Lupus – Systematic lupus erythematosus (SLE)
Systematic lupus erythematosus ( wolf disease ) is an autoimmune disease that affects blood vessels, the skin and the kidneys in particular. The term “lupus” (wolf) and “erythematosus” (redness) is due to the external signs of the disease. The typical skin damage (lesion and reddening of the skin) is reminiscent of an injury caused by a wolf bite.
What is lupus erythematosus (wolf disease)?
Systemic lupus erythematosus (SLE) is a very rare systemic autoimmune disease. The term “systemic” refers to the fact that the disease can affect the entire body.
In autoimmune diseases, the immune system mistakenly identifies the body’s own tissues or organs as foreign bodies and produces antibodies (autoantibodies). For example, systemic lupus erythematosus causes damage to affected tissue and the typical redness of the skin (skin lesions).
The term systemic lupus erythematosus is derived from a typical red, scar-like facial rash (erythema). The causes of the disease are not exactly known. Both viruses and UV radiation are suspected of triggering lupus erythematosus. An earlier name for lupus erythematosus is the so-called “wolf disease”.
Causes
Various factors are discussed as the cause of the development of systemic lupus erythematosus (SLE): For example, the disease risk of an identical twin of a person affected by systemic lupus erythematosus is higher than that of the normal population.As a so-called autoimmune disease, the immune system (autoantibodies) attacks the cell nuclei of cells as a result of the disease – and these contain the genetic information, the DNA.
It is therefore believed that a hereditary component (predisposition) plays an important role in the disease. Infectious causes are also discussed: It is known that the disease occurs more frequently after viral infections (human herpes virus 4). An unfavorable influence of UV light on the risk of developing lupus erythematosus is also known.
Symptoms and course
Possible signs of lupus erythematosus:
- Skin redness (lesions)
Lupus erythematosus is also known as “wolf disease” or “butterfly disease”. It is a rheumatic disease that leads to severe redness of the face, which forms scars after subsiding. Since these scars give a human face something wolf-like in the eyes of other people, the name “wolf disease” became popular; since the redness has about the shape of a moth, it is also called “butterfly disease”.
Lupus erythematosus is an autoimmune disease: Due to a defect in the immune system, the body no longer recognizes its own cells and begins to attack them as supposed foreign bodies. The cause of emerging symptoms is the present malfunction. In the course of the disease, chronic inflammation of the skin and joints can occur, which can even affect other organs. The disease is therefore considered a systemic autoimmune disease. In addition to rheumatic complaints, optical distortion is also of considerable importance for those affected.
Lupus erythematosus usually begins with the mentioned reddening of the skin, which, however, usually causes those affected to visit a doctor too late, as a rash or allergy is often suspected as the cause. Later, the disease can affect various organs and even the brain. In rare cases, lupus erythematosus even leads to death, which has become rare today.
When to see a doctor?
Systemic lupus erythermatosus is a serious disease that needs to be diagnosed and treated early. People who notice typical symptoms such as fatigue or fatigue are best advised to consult their family doctor.
If the symptoms worsen quickly or there are other signs of illness, the medical emergency service is the right contact person. In the case of a high fever and severe weight loss, the person concerned must be taken to the hospital immediately.
People who already have a skin condition are particularly prone to developing SLE. People with diseases of the immune system and hormonal complaints also belong to the risk groups and should rush to the general practitioner with the symptoms mentioned. Further treatment is carried out by the dermatologist or an internist. In some cases, surgical intervention is necessary.
Since the disease is often accompanied by psychological problems, a therapist should be consulted to treat the physical symptoms. If necessary, the general practitioner will also establish contact with other affected persons or refer the patient to a specialist clinic.
Diagnosis
The suspected diagnosis of systemic lupus erythematosus can already be made on the basis of the description of symptoms with typical complaints such as discoid skin rash, butterfly erythema or Joint inflammation . Since SLE is a disease of the rheumatic type, the definitive diagnosis is often only made by a rheumatologist. In the case of mild courses, the symptoms of the disease can also be ambiguous, which can often lead to years of misdiagnosis. In order to confirm the diagnosis, in addition to X-rays and laboratory tests, tissue samples are also necessary, which are examined histologically, i.e. histologically.
