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Causes, signs and symptoms of chronic systemic lupus erythematosus


Chronic systemic lupus erythematosus – is a disease that occurs as a result of violation of autoimmune processes in the body with involvement of all organs. The primary symptom of the disease are typical skin rash. It is not widespread and relatively rare, 2-3 cases per thousand of the population, more frequently among women of childbearing age. The risk groups primarily include persons with a genetic predisposition and identical twins.

The reasons for the development of systemic lupus erythematosus

It is considered that the occurrence of chronic systemic lupus erythematosus contributes to the violation of immune regulation, that is education in the body of abnormal antibodies (autoantibodies) is influenced by genetic factors, which confirms the relationship of the disease with a hereditary deficiency of components of the immune system.

Although chronic systemic lupus erythematosus is diagnosed mostly in middle-aged women, hormonal nature of the disease has not been confirmed. This factor likely contributes to manifestation of the disease than is the impetus for its development. If a woman identifies systemic lupus lupus, she does not recommend receiving preformed contraceptives, not to burden the manifestations of the disease.

Also holds the view that the external negative factors – toxic substances and uncontrolled intake of certain medications, and viruses, are predisposing for the occurrence of disease.

Due to infections of viral etiology, exposure to excessive amounts of sunlight or ultraviolet radiation, psychological or physical stress, as a consequence of hormonal failure in the body is disrupted the immune system and leads to the formation of antibodies against its own healthy tissue. Immune attack exposed cells of the connective tissue that leads to severe manifestations of allergic effects. The process further goes to all the internal organs.

Chronic systemic lupus erythematosus quite a long time may be asymptomatic and only manifest by skin rash and minor changes in the musculoskeletal system. But inside the body during this period, the accumulation of immune system disorders that may cause inflammation in almost any organ in the body.

Signs of developing lupus

Systemic lupus erythematosus affects directly connective tissue which is present in all organs and systems of man, so the clinical picture may manifest itself in many ways.

First of all pay attention to the appearance of specific lesions on the skin in the form of "butterfly"and"cleavage" on the skin of the breast. Greatly enhanced the sensitivity of the skin to ultraviolet radiation, which is manifested in the form of redness, spots and rashes. Also a clear sign is the appearance on the surface of the body discoid elements with a bright red border, pale middle, and bluish-red spots, similar to spiders in the lower extremities.

The symptoms of lupus

Most often the earliest symptom of disease is lupus arthritis and polyarthritis, polyarthralgia. Affects primarily small joints of the arm bones, wrist, ankle and rarely the knee. Appear sharp or aching pain, noticeable swelling and redness in the area involved in the pathological process of the joints. Even if the deformation, polyarthritis, usually not erosive in nature. Restriction of movement in the affected limb ends with a resistant strain and subsequently, a complete immobilization of the bone joints.

As a result of damage to the external serous membranes of internal organs occurs lupus pneumonitis and pleurisy. Patients complain of coughing and pain during breathing in the chest. When listening you can clearly hear crackles in both lower lobes of the lungs.

Pericarditis and myocarditis – common signs of defeat of the cardiovascular system in lupus, leading to disruption of the heart. Appear the pinching pain, changes in the heart rate. Complications such as endocarditis usually has no clinical manifestations and detected only in laboratory and clinical studies.

Pathological changes in the blood vessels accompanied by the appearance of cyanosis and weakness in the feet and hands, the limbs become cold, the patients felt the feeling of coldness.

One of the most severe complications of chronic systemic lupus erythematosus is glomerulonephritis, accompanied by urinary, nephritic or nephrotic syndromes. Pronounced dense edema, increased blood pressure, polycythemia, and protein in urine – during malignant all these symptoms quickly lead to the development of renal failure.

At all stages of the disease patients present disorders of the nervous and mental state: asthenovegetative syndromethe beginning of the disease and further there is a loss of all departments of the Central and peripheral nervous system – encephalitis, myelitis, polyneuritis. Very rarely there may be attacks of epilepsy, visual and auditory hallucinations, delusional state.

Abdominal syndrome accompanied by pain in the abdomen, dyspeptic disorders and anorexia. Hepatitis, systemic lupus erythematosus develops very rarely.

Diagnosis of systemic lupus erythematosus

Important role in the diagnosis plays a comprehensive examination, including clinical, laboratory, immunological and histological data. The doctor's initial examination allows to determine the nature of lesions on the skin and mucosa of the mouth, sensitivity to UV radiation.

Immunological methods of diagnosis are used to clarify the systemic nature of the disease studies of the affected and healthy areas of the skin, changes in blood formula, inherent in lupus, detection of antinuclear antibodies. At Wasserman (blood for syphilis) may be a false positive result.

Such mandatory research methods as urinalysis, General and biochemical blood tests, electrocardiography, radiography of the joints, of the chest, ultrasound examination of abdominal cavity organs and kidneys, and neurological examination help to identify the spread of the disease on the internal organs.

Careful differentiation of the diagnosis of different skin diseases with similar clinical manifestations in the form of edematous erythema and plaques, mainly on the face.

The pathogenesis and etiology of the disease

Chronic lupus erythematosus – this disease is genetic, as evidenced by the presence in the blood and tissues of the sick person, autoantibodies, cells of lupus, as well as circulating and stored directly in tissues of immune complexes. Predisposing factors, or the impetus for the development of the pathological process can come from different factors: exogenous (viruses, drugs, trauma, stress and other) or endogenous, which include hormonal disorders, abortion, birth.

Classification of red systemic lupus

According to the clinical and laboratory characteristics, the disease has threestage activity – high, moderate and minimal.

The disease occurs in an acute form, characterized by fever, significant sharp decline in body weight, severe pain in the joints, skin symptoms and is accompanied by severe lesions of internal organs and the nervous system. In the further course of the disease becomes recurrent with characteristic polisindromnoe.
Subacute course of the disease peculiar to the gradual development of the process – the body temperature may be normal or rise to the low digits, cutaneous manifestations are not so pronounced as in the acute version, the blood little change. Threat this form is the fact that the development of the pathological process affects all the internal organs and systems of the body, usually with blurred clinical picture.

Chronic lupus manifests itself, typically one or more symptoms. On the background of well-being, the patients have only skin manifestations and arthritis. Process develops slowly and gradually captures all new organs and systems. For a long time observed relapses and polyarthritis syndrome, discoid lupus, only 5-10 years after the onset of the disease appears peculiar to her polisindromnoe.

Treatment of chronic systemic lupus erythematosus

The sooner the treatment, the greater the chance of avoiding irreversible pathological changes in organs and systems of the body. Therapy includes anti-inflammatory drugs, means that suppress the activity of the immune system and corticosteroid hormones. Unfortunately, for approximately half of the patients this treatment is not effective. In these cases, the therapy of stem cells. In most cases autoimmune aggression then is not observed. This method is recommended even in advanced cases.