What kind of disease is lupus erythematosus. Lupus erythematosus: what kind of disease and how to treat it

Systemic lupus erythematosus is a disease that is associated with a disorder. She simply perceives the cells of her own body as foreign and begins to actively fight them. During this process, harmful, toxic substances are produced in the body - they affect almost all organs and systems.

According to statistics, more often systemic lupus erythematosus is diagnosed in women aged 15-25 years.

Reasons for the development of systemic lupus erythematosus

It is recognized all over the world that the only reason for the development of the disease in question is the formation of abnormal antibodies in the body. This occurs under the direct influence of genetic factors, which confirms the relationship of the disease with a congenital deficiency of the components of the immune system.

Despite the established fact of diagnosing systemic lupus erythematosus in most women, no evidence of a connection between the disease in question and hormonal disruptions was found.

Note:  hormonal disorders only provoke manifestations of systemic lupus erythematosus, therefore, when diagnosing this disease, doctors forbid patients to take oral contraceptives.

The disease under consideration can be asymptomatic for a long time - patients will only notice a pain syndrome of low intensity in the joints and muscle tissues and periodically appearing rashes on the skin. But during such an asymptomatic course of lupus erythematosus, abnormal antibodies accumulate in the body - at any time they can result in serious pathological damage to organs.

There are two forms of the systemic lupus erythematosus - acute and chronic. Depending on the form that will be diagnosed in the patient, the symptoms of lupus erythematosus will also vary. The only visible phenomenon that is considered the main symptom of the disease in question is a rash on the face, affecting the nose bridge and spreading to the cheekbones. Doctors call this rash a "butterfly."

Acute form

In this case, systemic lupus erythematosus always begins its development suddenly - fever, inflammation of the characteristic "butterfly" on the face. Interestingly, the acute course of the described disease can last 1-2 years. But if a competent prescription of medicines is made and hormonal drugs are selected, then a long-term remission may develop.

Chronic form

The course of this form of the disease is long, characterized by a wavy character and frequent relapses. The chronic form is manifested by polyarthritis, polyserositis, Raynaud's syndrome. For 5-10 years of the chronic course of systemic lupus erythematosus, pathologies of the lungs, kidneys, and heart are necessarily added to all the described manifestations of the disease.

In medicine, it is customary to distinguish between three degrees of development of systemic lupus erythematosus:

• minimum;
• average;
• high.

They are determined during the manifestation of morphological and immunological disorders.

What is going on in the body?

Patients with the development of systemic lupus erythematosus present a variety of complaints, some specific simply does not exist. Here are just a few of them.:

• spontaneous, unmotivated increase in body temperature;
• periodically occurring pains in large and small joints;
• sleep is disturbed - at night, patients often wake up, which leads to fatigue;
• general weakness appears.

Systemic lupus erythematosus is a progressive disease, so pathological changes occur in the body over time.

Joints

According to statistics, almost all patients with diagnosed lupus erythematosus have lupus arthritis. And most often, these joints undergo small joints - hands, ankle joints, and wrist joints. Deformation of the joints of the fingers of the upper extremities is often diagnosed, which provokes severe pain in the muscles.

Skin lesion is the most typical manifestation of the disease in question. Systemic lupus erythematosus is characterized by the appearance of rashes in the nose and cheekbones, referred to as the “butterfly”. These rashes can have a different manifestation:

• vascular "butterfly" - unstable redness with a bluish tint, which most often worsens when exposed to external factors (cold, heat, patient’s internal excitement);
• erythematic-edematous spots - “butterfly” is characterized by keratinization of the skin;
• “Butterfly” with dense edema in the area of \u200b\u200blocalization of rashes - this happens against the background of general edema of the face;
• in the “butterfly” there will be a clearly defined atrophy that looks like a scar.

In some cases, rashes are not only localized in the face - they are observed on the neck (décolleté zone), in the scalp, on the lips, and even over the affected joints of the lower / upper extremities.

A separate case - rashes on the mucous membranes, can be diagnosed with thrush and minor hemorrhages.

Skin manifestations of systemic lupus erythematosus include vasculitis and trophic disorders, which include ulcers, pressure sores, nail deformation, and hair loss.

Serous membranes

Polyarthritis and polyserositis - this triad is the basis for the diagnosis of systemic lupus erythematosus. Polyserositis - this term refers to inflammation of the pleura (pleurisy), inflammation of the heart bag (pericarditis), less often, but peritonitis also occurs (an inflammatory process in the peritoneum). It is noteworthy that the inflammatory process with systemic lupus erythematosus "migrates" from one serous membrane to another.

With the development of systemic lupus erythematosus, doctors note the defeat of two, and in some cases three, of the heart membranes. Against the background of the disease in question, pericarditis, atypical endocarditis of the warty type, myocarditis are diagnosed.

Lesions of the vascular system leads to the appearance of signs of Raynaud's syndrome.

Lungs

Actually the disease in question does not affect the lungs, a secondary infection occurs - pneumococcal. In rare cases, vascular pneumonia can be diagnosed - its appearance is associated with damage to the vascular system.

Gastrointestinal tract

Patients in connection with the development of systemic lupus erythematosus noted loss of appetite and dyspeptic disorders. Very rarely, necrotic processes can develop - for example, esophageal ulcers, aphthous stomatitis.

Kidney

Most often, with the disease in question, glomerulonephritis develops. This is a rather dangerous condition that can lead to disability.

Neuropsychic sphere

In 50% of cases, patients with a diagnosis of systemic lupus erythematosus are diagnosed with disorders in the psycho-emotional background: irritation, fatigue, unmotivated aggression. This includes sleep disturbances,. And the most severe manifestations are meningoencephalitis, encephalomyelitis.

Diagnostic measures

Systemic lupus erythematosus is diagnosed based on a patient examination and laboratory tests. A large number of lupus cells — LE cells — will be detected in the blood. But for the diagnosis of the disease in question, the presence of a complete clinical picture is very important. There are certain criteria in medicine:

• characteristic rashes on the face - “butterfly”;
• alopecia - baldness;
• discoid lupus;
• ulceration on the mucous membrane of the oral cavity and nasopharynx;
• false positive Wassermann reaction;
• arthritis with no deformation of the affected joints;
• hypersensitivity to ultraviolet rays;
• pleurisy;
• pericarditis;
• manifestations of psychosis;
• raynaud's syndrome.

If 3 of any of the above criteria are available, and LE cells are found in the blood, then this is the basis for the diagnosis of systemic lupus erythematosus.

Principles of treatment of systemic lupus erythematosus

If the disease in question was diagnosed at an early stage of its development, then the treatment will be very effective. But doctors give such a forecast only if they undergo therapy in stationary conditions with each exacerbation of the disease.

If the patient's complaints are dominated by signs of inflammatory processes in large and small joints, then the following appointments are made:

• salicylates;
• analgin;
• non-steroidal anti-inflammatory drugs;
• indomethacin.

