Systemic Lupus Erythematosus Essays - Autoimmune Diseases, RTT

Systemic Lupus Erythematosus SYSTEMIC LUPUS ERYTHEMATOSUS HOPE IS GROWING Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which may affect many different organs and tissues in the body. Women of child bearing age are typically affected, but individuals of any age, sex, or race may develop the disease. SLE while uncommon, is not rare, with an estimated disease prevalence of 1 in every 2,000 population. It is a condition which appears to be increasing in prominence especially over the last 15 to 20 years. This is likely explained by the earlier recognition of milder cases because of increased patient and physician awareness and by the enhanced availability of sensitive laboratory tests helpful in the diagnosis. Although the exact cause is not known, most of the features of the disease seem to be due to a fundamental abnormality of the body's immune system. The immune system is the body's defence mechanism against foreign substances entering the body. It depends on the formation of compounds called antibodies and on hite cells called lymphocytes which rise to the defense of the body in case of invasion by foreign agents such as germs or viruses. This is a normal and desirable process in the healthy individual. In patients with SLE, there seems to be a defect in the body's immune system whereby antibodies are mistakenly formed against the body's own tissues. This leads to inflammation and damage in the tissues so affected. Patients with SLE can be identified by the presence of these abnormal antibodies in their blood stream. It is not clear what triggers this immune abnormality but several factors seem to be contributory in some patients. These include infection, hormonal, genetic, and unidentified environmental factors. Some drugs including those used for the treatment of tuberculosis (isoniazid), high blood pressure (hydralazine), and convulsions (dilantin) have also occasionally been associated with the development of SLE. Clinical Features The majority of patients with SLE have very mild symptoms which can be easily controlled with simple measures. A small minority have more serious manifestations which may require more aggressive forms of treatment.The seriousness of the disease is frequently related to the type and number of organs affected. The following is a summary of some of the signs and symptoms that may occur in lupus patients grouped according to the organs or tissues affected: General symptoms Fever and unusual fatigue occur in up to 80 or 90% of SLE patients at some time during the course of their illness. Skin rash a very common feature occurring in many patients. The classic rash is called a butterfly rash because it occurs in a butterfly-like patch over the bridge of the nose and cheeks. This type of rash is in fact quite uncommon with most lupus rashes being far less specific and occurring anywhere on the body but especially over sun exposed areas. Many lupus rashes appear to be provoked or aggravated by direct sun exposure. Sores may also occur in the nose and mouth, and scalp hair loss may occur in some individuals. In a closely related condition called discoid lupus erythematosus (DLE), the rash may arise as distinct scaly and reddish patches which may heal with scarring. Patients with DLE are frequently otherwise well. They demonstrate few, if any, of the symptoms of SLE and usually have a nearly normal laboratory profile. Joints - stiffness, pain, and swelling may commonly occur. Unlike rheumatoid arthritis however, permanent damage to the joints is almost unheard of. Membranes of the heart and lungs, the linings of the heart and lungs may occasionally become inflamed in SLE patients leading to sharp chest pains and shortness of breath. If it involves the lung, the condition is called pleuritis. If it affects the heart, the condition is called pericarditis. Blood cells - a number of abnormalities may occur in the blood including anaemia or a fall in the red blood cell count and/or falls in the white cell count or platelet count (particles in the blood that help with clotting) and thus lead to potential problems with bleeding. Kidneys - often a sign of more serious disease, inflammation of the kidney may lead to loss of protein in the urine, increased blood pressure and occasionally kidney failure. Brain and nerves - fortunately, a relatively rare problem, patients so