Systemic lupus erythematosus

Systemic lupus erythematosus (SLE), or “lupus,” is a long-term autoimmune illness. In lupus, the body's immune system that normally protects from infection and disease, turns haywire and causes inflammation and damage to the body's cells and organs.

Last Updated: February 21, 2024

Lupus develops among people who inherited the tendency for the disease and are exposed to certain triggers, such as sunlight, fluctuating or excess hormones, medications, infections, pregnancy, and stress.

In the Philippines, lupus occurs in around 30 to 50 per 100,000 people. Around 9 in 10 adults living with lupus are women. The symptoms usually start when they are between 20-40 years old. SLE can also affect men, the elderly, and even children. It is more widespread than most people think.

SLE can present itself in different ways and, like thumbprints, no two patients are exactly the same. It can be very mild, or bad enough to cause hospitalization. It may even lead to death, especially if left untreated.

Lupus can involve any organ of the body, most frequently the skin, muscles, bones and joints, blood, and the kidneys. The more common symptoms of lupus include the following:

  • Unexplained fatigue, weight loss, or fever
  • Different kinds of rashes, most typical is seen across the cheeks and bridge of the nose after sun exposure, the malar or “butterfly” rash
  • Excessive hair loss and even balding
  • Mouth sores that may be painful or painless
  • Achy or swollen joints and muscles
  • Shortness of breath
  • Pale skin
  • Fingers that turn white/blue with cold exposure
  • Leg edema and frothy urine
  • Convulsions
  • Behavioral and mood changes

There is no single test that can tell us a person has SLE. All the signs and symptoms and the results of several laboratory tests that demonstrate the presence of inflammation in different organs and the presence of autoantibodies in the blood are considered.

Similar to other long-term autoimmune conditions, medications have to be maintained to control inflammation and prevent damage in the body. Anti- inflammatory medicines (non-steroidal and/or corticosteroids), disease-modifying anti-rheumatic drugs (hydroxychloroquine, methotrexate, azathioprine, mycophenolate, cyclophosphamide, and/or cyclosporin) and medicines to manage other concomitant diseases are prescribed. The treatment depends on the predominant manifestation of the disease, individual characteristics of patients, and their preferences and resources. Use of these medicines have to be closely coordinated with one’s rheumatologist if SLE is diagnosed. Sun protection, stress management, good hygiene, healthy eating, sleep, and physical activity form a crucial part of the daily treatment.

People living with lupus can keep their disease under control, prevent complications, and live well. The following are important reminders:

  • Protect the skin from sun exposure during the day using sunblock, clothes, hat, umbrella, or other shades even when the sun’s rays are not intense.
  • Maintain calcium and vitamin D supplements.
  • Take medications and report for doctor’s consultation regularly as scheduled even when feeling well.
  • Be aware of symptoms of disease flare and seek medical help when they occur. Understand their triggers and keep them at bay with best efforts.
  • Maintain healthy sleep, food, leisure, and balanced physical activities and relaxation.

References

https://www.rheumatology.org/Portals/0/Files/Lupus-Fact-Sheet.pdf

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-systemic-lupus-erythematosus-in-adults?search=systemic%20lupus%20erythematosus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Last Updated: February 21, 2024