Treatment with these drugs is ongoing. Doctors should consider the possible occurrence of allergic reactions during long-term therapy and the ability of these drugs to provoke the formation of edema.

The chronic form of the disease in question is treated with quinoline drugs. They should be taken no more than 14 days in a row, because they provoke the development of side effects - nausea, vomiting, tinnitus, headache.

The main treatment for systemic lupus erythematosus is the glucocorticosteroid line of drugs. Doctors must prescribe them to patients who have serous membranes, as well as the heart / kidneys / blood vessels. Most often, prednisone is prescribed, but if the body does not respond to therapy with this drug, then doctors make a replacement for dexamethasone or triampcinolone.

If there is no effect in the treatment of glucocorticosteroid drugs, experts recommend the use of cytotoxic immunosuppressants. In general, these drugs are indicated for severe forms of systemic lupus erythematosus, when many organs and systems are affected.

Important:  It is strictly forbidden for patients with a diagnosis of systemic lupus erythematosus to visit resorts and undergo treatment in southern sanatoriums - this can trigger the onset of another exacerbation of the disease.

Preventive actions

Primary prevention is the identification of a similar disease in the family of patients. Even if a systemic lupus erythematosus has been diagnosed in the most distant relative, or if the patient has isolated skin lesions, it is worth adhering to certain recommendations. They are following:

• avoid ultraviolet radiation;
• do not be in direct sunlight;
• follow a salt-restricted diet;
• regularly undergo preventive examinations by a dermatologist and infectious disease specialist.

In case of diagnosing systemic lupus erythematosus, the risk of developing an exacerbation of the disease should be minimized - this will be secondary prevention. It is necessary to undergo adequate, competent treatment in a timely manner, it is advisable to avoid vaccination and surgical interventions.

Systemic lupus erythematosus is not treated with traditional medicine - the cause of this pathology lies in the internal immune processes, so no medicinal plants will help.

Lupus is an autoimmune type of disease in which the defense system of the human body (that is, its immune system) attacks its own tissues, while ignoring foreign organisms and substances in the form of viruses and bacteria. This process is accompanied by inflammation and lupus, the symptoms of which are manifested in the form of pain, swelling and tissue damage throughout the body, being in its acute stage, provokes the appearance of other serious diseases.

general information

Lupus, as understood in its abbreviated name, is fully defined as systemic lupus erythematosus. And although in a significant number of patients with this disease the manifestation of symptoms occurs in a weak expression, lupus itself is incurable, threatening in many cases an exacerbation. Patients can control the characteristic symptoms, as well as prevent the development of various diseases related to organs, for which they should undergo regular examinations by a specialist, devoting a considerable amount of time to an active lifestyle and rest, and, of course, taking timely prescribed medications.

Lupus: symptoms of the disease

The main symptoms that appear with lupus are severe fatigue and the appearance of a skin rash, in addition, joint pain also appears. In the case of disease progression, these types of lesions become relevant, which affect the functioning and general condition of the heart, kidneys, nervous system, blood and lungs.

Symptoms that appear with lupus directly depend on which organs are affected by it, as well as on what degree of damage is characteristic of them at a particular time of their manifestation. Consider the main of these symptoms.

• Weakness.Almost all patients with a diagnosis of lupus claim that they have to experience fatigue in varying degrees of its manifestation. And even if we are talking about weak lupus, its symptoms make significant adjustments to the patient’s usual lifestyle, interfering with active activities and sports. If fatigue is noted sufficiently strong in its manifestation, then we are already talking about it as a sign indicating an imminent aggravation of symptoms.
• Pain in muscles, in joints.  Most patients who are diagnosed with lupus have to experience joint pain (i.e.) from time to time. At the same time, more than 70% of the total number of them claim that the pain in the muscles was the first manifestation of the disease. As for the joints, they can undergo redness, they also swell a little and get warm. Some of the cases indicate a feeling of immobility in the morning. With lupus, arthritis primarily occurs in the wrists, as well as in the hands, knees, ankles and elbows.
• Skin diseases.  The overwhelming majority of patients with lupus also experience the appearance of a skin rash. Systemic lupus erythematosus, the symptoms of which indicate a possible involvement in this disease, precisely due to this manifestation make it possible to diagnose the disease. On the nose and cheeks, in addition to the characteristic rash, red painful spots often appear in the arms, back, neck, lips and even in the mouth. Also, the rash may be purple bumpy or red and dry, still focusing on the face, scalp, neck, chest and arms.
• Hypersensitivity to light.  In particular, ultraviolet (solarium, sun) contributes to an exacerbation of the rash, while also provoking an exacerbation of the remaining symptoms characteristic of lupus. Particularly sensitive to such exposure to ultraviolet light people are fair-haired and white-skinned.
• Violations of the nervous system.  Quite often, lupus is accompanied by diseases associated with the work of the nervous system. These include headaches and depression, anxiety, etc. A relevant, albeit less common, manifestation is memory impairment.
• Various heart diseases. Many of the patients with lupus also experience this type of disease. So, often there is inflammation in the pericardial sac (otherwise defined as pericarditis). This, in turn, can provoke the appearance of acute pain in the center of the left side of the chest. Further, such pain can spread to the back and neck, as well as to the shoulders and arms.
• Mental disorders.  Lupus is also accompanied by mental disorders, for example, they may consist in a constant and unmotivated sense of anxiety or may be expressed as depression. These symptoms are caused both by the disease itself and by drugs against it, and stresses accompanying many different chronic diseases also play a role in their appearance.
• Change in temperature.Often, lupus appears with one of its symptoms, such as low temperature, which also in some cases allows you to diagnose this disease.
• Weight change.  Lupus exacerbations are usually accompanied by rapid weight loss.
• Hair loss.  Hair loss in the case of lupus is a temporary manifestation. Loss occurs either in small pieces, or evenly along the entire head.
• Inflammation of the lymph nodes.  With exacerbation of the symptoms characteristic of lupus, patients often experience swelling of the lymph nodes.
• Raynaud's phenomenon (or vibrational illness).  This disease in some cases is accompanied by lupus, while small vessels are exposed to the lesion along which blood flows to the soft tissues and to the skin under them in the area of \u200b\u200bthe fingers and toes. Due to this process, they acquire a white, red or bluish tint. In addition, the affected areas experience numbness and tingling with a simultaneous increase in their temperature.
• Inflammatory processes in the blood vessels of the skin (or skin vasculitis).  Lupus erythematosus, the symptoms of which we have listed, can also be accompanied by inflammation of the blood vessels and their bleeding, which, in turn, provokes the formation of red or blue spots of various sizes on the skin, as well as in the nail plates.
• Swelling of the feet, palms.Some patients with lupus experience kidney disease caused by it. This becomes an obstacle to removing fluid from the body. Accordingly, the accumulation of excess fluid can lead to swelling of the feet and hands.
• Anemia. Anemia, as you may know, is a condition characterized by a decrease in the amount of hemoglobin in the blood cells, due to which oxygen is transported. Many people who have certain chronic diseases face time with, which is caused, respectively, by a decrease in the level of red blood cells.

