Systemic Lupus Erythematosus
Systemic lupus erythematosus, often known simply as lupus or abbreviated to SLE, is a systemic autoimmune disease or an autoimmune connective tissue disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage. It is a hypersensitivity reaction of the type III variety, caused by antibody-immune complex formation. There are several explanations put forth for the term lupus erythematosus. Lupus is Latin for wolf, and "erythro" is derived from Greek for "red." All explanations originate with the reddish, butterfly-shaped malar rash that the disease classically exhibits across the nose and cheeks. In various accounts, some doctors thought the rash resembled the pattern of fur on a wolf's face. In other accounts, doctors thought that the rash, which was often more severe in earlier centuries, created lesions that resembled wolf bites or scratches. Another account claims that the term "lupus" did not come from Latin directly, but from the term for a French style of mask that women reportedly wore to conceal the rash on their faces. The mask is called a "loup," French for "wolf." There are actually an entire class of diseases known as lupus that are lesser components of SLE. SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions. The disease occurs nine times more often in women than in men, especially in women in child-bearing years ages 15 to 35, and is also more common in those of non-European descent. Most often respiratory therapists work with lupus patients when a flare affects lung and pleura inflammation.
SLE is treatable using immunosuppression, mainly with a drug known as cyclophosphamide, as well as corticosteroids and other immunosuppressants. Currently these drugs offer temporary relief as the disease has no cure. SLE can be fatal, although with recent medical advances, fatalities are becoming increasingly rare. As recently as 15 years ago, lupus was a high mortality rate disease. But currently, survival for people with SLE in the United States, Canada, and Europe has risen to approximately 95% at five years, 90% at 10 years, and 78% at 20 years, and now approaches that of matched controls without lupus. Childhood lupus typically manifests between the ages of 3 and 15, with girls outnumbering boys 4:1.
Lupus is difficult to diagnose due to the fact that it’s symptoms mimic a number of other diseases. It is one of a group of diseases known as the “great imitators” due to this fact. Part of this problem is that lupus affects multiple systems and patients and doctors mistakenly only treat one problem. Diagnosis can be elusive with patients suffering unexplained symptoms of SLE for years. There appear to be genetic links for SLE which help diagnose the disease in relatives of lupus sufferers. Typically SLE sufferers complain of low grade fever, joint pain, malaise (that general feeling “that something is not right”), myalgias (“muscle pain”) and temporary loss of cognitive abilities. Since these are common signs of other diseases, this also lends credence to “the great imitator” name.
As many as 30 percent of SLE sufferers have dermatological problems with 30 to 50 percent suffering from a malar rash known as the butterfly rash for its relative shape. Some exhibit red, scaly patches on the skin, known as discoid lupus. Additional symptoms include alopecia (hair loss), skin lesions and mouth, nasal, urinary tract and/or vaginal ulcers. The skin around the eyes are particularly delicate with tiny tears occurring after only minimal rubbing.
SLE sufferers typically encounter arthritis pain in the joints, particularly the small joints of the hand and wrist. The Lupus Foundation of...
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