Quick Facts About Lupus Disease
- Lupus is an autoimmune disease that causes problems in the body’s immune system. It can be mild or life-threatening.
- Lupus is not contagious.
- The type we just call “lupus” is known as systemic lupus erythematosus or SLE.
- More than 90% of lupus patients are women.
- This disease is more common between the ages of 15 and 45.
- Most doctors believe that lupus is due to genetic and environmental stimuli.
- Risk factors include extreme stress, exposure to sun (ultraviolet) light, smoking, certain medications and antibiotics, infections, Epstein-Barr virus (in children) and exposure to certain chemicals.
- Although there is no definitive cure for lupus, lupus and its symptoms can be controlled with medications.
- Lupus treatment options include corticosteroids, immunosuppressive medications, and lifestyle changes.
What does lupus cause?
- It causes a red rash called ‘butterfly rash’ on the cheeks and bridge of the nose. There is also a coin-shaped, scaly and raised rash on the face, scalp, ears, chest and arms, which can leave scars as it heals.
- Sensitivity to light, excessive skin reaction to sunlight are observed. It is generally not seen in the part covered by clothing.
- Small, painless sores may appear in the mouth or nose. Those in the nose can cause nosebleeds.
- Joint pain and swelling affect the vast majority of lupus patients. Pain can move from one joint to another and may appear symmetrically in the same joints on both sides of the body.
- Inflammation of the lungs and the layers surrounding the heart can cause fluid to collect around the heart and lungs. It causes a type of chest pain that increases with breathing.
- Almost all patients with SLE have kidney damage. Initially, it is usually asymptomatic and can only be detected by urinalysis and blood tests for kidney function. Those with significant kidney damage may experience protein and/or blood in the urine and swelling, particularly in the feet and legs.
- It can also cause damage to the central nervous system; Neuro-psychiatric problems such as headache, seizures and difficulty concentrating and remembering, mood changes, depression and psychosis (a serious mental condition in which thinking and behavior are impaired) may be observed.
- May cause blood cell disorders.
The Effect of Lupus Fatigue and Pain on Activities of Daily Living
A. Genetic Factors
B. Environmental Factors
Symptoms of Lupus Disease
- Skin changes. A butterfly-shaped rash, especially on the nose and cheeks, is typical. However, a rash develops on any area of the skin that is exposed to the sun.
- Findings related to inflammation in the veins. Small vessels of the skin are often affected and inflammation called vasculitis develops. There is a subcutaneous hemorrhage in the form of spots around the nails. It can also cause inflammation of the oral mucosa.
- Hair-related findings. There may be regional shedding in the hair, and this hair loss usually does not replace the new ones.
- Raynaud’s syndrome, in which there is a white and purple color change that occurs in the cold, is an important finding.
- Joint findings. There is arthralgia, i.e. joint pain, in both large and small joints. The pain is more pronounced, especially in the morning. In some patients, swelling, redness and temperature increase due to arthritis, i.e. joint inflammation, are also seen.
- Muscle involvement. Pain and inflammation develop in the muscles.
- Kidney findings. Renal involvement is seen in 70% of patients. In these people, blood and protein are detected in the urine. Edema develops due to fluid retention in the tissues. In severe cases, kidney inflammation can be seen, which can progress to kidney failure.
- There are symptoms and psychological problems related to the nervous system such as migraine, epilepsy, balance problems. Stroke may occur in some patients.
- Digestive problems are common due to gastrointestinal involvement and pancreatitis.
- There are signs of inflammation in the lining of the lungs or heart, such as chest pain. When there is fluid accumulation and inflammation between the lung membranes, a chest pain that increases with breathing occurs. Inflammation of the pericardium is called pericarditis and is common in lupus.
- Pneumonia develops as a result of inflammation in the lung tissue.
- There is enlargement of lymph nodes, spleen and liver.
- Abdominal pain is seen because the peritoneum is inflamed.
Systemic Lupus Erythematosus Immunological and Pathological Features
A. Pathological Findings in Skin Lesions
B. Pathological Findings in Vessels
C. Pathological Findings in the Kidney
D. Other Pathological Findings
1. General Symptoms
2. Musculoskeletal Findings
3. Skin Lesions
A. Specific Skin Lesions
a. Acute Skin Lesions:
b. Subacute Cutaneous Lupus
B. Chronic Lesions
Diagnosis of Lupus
- malar rash
- discoid rash
- sun sensitivity
- Oral ulcers
- non erosive arthritis
- Serosite ( a) Pleuritis or b) pericarditis )
- Kidney disorder (a) proteinuria> 0.5 g/day or 3+ or b) cell casts )
- Neurological findings ( a) Seizures or b) psychosis )
- Hematological disorders ( a) hemolytic anemia or b) leukopenia< 4000/mm3 (at least twice) or c) lymphopenia< 1500/mm3 (at least twice) or d) thrombocytopenia< 100 000/mm3 )
- immunological disorders
- Positive anti-ds-DNA antibody
- Positive anti-Sm antibody
- Presence of positive antiphospholipid antibodies;
- Presence of IgG or IgM type anticardiolipin antibodies
- Lupus anticoagulant test positivity with standard method
- False-positive syphilis test positivity in the last 6 months
- ANA positivity