intolerance, stress; in women - childbirth or abortion.

Classification

The disease is classified according to the stages of the course of the disease:

Acute systemic lupus erythematosus. The most malignant form of the disease, characterized by a continuously progressive course, a sharp increase and a multiplicity of symptoms, resistance to therapy. This type of systemic lupus erythematosus often occurs in children.
The subacute form is characterized by the frequency of exacerbations, however, with a lesser degree of symptomatology than in the acute course of SLE. Organ damage develops during the first 12 months of the disease.
Chronic form characterized by a long-term manifestation of one or more symptoms. The combination of SLE with antiphospholipid syndrome in the chronic form of the disease is especially characteristic.

Also, during the course of the disease, three main stages are distinguished:

Minimum . There are minor headaches and joint pains, periodic increase body temperature, malaise, as well as the initial skin signs of the disease.
Moderate. Significant damage to the face and body, involvement in the pathological process of blood vessels, joints, internal organs.
Expressed. There are complications from the internal organs, brain, circulatory system, musculoskeletal system.

Systemic lupus erythematosus is characterized by lupus crises, in which the activity of the disease is maximum. The duration of the crisis can be from one day to two weeks.

Symptoms of lupus erythematosus

In adults, systemic lupus erythematosus manifests itself in a large number of symptoms, which is due to damage to the tissues of almost all organs and systems. In some cases, the manifestations of the disease are limited exclusively to 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 they talk about the systemic nature of the disease.

On initial stages disease lupus erythematosus is characterized by a continuous course with periodic remissions, but almost always goes into a systemic form. More often there is erythematous dermatitis on the face like a butterfly - erythema on the cheeks, cheekbones and always on the back of the nose. Hypersensitivity to solar radiation appears - photodermatoses are usually round in shape, are of a multiple nature.

Joint damage occurs in 90% of patients with SLE. The pathological process involves small joints, usually fingers. The lesion is symmetrical, patients are concerned about pain and stiffness. Joint deformity rarely develops. Aseptic (without an inflammatory component) bone necrosis is common. The head of the femur and the knee joint are affected. Symptoms of functional insufficiency predominate in the clinic lower limb. When the ligamentous apparatus is involved in the pathological process, non-permanent contractures develop, in severe cases, dislocations and subluxations.

Common symptoms of SLE:

Soreness and swelling of the joints, muscle pain;
unexplained fever;
chronic fatigue syndrome;
Rashes on the skin of the face of red color or a change in the color of the skin;
Pain in chest with deep breathing;
Increased hair loss;
Whitening or blueness of the skin of the fingers or feet in the cold or under stress (Raynaud's syndrome);
Increased sensitivity to the sun;
Swelling (swelling) of the legs and/or around the eyes;
Enlarged lymph nodes.

For dermatological signs diseases include:

Classic rash on the bridge of the nose and cheeks;
Spots on limbs, trunk;
Baldness;
Brittle nails;
Trophic ulcers.

Mucous membranes:

Redness and ulceration (appearance of ulcers) of the red border of the lips.
Erosions (surface defects - "corrosion" of the mucous membrane) and ulcers on the oral mucosa.
Lupus-cheilitis is a pronounced dense swelling of the lips, with grayish scales tightly adjacent to each other.

Damage to the cardiovascular system:

Lupus myocarditis.
Pericarditis.
Libman-Sachs endocarditis.
Defeat coronary arteries and development of myocardial infarction.
Vasculitis.

With damage to the nervous system The most common manifestation is asthenic syndrome:

Weakness, insomnia, irritability, depression, headaches.

With further progression, the development of epileptic seizures, impaired memory and intelligence, psychosis is possible. Some patients develop serous meningitis, optic neuritis, intracranial hypertension.