The pathologist finds a so-called lupus band in SLE, which corresponds to the immune complexes embedded in the skin. So-called autoantibodies can usually be detected in high concentrations in the blood serum. As a scientific association of rheumatologists, the American College of Rheumatology has published classification criteria that are internationally valid for the diagnosis of lupus erythematosus. There are a total of 11 criteria, of which at least 4 must be met in order for the diagnosis to be made with certainty. The main symptoms are the detection of antinuclear antibodies, ANA and increased sensitivity to light, photosensitivity.
Complications
Systemic lupus erythematosus affects the entire body. Serious complications are to be expected, especially in the area of the kidneys and the central nervous system. Inflammation of the Kidneys, known as lupus nephritis, can lead to a deterioration or even a loss of the kidneys’ natural filtering function. As a result of renal insufficiency, other symptoms occur, for example water retention in the tissue, cardiac arrhythmia , dizziness and brief loss of consciousness.
Lupus patients also have an increased risk of calcification of the blood vessels. As a result, heart and vascular diseases can develop, which in turn are associated with serious complications. In the most severe case of systemic lupus erythematosus to an immunologically induced inflammation of the spinal cord. This results in paralysis of the legs and arms. If left untreated, spinal cord inflammation can lead to paraplegia. Inflammation of the optic nerve can lead to visual disturbances and ultimately to complete blindness. Finally, lupus patients are also more susceptible to infections and malignancies. Drug treatment may cause side effects or trigger an allergic reaction.
treatment and therapy
There is currently no complete cure for systemic lupus erythematosus. Therapy therefore consists primarily of treating the symptoms associated with lupus erythematosus: the focal points of the symptoms are different for each patient, which is why a corresponding therapy program must be tailored to the individual.
Slight symptoms, such as reddening of the skin, can be treated with special skin ointments.
In addition to treating the symptoms, the main aim of the therapy is to curb the progression of the underlying disease: Since the body damage in the context of the disease is caused by chronic inflammatory processes (as a result of the attack by the autoantibodies), drugs can be used, for example, that stimulate the activity of the immune system inhibit. These drugs belong to the group of Immunosuppressants (e.g. azathioprine).
Due to a low activity of the immune system, the risk of active autoantibodies in the disease should also be reduced. The short-term use of Cortisone (cortisone therapy, also known as shock therapy) can help against acute inflammatory processes associated with lupus erythematosus.
In principle, medicine does not yet know of any effective methods of preventing lupus erythematosus, because the exact cause of this Autoimmune disease is still largely unknown.
Prevention
For people who are already suffering from systemic lupus erythematosus, however, it can be helpful to take various measures to prevent acute flare-ups.
Since UV light is one of the possible triggers for the disease, extensive sunbathing should be avoided. If contact with solar radiation is unavoidable, adequate sun protection should be provided.
At low temperatures, adequate protection against the cold must be ensured. Hands and feet in particular should be kept warm here.
Regular exercise and largely avoiding the consumption of alcohol and nicotine also have a positive effect on the course of the disease.
Outlook and prognosis
The overall prognosis for systematic lupus erythematosus is still unfavorable. Despite all efforts, the disease cannot be completely cured according to the current scientific and medical status.
In the course of life there are always phases of a symptom-free period. This can last for several months or years. Nevertheless, a lifelong therapy is scheduled, which can only be interrupted in exceptional cases under particularly positive development processes. Although the survival rate for patients with systematic lupus erythematosus has increased significantly in recent decades, the disease is fatal in 10% of patients.
The prognosis improves with early diagnosis and treatment as soon as possible. The lifestyle of these patients is significantly less restricted than when therapy is started at an advanced stage.
In the course of life, the intervals between the disease-related relapses become ever greater. This means that some patients can interrupt the treatment for a while after consulting their doctor and experience a symptom-free phase. It can last up to several years, but the patient is not considered cured. In addition, the intensity of the relapses decreases continuously with increasing age of the patient.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.