Systemic lupus erythematosus: symptoms that need to be addressed

Treatment of lupus should begin as soon as possible - this will avoid damage to organs that are irreversible in their consequences. As for the main drugs used in anti-lupus therapy, these include anti-inflammatory drugs and corticosteroids, as well as drugs whose action is aimed at suppressing the activity characteristic of the immune system. Meanwhile, about half of the total number of patients diagnosed with systemic lupus erythematosus cannot be treated using standard methods for them.

For this reason, stem cell therapy is prescribed. It consists in their collection from the patient, after which therapy is carried out aimed at suppressing the immune system, which completely destroys it. Further, in order to restore the immune system, stem cells that were previously removed are introduced into the bloodstream. As a rule, the effectiveness of this method is achieved with a refractory and severe course of the disease, and it is recommended even in the most severe, if not hopeless cases.

As for the diagnosis of the disease, in the event of any of the listed symptoms in case of suspicion of it, you should contact a rheumatologist.

Systemic lupus erythematosus (SLE) is a disease in which, due to a malfunction of the immune system, inflammatory reactions develop in various organs and tissues.

The disease proceeds with periods of exacerbation and remission, the occurrence of which is difficult to predict. In the final, systemic lupus erythematosus leads to the formation of insufficiency of one or another organ, or several organs.

Women suffer from systemic lupus erythematosus 10 times more often than men. The disease is most common at the age of 15-25 years. Most often, the disease manifests during puberty, during pregnancy and in the postpartum period.

Causes of Systemic Lupus Erythematosus

The cause of systemic lupus erythematosus is not known. The indirect influence of a number of factors of the external and internal environment, such as heredity, viral and bacterial infection, hormonal changes, environmental factors, is discussed.

For the onset of the disease, a genetic role plays a role. It is proved that if lupus is detected in one of the twins, then the risk that the second can get sick increases by 2 times. Opponents of this theory indicate that the gene responsible for the development of the disease has not yet been found. In addition, in children, one of whose parents is ill with systemic lupus erythematosus, only 5% develop a disease.

The frequent detection of the Epstein-Barr virus in patients with systemic lupus erythematosus speaks in favor of the viral and bacterial theory. In addition, it has been proven that the DNA of certain bacteria can stimulate the synthesis of antinuclear autoantibodies.

In women with SLE in the blood, an increase in such hormones as estrogen and prolactin is often determined. Often the disease manifests during pregnancy or after childbirth. All this speaks in favor of the hormonal theory of the development of the disease.

It is known that ultraviolet rays in a number of predisposed individuals can start the production of autoantibodies by skin cells, which can lead to the emergence or exacerbation of an existing disease.

Unfortunately, none of the theories reliably explains the cause of the development of the disease. Therefore, at present, systemic lupus erythematosus is considered a polyetiological disease.

Symptoms of systemic lupus erythematosus

Under the influence of one or more of the above factors under conditions of improper functioning of the immune system, DNA of various cells is “exposed”. Such cells are perceived by the body as foreign (antigens), and to protect against them, special antibody proteins are produced that are specific to these cells. In the interaction of antibodies and antigens, immune complexes are formed that are fixed in various organs. These complexes lead to the development of immune inflammation and cell damage. Especially often cells of connective tissue are affected. Given the widespread distribution of connective tissue in the body, with systemic lupus erythematosus, almost all organs and tissues of the body are involved in the pathological process. Immune complexes, fixing on the wall of blood vessels, can provoke thrombosis. Circulating antibodies due to their toxic effects lead to the development of anemia and thrombocytopenia.

Systemic lupus erythematosus refers to chronic diseases occurring with periods of exacerbation and remission. Depending on the initial manifestations, the following options for the course of the disease are distinguished:

acute course of SLE  - manifested by fever, weakness, fatigue, pain in the joints. Very often, patients indicate the day onset of the disease. Within 1-2 months, a detailed clinical picture of the defeat of vital organs is formed. With a rapidly progressing course, after 1-2 years, patients usually die.
subacute SLE  - The first symptoms of the disease are not so pronounced. From manifestation to organ damage, an average of 1-1.5 years passes.
chronic course of SLE  - Over the years, one or more symptoms have occurred. In the chronic course, periods of exacerbation are rare, without disrupting the functioning of vital organs. Often, minimum doses of drugs are required to treat the disease.

As a rule, the initial manifestations of the disease are nonspecific, when taking anti-inflammatory drugs or spontaneously they go away without a trace. Often the first sign of illness is the appearance on the face of redness in the form of butterfly wings, which also disappears with time. The period of remission, depending on the type of course, can be quite long. Then, under the influence of some predisposing factor (prolonged exposure to the sun, pregnancy), an exacerbation of the disease occurs, which also subsequently changes to a phase of remission. Over time, symptoms of organ damage join in with nonspecific manifestations. For a detailed clinical picture, damage to the following organs is characteristic.

1. Skin, nails and hair. Skin lesions are one of the most common symptoms of the disease. Often the symptoms appear or intensify after prolonged exposure to the sun, frost, with a psycho-emotional shock. A characteristic feature of SLE is the appearance in the area of \u200b\u200bthe cheeks and nose of the redness of the skin in the form of butterfly wings.

Butterfly type erythema

Also, as a rule, in open areas of the skin (face, upper limbs, decollete), there are various shapes and sizes of redness of the skin, prone to peripheral growth-centrifugal Bietta erythema. Discoid lupus erythematosus is characterized by the appearance of redness on the skin, which is then replaced by inflammatory edema, then the skin becomes denser in this area, and atrophy sites with scarring are formed in the end.

Foci of discoid lupus can occur in various areas, in this case they indicate dissemination of the process. Another striking manifestation of skin lesions is capillary redness and swelling and numerous small-point hemorrhages on the pads of the fingers, palms, soles. Damage to hair with systemic lupus erythematosus is manifested by baldness. Changes in the structure of nails, up to atrophy of the periungual cushion, occurs during an exacerbation of the disease.

2. Mucous membranes. The mucous membrane of the mouth and nose is usually affected. The pathological process is characterized by the appearance of redness, the formation of erosion of the mucous membrane (enanthem), as well as small oral ulcers (aphthous stomatitis).

Aphthous stomatitis

With the appearance of cracks, erosion and ulcers of the red border of the lips, lupus cheilitis is diagnosed.