Nephrological manifestations of SLE:

Lupus Jade - inflammatory disease kidneys, in which there is a thickening of the glomerular membrane, fibrin is deposited, hyaline blood clots are formed. In the absence of adequate treatment, the patient may develop a persistent decrease in kidney function.
Hematuria or proteinuria, which is not accompanied by pain and does not bother the person. Often this is the only manifestation of lupus from the urinary system. Since the diagnosis of SLE is being carried out in a timely manner and effective treatment, then acute renal failure develops only in 5% of cases.

Gastrointestinal tract:

Erosive and ulcerative lesions - patients are concerned about lack of appetite, nausea, vomiting, heartburn, pain in various parts of the abdomen.
Intestinal infarction due to inflammation of the vessels supplying the intestines - the picture develops acute abdomen» with high-intensity pain, localized more often around the navel and in the lower abdomen.
Lupus hepatitis - jaundice, an increase in the size of the liver.

Lung damage:

Pleurisy.
Acute lupus pneumonitis.
The defeat of the connective tissue of the lungs with the formation of multiple foci of necrosis.
Pulmonary hypertension.
Pulmonary embolism.
Bronchitis and pneumonia.

It is almost impossible to assume that you have lupus before a visit to the doctor. Seek advice if you develop an unusual rash, fever, joint pain, fatigue.

Systemic lupus erythematosus: photos in adults

What systemic lupus erythematosus looks like, we offer detailed photos for viewing.

Diagnostics

If systemic lupus erythematosus is suspected, the patient is referred for a consultation with a rheumatologist and dermatologist. Several systems of diagnostic signs have been developed for the diagnosis of systemic lupus erythematosus.
At present, the system developed by the American Rheumatic Association is preferred as more modern.

The system includes the following criteria:

butterfly sign:
discoid rash;
the formation of ulcers on the mucous membranes;
kidney damage - protein in the urine, casts in the urine;
brain damage, convulsions, psychosis;
increased sensitivity of the skin to light - the appearance of a rash after exposure to the sun;
arthritis - damage to two or more joints;
polyserositis;
decrease in the number of erythrocytes, leukocytes and platelets in clinical analysis blood;
detection of antinuclear antibodies (ANA) in the blood.
the appearance of specific antibodies in the blood: anti-DNA antibodies, anti-Sm antibodies, false-positive Wassermann reaction, anticardiolipin antibodies, lupus anticoagulant, positive test for LE cells.

The main goal of treating systemic lupus erythematosus is to suppress the body's autoimmune reaction, which underlies all symptoms. Patients are prescribed various types of drugs.

Treatment of systemic lupus erythematosus

Unfortunately, there is no complete cure for lupus. Therefore, therapy is selected in such a way as to reduce the manifestations of symptoms, stop the inflammatory, as well as autoimmune processes.

The treatment of SLE is strictly individual and may change with the course of the disease. Diagnosis and treatment of lupus is often a joint effort of the patient and physicians of various specialties.

Modern drugs for the treatment of lupus:

Glucocorticosteroids (prednisolone or others) are powerful drugs that fight inflammation in lupus.
Cytostatic immunosuppressants (azathioprine, cyclophosphamide, etc.) - drugs that suppress immune system, can be very helpful in lupus and other autoimmune diseases.
TNF-α blockers (Infliximab, Adalimumab, Etanercept).
Extracorporeal detoxification (plasmapheresis, hemosorption, cryoplasmosorption).
Pulse therapy with high doses of glucocorticosteroids and / or cytostatics.
Non-steroidal anti-inflammatory drugs - may be used to treat the inflammation, swelling, and pain caused by lupus.
symptomatic treatment.

If you suffer from lupus, there are several steps you can take to help yourself. Simple measures can make flare-ups less frequent and improve your quality of life:

Quit smoking.
Exercise regularly.
Stick to a healthy diet.
Watch out for the sun.
Adequate rest.

The prognosis for life in systemic lupus is unfavorable, but the latest advances in medicine and the use of modern drugs give a chance to prolong life. Already more than 70% of patients live more than 20 years after the initial manifestations of the disease.