Systemic Lupus Erythematosus (SLE) | Arunalaya Healthcare -

Best Systemic Lupus Erythematosus(SLE) Treatment in Delhi

What is Systemic Lupus Erythematosus(SLE) ?

Systemic Lupus Erythematosus (SLE), commonly known as lupus, is a chronic autoimmune disease where the body’s immune system mistakenly attacks its own healthy tissues and organs. Instead of fighting off foreign invaders like bacteria and viruses, the immune system produces autoantibodies that target and damage various parts of the body.

SLE is a systemic disease, meaning it can affect almost any organ system, including the skin, joints, kidneys, brain, heart, lungs, and blood cells. The disease can range from mild to severe and life-threatening.

Causes of SLE

The exact cause of SLE is unknown, but it is believed to result from a complex interplay of genetic, environmental, hormonal, and immunological factors:-
- Genetics: While no single gene directly causes lupus, people with an inherited predisposition may be more susceptible. Multiple genes involved in immune system function are thought to play a role. Lupus can run in families, but it is not directly inherited.
- Environmental Triggers: It is thought that an environmental trigger can initiate the disease in genetically predisposed individuals. Potential triggers include:-
- Sunlight (UV light): Exposure to ultraviolet light can cause lupus flares, particularly skin rashes.
- Infections: Certain viral infections, especially the Epstein-Barr virus (EBV), have been implicated. The mechanism might involve “molecular mimicry,” where the immune system confuses viral proteins with the body’s own proteins.
- Medications: Some prescription drugs (e.g., certain blood pressure medications, anti-seizure drugs) can induce a temporary form of lupus known as drug-induced lupus, which usually resolves after stopping the medication.
- Silica exposure: Found in sand, stone, and concrete.
- Smoking: Can worsen lupus symptoms and increase the risk of complications.
- Hormones: Hormonal influences are significant. SLE is far more common in women (about 9 times more likely than men), especially during their reproductive years (ages 15-45). Estrogen is thought to play a role in stimulating the immune system. Hormonal changes during puberty, childbirth, or menopause can sometimes trigger or worsen lupus.
- Immune System Dysfunction: In SLE, there is a breakdown in the immune system’s ability to distinguish between “self” and “non-self.” This leads to the production of autoantibodies that attack the body’s own tissues. A failure to properly clear away dead cells (apoptosis) may also contribute, releasing substances that provoke an inappropriate immune response.

Symptoms

Fatigue: Extreme and persistent tiredness that does not improve with rest.
Joint Pain and Swelling (Arthritis): Affecting joints, often symmetrically, particularly in the fingers, hands, wrists, and knees. Pain can be migratory, moving from one joint to another.
Skin Rashes:
- Malar (Butterfly) Rash: A characteristic red or purple rash over the cheeks and bridge of the nose, resembling a butterfly, appearing in about half of people with SLE.
- Discoid Rash: Red, raised, scaly patches that can cause scarring, particularly on the face, scalp, and ears.
- Photosensitivity: Increased sensitivity to sunlight, leading to rashes or worsening existing ones.
- Fever: Unexplained, low-grade fever.
- Hair Loss: Often generalized thinning, but can also occur in patches.
- Mouth Sores: Painless ulcers in the mouth or nose.
- Chest Pain: Often due to inflammation of the lining around the heart (pericarditis) or lungs (pleurisy), causing sharp pain that worsens with deep breaths.
- Kidney Problems (Lupus Nephritis): Can range from mild to severe, potentially leading to kidney failure. Symptoms might include swelling in the legs, feet, or hands, high blood pressure, or foamy urine.
- Neurological Symptoms: Headaches, dizziness, memory problems, confusion, seizures, or even psychosis.
- Blood Problems: Anemia (low red blood cell count), low white blood cell count (leukopenia), or low platelet count (thrombocytopenia).
- Raynaud’s Phenomenon: Fingers and toes turn white or blue and feel numb or tingly when exposed to cold or stress.
- Swollen Glands: In the neck, armpits, or groin.
- Weight Loss: Unexplained weight loss.

Diagnosis of SLE

Diagnosing SLE can be complex due to its varied and non-specific symptoms. No single test can confirm the diagnosis.

- Medical History and Physical Exam: A detailed history of symptoms and a thorough physical examination looking for characteristic signs.
Blood Tests:
- Antinuclear Antibody (ANA) Test: A positive ANA test is present in most people with lupus, but a positive ANA alone does not mean a person has lupus (it can be positive in other autoimmune diseases or even healthy individuals).
- Specific Autoantibody Tests: If ANA is positive, more specific antibody tests are done, such as anti-dsDNA (double-stranded DNA) and anti-Sm (Smith antigen) antibodies, which are highly specific for lupus.
- Complete Blood Count (CBC): To check for anemia, low white blood cell count, or low platelet count.
- Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP): These are markers of inflammation, often elevated in lupus flares.
- Kidney and Liver Function Tests: To assess organ involvement.
- Urine Tests (Urinalysis): To check for protein or blood in the urine, indicating kidney involvement.
- Imaging Tests: X-rays, echocardiograms (for heart), or CT/MRI scans (for lungs or brain) may be used to assess organ damage.
- Biopsies: Skin biopsy (for rashes) or kidney biopsy (for lupus nephritis) can confirm lupus-related changes.

Treatment for SLE

There is no cure for SLE, but treatments aim to manage symptoms, reduce inflammation, prevent flares, and minimize organ damage. Treatment is highly individualized and depends on the specific symptoms, their severity, and the organs involved.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): For mild joint and muscle pain, fever, and inflammation (e.g., ibuprofen, naproxen).

- Antimalarial Drugs: Hydroxychloroquine (Plaquenil) is a cornerstone of lupus treatment. It helps with fatigue, joint pain, skin rashes, and can reduce flares. It may also help prevent blood clots and organ damage.
- Corticosteroids (Steroids): Such as prednisone, are powerful anti-inflammatory and immunosuppressive drugs. They are used for moderate to severe lupus, especially when organs are involved, to quickly control inflammation. They are often tapered to the lowest effective dose due to potential side effects.
Lifestyle Management is also crucial:
- Sun Protection: Avoiding direct sunlight, using high SPF sunscreen, and wearing protective clothing.
- Healthy Diet: A balanced, heart-healthy diet.
- Regular Exercise: To maintain strength, flexibility, and overall well-being.
- Stress Management: Stress can trigger flares.
- Avoid Smoking: Smoking significantly worsens lupus.
- Adequate Rest: Managing fatigue is key.

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