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 | موضوع: Systemic Lupus Erythematosus_Lupus  الخميس 26 مارس 2009, 23:10 | |
| Systemic Lupus Erythematosus_LupusWhat is lupus?
Systemic lupus erythematosus, also known as SLE, or simply lupus, is a
disease that is characterized by periodic episodes of inflammation of
and damage to the joints, tendons, other connective tissues, and
organs, including the heart, lungs, blood vessels, brain, kidneys, and
skin. The heart, lungs, kidneys, and brain are the organs most
affected. Lupus affects each individual differently and the effects of
the illness range from mild to severe. Lupus can potentially be fatal.
The majority of people who have lupus are young women (late teens to
30s). This may be due to the fact that estrogen (a female hormone)
seems to be associated with lupus. Lupus affects more
African-Americans, Asian Americans, Latinos, and Native Americans than
Caucasian Americans. Lupus in children occurs most often at the age of
10 and older; lupus is rare in children younger than 5 years of age.
The disease is known to have periods of flare-ups and periods of
remission (partial or complete lack of symptoms). Children with lupus
can have a large degree of kidney involvement. The severity of the
kidney involvement can alter the survival rate of patients with lupus.
In some cases, kidney damage is so severe it leads to kidney failure.
What causes lupus?
Lupus is an autoimmune disorder, which means the body's immune system attacks its own healthy cells and tissues.
Lupus is considered to be a multifactorial condition. Multifactorial
inheritance means that "many factors" are involved in causing a health
problem. The factors are usually both genetic and environmental, where
a combination of genes from both parents, in addition to unknown
environmental factors, produce the trait or condition. Often one gender
(either males or females) is affected more frequently than the other in
multifactorial traits. Multifactorial traits do recur in families
because they are partly caused by genes. Females are affected with
lupus three to ten times more often than males.
A group of genes on chromosome 6 codes for the HLA (human leukocyte
antigens) antigens which play a major role in susceptibility and
resistance to disease. Specific HLA antigens influence the development
of many common disorders, many that are autoimmune related and are
inherited as multifactorial traits. When a person has the specific HLA
antigen type associated with the disease, they may have a genetic
susceptibility to have the condition and be more apt to develop it. The
HLA antigen associated with lupus is called DR2 and DR3. It is
important to understand that a person without these antigens may also
develop lupus, so that HLA antigen testing is not diagnostic or
accurate for prediction of the condition.
What is the immune system?
The purpose of the immune system is to keep infectious microorganisms,
such as certain bacteria, viruses, and fungi, out of the body, and to
destroy any infectious microorganisms that do invade the body. The
immune system is made up of a complex and vital network of cells and
organs that protect the body from infection.
When the immune system does not function properly, a number of diseases
can occur. Allergies and hypersensitivity to certain substances are
considered immune system disorders. In addition, the immune system
plays a role in the rejection process of transplanted organs or tissue.
Other examples of immune disorders include the followingautoimmune diseases, such as juvenile diabetes, rheumatoid arthritis, and anemia
immunodeficiency diseases, such as acquired immunodeficiency syndrome (AIDS) and severe combined immunodeficiency (SCID) :
 What are the symptoms of lupus?
Lupus symptoms are usually chronic
and relapsing. The following are the most common symptoms of lupus.
However, each individual may experience symptoms differently. Symptoms
may include:
malar rash - a rash shaped like a butterfly that is usually found on the bridge of the nose and the cheeks.
discoid rash - a raised rash found on the head, arms, chest, or back.
fever
inflammation of the joints
sunlight sensitivity
hair loss
mouth ulcers
fluid around the lungs, heart, or other organs
kidney problems
low white blood cell or low platelet count
Raynaud's phenomenon - a condition in which the blood vessels of the
fingers and toes go into spasm when triggered by factors such as cold,
stress, or illness.
weight loss
nerve or brain dysfunction
anemia
The symptoms of lupus may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
How is lupus diagnosed?
Lupus is difficult to diagnose
because of the vagueness of the symptoms each person might have. There
is no single test that can diagnose lupus. A diagnosis is usually
confirmed based on a complete medical history, reported symptoms, and a
physical examination that may include the following:
blood test
(to detect for certain antibodies that are present in most people with lupus)
blood and urine tests
(to assess kidney function)
complement test
(to measure the level of complement, a group of proteins in the blood
that help destroy foreign substances; low levels of complement in the
blood are often associated with lupus)
x-rays
a diagnostic test which uses invisible electromagnetic energy beams to
produce images of internal tissues, bones, and organs onto film.
Further, the American College of
Rheumatology created a set of criteria to assist physicians in making a
diagnosis of lupus. The individual must have four of the 11 specific
criteria to be diagnosed with lupus. It is important to remember that
having some of the following symptoms does not mean that lupus is the
diagnosis. The criteria include the following:
malar rash - a rash shaped like a butterfly that is usually found of the bridge of the nose and the cheeks.
discoid rash - a raised rash usually found on the head, arms, chest, or back.
sunlight sensitivity
mouth ulcers
inflammation of the joints
heart or lung involvement
kidney problems
seizures or other neurological problems
positive blood tests
changes in normal blood values
Treatment for lupus:
There is no cure for lupus. Specific treatment for lupus will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
your tolerance for specific medications, procedures, and therapies
expectation for the course of the disease
specific organs that are affected
your opinion or preference
If lupus symptoms are mild,
treatment may not be necessary, other than possibly nonsteroidal
anti-inflammatory medications (NSAIDs) for joint pain. Other treatment
may include:
hydroxychloroquine, quinacrine, chloroquine, or a combination of these medications
corticosteroids (to control inflammation)
immunosuppressive medication (to suppress the body's autoimmune system)
liberal use of sunscreen, decreased time outdoors between 10:00 a.m.
and 4:00 p.m., and wearing hats and long sleeves when outdoors, as
about one-third of persons with lupus have the tendency to develop a
rash in the sun
rest, including at least eight to 10 hours of sleep at night; naps and breaks during the day
stress reduction
well-balanced diet
immediate treatment of infections
Children with lupus should not
receive immunizations with live viruses, including chickenpox, MMR
(measles, mumps, rubella), and oral polio vaccines. Consult your
child's physician regarding all vaccines | |
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