Systemic Lupus Erythematosus (SLE)

  • Systemic lupus erythematosus (also known as lupus or SLE) is a chronic inflammatory disease that can affect various parts of the body.
  • Lupus is an autoimmune condition, which means that your body’s immune system attacks your own body tissues, assuming they are foreign. This can lead to pain, swelling, and damage to organs such as the brain, blood cells, kidneys.
  • People with lupus often have disease flares, in which symptoms worsen, followed by a period of remission, in which symptoms improve.
  • Lupus is mild in some people and is life-threatening in others. However, treatments are available to reduce symptoms, reverse inflammation, and minimize organ damage.
  • SLE or Lupus is usually a disease of child bearing age females.
  • This is an autoimmune disease and UV light from Sun exposure may lead to lupus flares.
  • It can be less serious when only affect skin, joints or hair etc but become life threatening if involve kidneys, heart or/and the brain etc.
  • Intensity and duration of treatment depends on the organs involved.
  • Although lupus usually affect females of 15 -45 year of age it can affect children.
  • Lupus occurs nine times more often in women than in men..
Lupus evaded the understanding of scientists of many years because it has the ability to deceive the observer. For one, it comes and goes and the patient may feel completely alright at one moment and reeling in discomfort the next. Secondly, it is called the “great imitator” because its symptoms mimic many other diseases. Lastly, like a chameleon, it changes color and form that is a variety of symptoms develops over a period of time, but not all at once.A variety of symptoms that include fatigue, skin rashes, fevers, and pain or swelling in the joints are the most common presenting symptoms of lupus.Other symptoms can include sun sensitivity, oral ulcers, arthritis, lung problems, heart problems, kidney problems, seizures, psychosis, and blood cell and immunological abnormalities.This causes a delay in diagnosis as the initial symptom guide the patient to a different department other than rheumatology. For example, patient may have initially low blood cells or anemia and admitted in hematology, patient may have blood and protein in urine for which admitted with nephrology etc. Subsequently when they develop symptoms of multiple systems, then a test for lupus is sent and referred to rheumatologist for consultation.The important organ involvement and their presentations are mention below. But the good news is there is nothing to be afraid as all patients don’t develop all the symptoms. so nothing to be scared and your rheumatologist can guide you in this regard.
  • Kidneys – Initially kidney involvement recognized through passage of blood and protein in urine. If not treated in time can lead to kidney failure.
  • Brain and central nervous system. - Headaches, dizziness, behavior changes, vision problems, and even strokes or seizures may be a part of lupus. Even many people with lupus experience memory problems and may have difficulty expressing their thoughts.
  • Blood and blood vessels. - Lupus may cause anemia and increased risk of bleeding due to low platelet or blood clotting. It can also cause inflammation of the blood vessels (vasculitis).
  • Lungs. - Some patient with lupus may develop an inflammation of the chest cavity lining (pleurisy), which can make breathing painful. Bleeding into lungs and pneumonia also are possible but very very rare.
  • Heart. Lupus can cause inflammation of heart muscle, arteries or heart membrane (pericarditis). The risk of cardiovascular disease and heart attacks also increase with long standing untreated patients.
The exact cause is not known and usually multifactorial. Lupus occurs when your immune system attacks healthy tissue in your own body (autoimmune disease). Lupus results from a combination of your genetics and your environment. In other words , people with an inherited genetic risk factor for lupus may develop the disease when they come into contact with an environmental trigger. Some potential triggers include:
  • Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people.
  • Infections. Having an infection can initiate lupus or cause a relapse in some people.
  • Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics.
Factors that may increase your risk of lupus include:
  • Your sex> – Lupus is more common in women.
  • Age. - Although lupus affects people of all ages, it’s most often diagnosed between the ages of 15 and 45.
  • Race. - Lupus is more common in African-Americans, Hispanics and Asian-Americans.
These peculiar properties of lupus prevent the doctor sometimes from reaching a diagnosis just by clinical examination. Indeed, it is not a disease which you always can judge from the outside, rather it is essential to “look inside “. This calls for a variety of tests in the laboratory, after drawing your blood.
  • Medical history : spending some time in taking a detail history really helps!!!
  • Complete exam
  • Routine Blood tests like Hb, WBC counts, platelet counts, liver function tests, urine examination etc.
  • Skin biopsy- In case you have a skin rash
  • Kidney biopsy – In case you are losing blood cell or more than 1-gram daily protein in urine
  • The first thing that comes to mind of a patient with Lupus and his/her well-wishers after knowing about the disease whether it can be cured. The answer is a big NO! but it does not mean that it cannot be treated.
  • Most of the chronic illness like diabetes, high blood pressure, bronchial asthma etc cannot be cured but if they will be adequately controlled and monitored then people with such diseases can live and enjoy their life just like their normal counterparts. So why worry?/li>
  • Treatment of Lupus has changed significantly over past few decades. Gone are those days where a diagnosis of Lupus meant a death sentence. With the proper understanding of disease and available of very effective drugs now the outlook of Lupus has changed enormously.
  • So my sincere request is not to get harassed thinking that everything has been lost and don’t run behind the “mirage” of cure and fall prey to fraudulent advertisements. Go as early as possible to your rheumatologist, discuss, form a treatment plan and comply with the regimen as this is the only way out.
All patients with Lupus are not same. There is a general rule that about half of Lupus patients will have milder disease confined to the skin and musculoskeletal system and does not require high dose of immunosuppression whereas the other half will have the more severe form of Lupus that attacks the internal organs. So, there is nothing to panic from the onset allow your doctor to formulate a treatment plan based on the extent of organ involvement. Lupus treatment is personalized. 
With proper treatment, a patient of lupus can lead a normal life. But if left untreated, a patient of lupus may develop kidney failure, frequent attacks of fever, joint pain, and many more life-threatening organ failures. Many patients may die due to organ failure if they have involvement of major organs like kidney and brain and they don’t take proper treatment under guidance
At OARC, we offer holistic care to patients suffering from all kind of arthritis and autoimmune diseases by our renowned rheumatologist. Because of severe chronic illness of the disease, we spend some time with the patient helping them to know about their disease, and demystify the myths regarding the disease and treatment. We have collaboration with NABL accredited laboAStory where all kind of blood tests can be done at reasonable costs. Our physiotherapist helps the patients and advise them to do needful therapy for preservation of joint and muscles. We also have patient support system where patient can approach in case of any emergency. We believe in a friendly relation with patients so that they can share all their sufferings and get the best possible treatment.