3. Musculoskeletal system. Joint damage occurs in 90% of patients with SLE.

Small joints, usually the fingers of the hand, are involved in the pathological process. The defeat is symmetrical in nature, patients are worried about pain and stiffness. Joint deformation rarely develops. Aseptic (without an inflammatory component) bone necrosis is common. The femoral head and knee are affected. The clinic is dominated by symptoms of functional insufficiency of the lower limb. When involved in the pathological process of the ligamentous apparatus, inconsistent contractures develop, in severe cases of dislocation and subluxation.

4. Respiratory system. The most common lung lesion. Pleurisy (fluid accumulation in the pleural cavity), as a rule, bilateral, accompanied by pain in the chest and shortness of breath. Acute lupus pneumonitis and pulmonary hemorrhages are life-threatening conditions and, without treatment, lead to the development of respiratory distress syndrome.

5. The cardiovascular system. The most common is Liebman-Sachs endocarditis with frequent mitral valve damage. In this case, as a result of inflammation, the valve cusps grow together and the formation of heart disease according to the type of stenosis. With pericarditis, the leaves of the pericardium thicken, and fluid may also appear between them. Myocarditis is manifested by pain in the chest area, enlarged heart. SLE often affects small and medium caliber vessels, including coronary arteries and brain arteries. Therefore, stroke, coronary heart disease are the main cause of death in patients with SLE.

6. Kidney. In patients with SLE with high activity of the process, lupus nephritis is formed.

7. Nervous system. Depending on the affected area, a wide range of neurological symptoms is revealed in patients with SLE, ranging from migraine-type headaches to transient ischemic attacks and strokes. During a period of high activity of the process, epileptic seizures, chorea, cerebral ataxia can occur. Peripheral neuropathy occurs in 20% of cases. Its most dramatic manifestation is neuritis of the optic nerve with loss of vision.

Diagnosis of systemic lupus erythematosus

A diagnosis of SLE is considered established if there are 4 or more of 11 criteria (American Rheumatology Association, 1982).

Butterfly type erythema	Fixed erythema (flat or elevated) on the cheekbones, with a tendency to spread to the nasolabial folds.
Discoid rash	Towering erythematous lesions with tight-fitting scales, skin atrophy and scarring over time.
Photosensitivity	The appearance or intensification of the severity of the rash after exposure to the sun.
Mucosal ulcers of the mouth and / or nasopharynx	As a rule, painless.
Arthritis	The appearance of edema and soreness of at least two joints without their deformation.
Serositis	Pleurisy or pericarditis.
Kidney damage	One of the following manifestations: a periodic increase in protein in the urine to 0.5 g / day or the definition of cylinders in the urine.
CNS damage	One of the following manifestations: convulsive seizures or psychoses not associated with other causes.
Hematologic disorders	One of the following manifestations: hemolytic anemia, lymphopenia, or thrombocytopenia, not associated with other causes.
Immune Disorders	Detection of LE cells, or antibodies to nDNA in serum, or antibodies to Smith antigen, or false-positive Wasserman reaction that lasts for 6 months without revealing pale treponema.
Antinuclear Antibodies	An increase in the titer of antinuclear antibodies, not associated with other reasons.

Immunological tests play an important role in the diagnosis of SLE. The absence of an antinuclear factor in the blood serum casts doubt on the diagnosis of SLE. Based on laboratory data, the degree of disease activity is determined.

With an increase in the degree of activity, the risk of damage to new organs and systems increases, as well as the aggravation of existing diseases.

Treatment of systemic lupus erythematosus

Treatment should be as appropriate as possible for a particular patient. Hospitalization is necessary in the following cases:

With persistent temperature increase for no apparent reason;
  when life-threatening conditions occur: rapidly progressing renal failure, acute pneumonitis or pulmonary hemorrhage.
  with the appearance of neurological complications.
  with a significant decrease in the number of platelets, red blood cells or lymphocytes in the blood.
  in the case when exacerbation of SLE is impossible to cure on an outpatient basis.

For the treatment of systemic lupus erythematosus in the period of exacerbation, hormonal drugs (prednisone) and cytostatics (cyclophosphamide) are widely used according to a certain scheme. With damage to the organs of the musculoskeletal system, as well as with an increase in temperature, non-steroidal anti-inflammatory drugs (diclofenac) are prescribed.

For adequate treatment of a disease of an organ, a specialist consultation in this area is necessary.

The prognosis for life with SLE with timely and proper treatment is favorable. The five-year survival rate of such patients is about 90%. But, nevertheless, the mortality rate of patients with SLE exceeds the general population by three times. Factors of an unfavorable prognosis are considered the early onset of the disease, male gender, the development of lupus nephritis, high activity of the process, infection.

Doctor therapist Sirotkina E.V.

Systemic lupus erythematosus is a disease in which the human immune system perceives its own structures as foreign elements. This is a disease of young women. 9 out of 10 patients are young girls aged 15 to 26 years.

Other pathology names are SLE, Liebamn-Sachs disease, diffuse connective tissue disorder. The disease got its main name because of a characteristic symptom - a rash on the face that resembles the silhouette of a butterfly. And in the Middle Ages, the affected area was associated with a place for wolf bites.

When systemic lupus erythematosus begins to progress, symptoms occur very quickly and form into entire symptom complexes. In the body during the development of the disease, such substances are formed that adversely affect absolutely all organs and tissues. The only difference is that the target organs are destroyed faster than other tissues and structures.

Probable triggering factors

The reasons why such an unfavorable autoimmune resolution process occurs have not yet been elucidated. There are only theories, as well as possible assumptions regarding the etiological role of some factors. These are the following aspects.

1. Chronic viral infection. We are talking about RNA viruses and retroviruses. In many patients with SLE, a huge amount of antibodies to these viruses was found in the blood, which indicates a previously raging infectious process.
2. Genetic predisposition. It has been proven that cases of lupus erythematosus are recorded more often in those patients whose close relatives suffered from such a disease.
3. Individual susceptibility to drugs can also cause a serious malfunction of the whole organism at the cellular level. We are talking about specific types of intolerance - a negative reaction to vaccines, serums.
4. Photosensitization and ultrasonic irradiation can cause various malfunctions.

The fact that young women are ill in the overwhelming majority of cases leads to the thought of “purely female” provoking factors. These are frequent and complex pregnancies, a history of multiple births, abortions and miscarriages.

Pathogenetic aspects of the development of systemic lupus erythematosus

The basis of the pathogenesis of SLE is a violation of the regulation of the basic defense processes by the immune system. For example, how antigens perceive protein components, primarily DNA. As a result of adhesion, chronic immune failure leads to the fact that even those cells that were previously completely free of immunocomplexes begin to suffer.

Classification of the disease according to MBC

Systemic lupus erythematosus, according to the classification of MBK, can be of the following types:

• SLE caused by taking pharmacological products;
• SLE, accompanied by damage to other organs and systems;
• lupus erythematosus, unspecified;
• other forms of SLE.

Clinical classification divides different types of ailment according to other criteria. First of all, take into account the nature of the flow:

• acute;
• subacute;
• recurrent polyarthritis;
• discoid lupus erythematosus;
• S-Reynaud;
• St. Werlhof;
• S-mShegrena;
• antiphospholipid syndrome.

The disease can be active in varying degrees. Depending on how rapidly the disease progresses, specialists use the following methods of designation:

• 0 - activity is completely absent;
• I is the minimum;
• II - moderate;
• III - high.

In the table below, another complex classification of the disease is considered. SLE is considered from the perspective of the severity of clinical manifestations, depending on which system has suffered the most.

Type of SLE by the severity of clinical manifestations	Clinical manifestations
Light SLE	Rash of erythematous nature, discoid rashes, Raynaud's phenomenon, baldness, ulcerative processes on the mucous membranes of the mouth, nasopharynx, feverish conditions of varying severity, pain in the joints and muscle, dry pericarditis, pleurisy with a small amount of exudative fluid.
Severe SLE	Myocarditis, pericarditis, pleurisy with a large amount of exudate, nephrotic syndrome, pulmonary hemorrhage, thrombocytopenic purpura, hemolytic anemia, vasculitis, central nervous system lesions of varying severity.

Systemic lupus erythematosus in children and patients over 40 years of age is relatively rare. The risk group is formed by women aged 15 to 26 years, as previously mentioned.

Initial manifestations that patients can turn to:

• weakness;
• weight loss;
• low-grade fever.

However, the progression of the disease forms a complex and rather vivid clinical picture. We consider separately each system involved in the pathological process.

Skin and mucous membranes

The most common symptom of lupus is characteristic skin changes. The pathological process is able to affect the tissue of the dermal tissue and mucous membranes in 28 different ways. The most characteristic of them are presented below.

1. Erythematous spots of various sizes and shapes, which can be located in isolation from each other or merge into one conglomerate. The color is saturated bright. The tissues are swollen, inflamed.
2. Erythematous foci with infiltration, atrophy of the dermis, peeling. Sometimes there are signs of hyperkeratosis. A symptom is characteristic of a chronic form of the disease.
3. Lupus cheilitis - redness of the lips, which eventually become crusty, erosive, followed by deep tissue atrophy.
4. Capillaries - edematous spots, localized in the area of \u200b\u200bthe fingertips, on the palms, soles.
5. Enanthema of the mucous tissues of the oral cavity - erythematous rashes, accompanied by severe hemorrhages and erosion.
6. Trophic disorders are pathological processes in which a person loses hair, nails, and skin tissue becomes excessively dry.
7. Ring-shaped rashes with telangiectasias.

Musculoskeletal system

Damage to the connective tissue greatly affects the functional potential of the musculoskeletal system. The following symptoms indicate that the bones and joints are involved in the pathological process:

• joint pain (prolonged, intense);
• polyarthritis of a symmetric type, which is accompanied by involvement in the inflammatory process of the interphalangeal joints of the hands;
• stiff joints, especially in the morning;
• the formation of flexion contractures of the fingers;
• the development of aseptic necrotic processes in inert and cartilage tissues.

No less strongly are “aggressions” of the autoimmune process and muscles. Patients complain of persistent myalgia, as well as severe muscle weakness. Polymyositis may develop.

Respiratory system

Considering how lupus erythematosus affects life expectancy, it is worth familiarizing yourself with the clinical picture of the affected lungs of the patient. The disease is accompanied by the following phenomena:

• dry or effusion pleurisy, accompanied by severe shortness of breath, shortness of breath, severe pain;
• lupus pneumonitis is manifested by shortness of breath, pain, dry cough, hemoptysis;
• pulmonary hypertension syndrome;
• Tela, as one of the types of complications.

The cardiovascular system

Pancarditis, or dry pericarditis, often develops. Diffuse myocarditis develops with the most active form of lupus. Such a pathological process is also complicated by circulatory failure.

With endocarditis, the valvular apparatus of the heart is affected. Mitral insufficiency is gradually formed, and then aortic valve insufficiency.

Vessels are also involved in the total destructive process. First of all, medium and small caliber vessels suffer. Thrombophlebitis and phlebitis often occur. If coronary arteries are affected, the risk of myocardial infarction increases.

Digestive tract

Patients complain of a constant feeling of nausea, often occurring vomiting. The appetite is completely absent. Over time, the mucous membrane of the digestive canal begins to affect erosive processes of varying severity.

If the vessels of the mesentery are affected, very severe pains begin to disturb the patient. Localization - around the navel. Stiffness of the abdominal muscles is observed. Liver destruction is expressed by such pathological phenomena - an increase in the organ, jaundice.

Kidney damage

There is a whole classification according to which lupus nephritis is divided into several global categories:

• I - the absence of any structural abnormalities in the biopsy;
• II - mesangial nephritis;
• III - focal glomerulonephritis of the proliferative type;
• IV - diffuse proliferative glomerulonephritis;
• V - membranous glomerulonephritis;
• VI - sclerosing glomerulonephritis.

The table discusses key aspects regarding basic laboratory research. Diagnostic results allow you to accurately establish the diagnosis.

The diagnosis is based on a combination of specific symptoms. There are 11 special criteria. If at least 4 of them are observed in a patient, they are diagnosed with systemic lupus erythematosus:

• rash in the form of a "butterfly";
• excessive skin sensitivity to ultraviolet rays;
• discoid rash;
• ulcerative processes localized on the mucous membranes;
• arthritis;
• pleurisy;
• kidney damage
• damage to the central nervous system;
• immunological disorders;
• problems with blood cells (leukopenia, anemia);
• antinuclear bodies.

For the treatment of diagnosed systemic lupus erythematosus, a number of special pharmacological products are used. The table considers all five groups of drugs that are relevant in modern schemes of therapeutic effects on patients.

The name of the group of pharmacological products	Specific Drug Examples	Features of appointment and application
Nonsteroidal anti-inflammatory drugs (NSAIDs)	Ibuprofen, Naproxen, Aspirin	Medications are prescribed only for a short period of time to eliminate the active inflammatory process.
Antimalarial drugs	Hydroxychloroquine	Funds are prescribed for a long period. The effect of taking medication occurs only after 1-2 months. Well established in the treatment of SLE with a pronounced sensitivity to ultraviolet radiation.
Corticosteroids	Prednisone prednisone	Medicines reduce the activity of the immune system, inhibit inflammatory reactions. Reception begins with the minimum doses, gradually increasing to the maximum. Cancellation is also carried out gradually, reducing the number of medicinal products.
Anti-rheumatic drugs	Azathioprine, Methotrexate, Cyclophosphamide	Drugs suppress inflammation. The effect is similar to hormonal drugs, but the mechanism of action on the tissues of the human body is different.
Biological PPMTB	Rituximab	Biological agents, the action of which is directed to B-lymphocytes synthesizing antibodies.

Duration of therapy and use of non-standard approaches to treatment

Treatment should last as long as the symptoms of the disease are observed. It is impossible to interrupt therapy under any pretext.

Today, patients are offered many alternative treatment options for such a complex disease. Each unverified method, methods associated with a number of risks and complications or not approved by official medicine, carry more harm than good.

Systemic lupus erythematosus can only be treated with medication under the strict supervision of a physician. This is the only way to get rid of the disease and lead a full life.

Predictions for Patients

The prognosis is favorable if the disease was detected as early as possible, when the tissues and organs have not yet undergone severe destruction. A mild rash and arthritis, for example, are very easy to control.

The advanced forms of the disease require aggressive treatment with large doses of various pharmacological products. In this case, it is not known what harms the body more: colossal doses of drugs or the pathological process itself.

Preventive actions

Prevention of systemic lupus erythematosus is aimed solely at preventing relapse of the disease, as well as at stopping the further progression of pathological processes. The essence of secondary preventive measures is the timely and adequate treatment of the disease.

Patients undertake to regularly undergo clinical examinations, to take hormonal medications in the correct dosage. Do not sunbathe in the sun, do not supercool, avoid injuries, do not vaccinate and get vaccinated. In case of exacerbation of the disease, you should immediately contact a specialist who has previously been involved in the treatment of this person.

Conclusion

Thus, systemic lupus erythematosus is a rather serious autoimmune disease that requires an integrated approach to treatment. In case of timely diagnosis, there is a chance to live a full life. That is why it is so important to consult a specialist in time at the first adverse signals.

Lupus erythematosus is among the diffuse diseases of connective tissue. Under the general name several clinical forms are combined. From this article you can find out what the symptoms of lupus erythematosus have, the causes of development, as well as the basic principles of treatment.

Mostly women are ill. It manifests, as a rule, at the age of 20 to 40 years. It is more common in countries with a humid marine climate and cold winds, while in the tropics the incidence is low. Blondes are more susceptible to disease than brunettes and blacks. Common signs include sensitivity to ultraviolet radiation, vascular rashes on the skin (erythema) and on mucous membranes (enanthema). A characteristic symptom is an erythematous rash on the face in the form of a butterfly.

Classification

A single classification is currently lacking, and all existing ones are very arbitrary. The division into two varieties is widespread: cutaneous - relatively benign, without damage to internal organs; systemic - severe, in which the pathological process extends not only to the skin and joints, but also to the heart, nervous system, kidneys, lungs, etc. Among skin forms, chronic discoid (limited) and disseminated chronic (with many foci) are distinguished. Cutaneous lupus erythematosus can be superficial (centrifugal Bietta erythema) and deep. In addition, there is a lupus erythematosus syndrome.

Systemic lupus erythematosus is acute, subacute and chronic, in the phase of activity - active and inactive, the degree of activity - high, moderate, minimal. Skin forms can be transformed into a systemic one. Some experts tend to believe that this is one disease that proceeds in two stages:

• pre-systemic - discoid and other skin forms;
• generalizations - systemic lupus erythematosus.

Why arises?

The reasons are still unknown. The disease is an autoimmune disease and develops as a result of the formation of a large number of immune complexes that are deposited in healthy tissues and damage it.

Some infections, drugs, chemicals, together with a hereditary predisposition, are usually considered to be provoking factors. Allocate lupus erythematosus syndrome, which develops as a consequence of taking certain medications and is reversible.

Discoid lupus erythematosus

Symptoms of this form of the disease appear gradually. First there is a characteristic (in the form of a butterfly) erythema on the face. Rashes are localized on the nose, cheeks, forehead, on the red border of the lips, in the scalp, on the ears, less often on the back surfaces of the legs and arms, upper body. The red border of the lips can be affected in isolation, elements of the rash rarely appear on the mucous membrane of the oral cavity. Skin manifestations are often accompanied by joint pain. Discoid lupus, the symptoms of which appear in the following sequence: erythematous rash, hyperkeratosis, atrophic phenomena, goes through three stages of development.

The first is called erythematous. During this period, a pair of clearly defined pink spots forms with a vascular mesh in the center, slight swelling is possible. Gradually, the elements increase in size, merge and form foci that resemble a butterfly in shape: its “back” is on the nose, and “wings” are located on the cheeks. There may be tingling and burning sensations.

The second stage is hyperkeratous. It is characterized by infiltration of the affected areas, on the site of the foci dense plaques appear, covered with small whitish scales. If you remove the flakes, under them you will find a section resembling a lemon peel. In the future, keratinization of elements occurs around which a red rim is formed.

The third stage is atrophic. As a result of cicatricial atrophy, the plaque takes the form of a saucer with a white area in the center. The process continues to progress, foci increase in size, new elements appear. In each focus, three zones can be found: in the center - a site of cicatricial atrophy, then - hyperkeratosis, along the edges - redness. In addition, pigmentation and telangiectasia (small dilated vessels, or spider veins) are observed.

Auricles, oral mucosa, scalp are less commonly affected. At the same time, comedones appear on the nose and ears, the mouths of the follicles expand. After the foci resolve, areas of baldness remain on the head, which is associated with cicatricial atrophy. Cracks, swelling, thickening are observed on the red border of the lips, keratinization of the epithelium, erosion on the mucosa. When the mucous membrane is damaged, pain and burning appear, which intensify when talking, eating.

With lupus erythematosus, the red border of the lips, several clinical forms are distinguished, among which:

• Typical. It is characterized by foci of oval-shaped infiltration or the spread of the process to the entire red border. The affected areas acquire a crimson color, the infiltrate is pronounced, the vessels are dilated. The surface is covered with whitish scales. If you separate them, there is pain and bleeding. In the center of the focus is a site of atrophy, along the edges are areas of the epithelium in the form of white stripes.
• Without severe atrophy. Hyperemia and keratotic scales appear on the red border. In contrast to the typical form, the scales exfoliate fairly easily, hyperkeratosis is poorly expressed, telangiectasia and infiltration, if observed, are insignificant.
• Erosive. In this case, there is quite a strong inflammation, the affected areas have a bright red color, there are swelling, cracks, erosion, bloody crusts. At the edges of the elements are scales and areas of atrophy. These symptoms of lupus are accompanied by burning, itching and pain, which intensifies when eating. After resolution, scars remain.
• Deep This form is rare. The affected area has the appearance of a nodular formation rising above the surface with hyperkeratosis and erythema from above.

Secondary glandular cheilitis quite often joins lupus erythematosus on the lips.

Much less often, the pathological process develops on the mucous membrane. It is localized, as a rule, on the mucous membranes of the cheeks, lips, sometimes in the palate and tongue. There are several forms, among which:

• Typical. It is manifested by foci of hyperemia, hyperkeratosis, infiltration. In the center there is a site of atrophy, along the edges there are sections of white stripes resembling a picket fence.
• Exudative-hyperemic is characterized by severe inflammation, while hyperkeratosis and atrophy are not too pronounced.
• With injuries, the exudative-hyperemic form can turn into an erosive-ulcerative one with painful elements, around which diverging strips of white color are localized. After healing, scars and cords usually remain. This variety has a tendency to malignancy.

Treatment of discoid lupus erythematosus

The main principle of treatment is hormonal drugs and immunosuppressants. These or other drugs are prescribed depending on which symptoms of lupus erythematosus have. Treatment usually lasts several months. If the elements of the rash are small, an ointment with corticosteroids should be applied to them. With heavy rashes, it is required to take oral corticosteroid drugs and immunosuppressants. Since the sun's rays exacerbate the disease, you should avoid exposure to the sun, and if necessary use a cream that protects against ultraviolet radiation. It is important to start treatment on time. Only in this way can scars be avoided or reduced.

Systemic lupus erythematosus: symptoms, treatment

This severe disease is characterized by unpredictability of the course. More recently, two decades ago, it was considered fatal. Women get sick much more often than men (10 times). The inflammatory process can begin in any tissues and organs where there is connective tissue. It occurs both in mild and severe, leading to disability or death. The severity depends on the variety and number of antibodies formed in the body, as well as on the organs involved in the pathological process.

Symptoms of SLE

Systemic lupus erythematosus is a disease whose symptoms vary. It proceeds in acute, subacute or chronic forms. It can begin suddenly with fever, the appearance of general weakness, weight loss, joint and muscle pain. Most have skin manifestations. As with discoid lupus, characteristic erythema forms in the face in the form of a clearly defined butterfly. The rash can spread to the neck, upper chest, scalp, limbs. Nodules and spots can appear on the tips of the fingers, erythema and atrophy in a mild form - on the soles and palms. Dystrophic phenomena occur in the form of pressure sores, hair loss, nail deformation. Perhaps the appearance of erosion, bubbles, petechiae. In severe cases, the vesicles open, areas with erosive-ulcerative surfaces form. The rash can appear on the legs and around the knee joints.

Systemic lupus erythematosus occurs with lesions of many internal organs and systems. In addition to skin syndrome, muscle and joint pain, diseases of the kidneys, heart, spleen, liver, as well as pleurisy, pneumonia, anemia, thrombocytopenia, and leukopenia can develop. In 10% of patients, the spleen increases. In young and children, an increase in lymph nodes is possible. Cases of damage to internal organs without skin symptoms are known. Severe forms can be fatal. The main causes of death are chronic renal failure, sepsis.

If red systemic lupus erythematosus proceeds in a mild form, the symptoms are characterized by the following: rash, arthritis, fever, headache, minor lesions of the lungs and heart. If the course of the disease is chronic, then exacerbations are replaced by periods of remission, which can last for years. In severe cases, serious damage to the heart, lungs, kidneys, as well as vasculitis, significant changes in the composition of the blood, severe disorders of the central nervous system are observed.

The occurring changes in SLE are very diverse, the generalization process is pronounced. These changes are especially noticeable in subcutaneous fat, intermuscular and periarticular tissues, vascular walls, kidneys, heart, and organs of the immune system.

All changes can be divided into five groups:

• dystrophic and necrotic in the connective tissue;
• inflammation of varying intensity in all organs;
• sclerotic;
• in the immune system (accumulations of lymphocytes in the spleen, bone marrow, lymph nodes);
• nuclear pathologies in the cells of all tissues and organs.

SLE manifestations

During the course of the disease, a polysyndromic picture develops with manifestations typical of each syndrome.

Skin signs

The lupus erythematosus symptoms are diverse and, as a rule, are of paramount importance in the diagnosis. They are absent in approximately 15% of patients. In a quarter of patients, changes in the skin are the first sign of a disease. About 60% of them develop at different stages of the disease.

Lupus erythematosus is a disease whose symptoms can be specific and nonspecific. In total, about 30 types of skin manifestations are distinguished - from erythema to bullous rashes.

The skin form is distinguished by three main clinical signs: erythema, follicular keratosis, atrophy. Discoid lesions are observed in a quarter of all patients with SLE, and they are characteristic of the chronic form.

Lupus erythematosus is a disease whose symptoms have their own characteristics. A typical form of erythema is the shape of a butterfly. Localization of rashes - open parts of the body: face, scalp, neck, upper chest and back, limbs.

Bietta centrifugal erythema (the superficial form of CV) has only one of the triad of symptoms - hyperemia, and the layer of scales, atrophy and scarring are absent. The foci are localized, as a rule, on the face and most often have the shape of a butterfly. Rashes in this case resemble psoriatic plaques or have the appearance of an annular rash without scarring.

With a rare form - the deep red lupus erythematosus Kaposi-Irganga - both typical foci and moving dense nodes are observed, sharply bounded and covered with normal skin.

The skin form proceeds continuously for a long time, exacerbating in the spring-summer period due to sensitivity to ultraviolet radiation. Changes on the skin are usually not accompanied by any sensations. Only the foci located on the oral mucosa are painful during eating.

Erythema with systemic lupus erythematosus can be limited or merging, different in size and shape. As a rule, they are swollen, have a sharp border with healthy skin. Among the skin manifestations of SLE, lupus cheilitis (hyperemia with grayish scales, with erosion, crusts and atrophy on the red border of the lips), erythema on the fingertips, soles, palms, and also erosion in the oral cavity should be called. Lupus erythematosus symptoms are trophic disorders: constant dry skin, diffuse alopecia, brittleness, thinning and deformation of nails. Systemic vasculitis is manifested by ulcers on the lower leg, atrophic scarring of the nail bed, gangrene of the fingertips. 30% of patients develop Raynaud's syndrome, characterized by such symptoms as cold hands and feet, goose bumps. Lesions of the mucous membranes of the nasopharynx, oral cavity, and vagina are observed in 30% of patients.

Lupus erythematosus disease also has more rare skin symptoms. These include bullous, hemorrhagic, urticarial, nodular, papulonecrotic and other types of rashes.

Joint syndrome

Joint lesions are observed in almost all patients with SLE (more than 90% of cases). It is these symptoms of lupus that make a person see a doctor. One joint or several can hurt, the pain is usually migratory, it lasts several minutes or several days. Inflammation develops in the wrist, knee and other joints. Expressed morning stiffness, the process is most often symmetrical. Not only joints are affected, but also the ligamentous apparatus. In the chronic form of SLE with a predominant lesion of the joints and periarticular tissues, limited mobility may be irreversible. In rare cases, bone erosion and joint deformities are possible.

Approximately 40% of patients exhibit myalgia. Focal myositis, which is characterized by muscle weakness, rarely develops.

There are known cases of aseptic bone necrosis in SLE, while in 25% of cases it is a lesion of the femoral head. Aseptic necrosis can be caused by the disease itself and by high doses of corticosteroids.

Pulmonary manifestations

In 50-70% of patients with SLE, pleurisy (effusion or dry) is diagnosed, which is considered an important diagnostic sign in lupus. With a small amount of effusion, the disease proceeds imperceptibly, but massive effusions also occur, in some cases requiring a puncture. Pulmonary pathologies in SLE are usually associated with classic vasculitis and are a manifestation of it. Often during exacerbation and involvement of other organs in the pathological process, lupus pneumonitis develops, characterized by shortness of breath, dry cough, chest pain, and sometimes hemoptysis.

With antiphospholipid syndrome, pulmonary embolism may develop (pulmonary embolism). In rare cases, pulmonary hypertension, pulmonary hemorrhage, diaphragm fibrosis, which is fraught with pulmonary dystrophy (a decrease in total lung volume).

Cardiovascular manifestations

Most often, with lupus erythematosus, pericarditis develops - up to 50%. As a rule, dry is observed, although cases with significant effusion are not excluded. With a prolonged course of SLE and recurrent pericarditis, even dry, large commissures form. In addition, myocarditis and endocarditis are often diagnosed. Myocarditis is manifested by arrhythmias or dysfunction of the heart muscle. Endocarditis is complicated by infectious diseases and troboembolism.

Of vessels in SLE, medium and small arteries are usually affected. Disorders such as erythematous rashes, digital capillaritis, reticular livedo (marbled skin), and necrosis of the fingertips are possible. Of venous lesions, thrombophlebitis associated with vasculitis is not uncommon. Coronary arteries are often involved in the pathological process: coronaritis and coronary atherosclerosis develop.

One of the causes of death in long-term SLE is myocardial infarction. There is a correlation between coronary artery disease and hypertension, therefore, if high blood pressure is detected, immediate treatment is required.

Manifestations from the gastrointestinal tract

Digestive system lesions in SLE are observed in almost half of patients. In this case, systemic lupus erythematosus symptoms have the following: lack of appetite, nausea, heartburn, vomiting, abdominal pain. An examination reveals a violation of the motility of the esophagus, its dilatation, ulceration of the gastric mucosa, esophagus, duodenum, ischemia of the gastric and intestinal walls with perforation, arteritis, degeneration of collagen fibers.

Acute pancreatitis is rarely diagnosed, but it significantly worsens the prognosis. From liver pathologies, both a slight increase in it and severe hepatitis are detected.

Renal syndrome

Lupus nephritis develops in 40% of patients with SLE, due to the deposition of immune complexes in the glomeruli. Six stages of this pathology are distinguished:

• disease with minimal changes;
• benign glomerulonephritis;
• glomerulonephritis focal proliferative;
• diffuse proliferative glomerulonephritis (after 10 years, 50% of patients develop chronic renal failure);
• slowly progressing membranous nephropathy;
• glomerulosclerosis is the final stage of lupus nephritis with irreversible changes in the renal parenchyma.

If the systemic lupus erythematosus has renal symptoms, then most likely you need to talk about a poor prognosis.

Nervous System Disorders

10% of patients with SLE develop vasculitis of cerebral vessels with manifestations such as fever, epileptic seizures, psychosis, coma, stupor, meningism.

Has systemic lupus erythematosus symptoms associated with mental disorders. Most patients have a decrease in memory, attention, mental disability.

Possible damage to the facial nerves, the development of peripheral neuropathy and transverse myelitis. Migraine-like headaches associated with central nervous system damage are common.

Hematologic syndrome

With SLE, hemolytic anemia, autoimmune thrombocytopenia, lymphopenia can develop.

Antiphospholipid Syndrome

This symptom complex was first described in SLE. It is manifested by thrombocytopenia, ischemic necrosis, Liebman-Sachs endocarditis, strokes, pulmonary embolism, live-vasculitis, thrombosis (arterial or venous), gangrene.

Drug Lupus Syndrome

About 50 drugs can cause it, including: Hydralazine, Isoniazid, Procainamide.

Manifested by myalgia, fever, arthralgia, arthritis, anemia, serositis. The kidneys are rarely affected. The severity of symptoms is in direct proportion to the dosages. Men and women get sick equally often. The only treatment is drug withdrawal. Aspirin and other non-steroidal anti-inflammatory drugs are sometimes prescribed. Corticosteroids may be indicated in extreme cases.

SLE treatment

It is difficult to talk about the prognosis, since the disease is unpredictable. If treatment began on time, it was possible to quickly suppress inflammation, then a long-term prognosis may be favorable.

Medications are selected taking into account what systemic lupus symptoms have. Treatment depends on the severity of the disease.

In the case of a mild form, preparations are indicated that reduce skin and joint manifestations, for example, Hydroxychloroquine, Quinacrine, and others. Anti-inflammatory non-steroid drugs can be prescribed to relieve joint pain, although not all doctors approve of NSAIDs for lupus erythematosus. With increased blood coagulability, aspirin is prescribed in small doses.

In severe form, it is necessary to start taking medications with prednisone (Metipred) as soon as possible. Dosage and duration of treatment depend on which organs are affected. To suppress the autoimmune reaction, immunosuppressants, for example, Cyclophosphomide, are prescribed. In case of vasculitis and severe damage to the kidneys and nervous system, complex treatment is indicated, including taking corticosteroids and immunosuppressants.

After it is possible to suppress the inflammatory process, the rheumatologist determines the dose of prednisone for prolonged use. If the test results have improved, the manifestations have decreased, the doctor gradually reduces the dose of the drug, while the patient may experience an exacerbation. Nowadays, it is possible to reduce the dosage of the drug to most patients with systemic lupus erythematosus.

If the disease has developed as a result of taking medication, then recovery occurs after discontinuation of the drug, sometimes after several months. No special treatment is required.

Features of the disease in women, men and children

As stated earlier, women are more susceptible to the disease. There is no consensus on who has more symptoms of lupus erythematosus - in women or men - does not exist. There is an assumption that in men the disease is more severe, the number of remissions is less, the generalization of the process is faster. Some researchers concluded that thrombocytopenia, renal syndrome and central nervous system lesions in SLE are more common in men, and articular symptoms of lupus erythematosus in women. Others did not share such an opinion, and some did not find any gender differences regarding the development of certain syndromes.

Symptoms of lupus erythematosus in children are polymorphic at the onset of the disease, and only 20% have mono-organ forms. The disease develops in waves, with alternating periods of exacerbations and remissions. It has a sharp onset, rapid progression, early generalization and worse than in adults, prognosis of lupus erythematosus in children. Symptoms at the onset of the disease are fever, malaise, weakness, poor appetite, weight loss, rapid hair loss. With a systemic form, the manifestations are as diverse as in adults.