Lupus

Systemic lupus erythematosis (SLE) is an autoimmune inflammatory disease that can affect many organ systems. The cause is unknown. The process is due to trapping of antigen-antibody complexes in capillaries of various organs. This complex is made up of foreign material, in this case the body's own cells recognized as foreign (the antigen) and cells to fight infection, the antibodies made by the body. This antigen-antibody complex clogs the capillaries (tiny blood vessels) of organs or causes destruction of the body's cells.

Who is affected? About 85% of patients are women. Symptoms appear after the first menstrual cycle. One in one thousand white women have lupus whereas 1/250 black women get the disease. If a mother has the disease, her daughter has a 1:40 chance of developing the disease, a son has a 1:250 chance. Other autoimmune diseases can be found in a patient's extended family.

Symptoms and signs include fever, anorexia, malaise and weight loss. There may be a butterfly shaped rash across the cheeks and nose. Discoid (coin) lesions can appear on the trunk and extremities. Joint pain occurs in 90% of patients. Eye changes can manifest as blindness in one eye, photophobia and degeneration of nerve endings in the retina. Lungs are affected with plueral effusion (water on the lungs), bronchopnuemonia or pneumonitis. The heart sack can become inflammed leading to heart failure and irregular heart rhythms. Brain complications may include psychosis, organic brain syndrome and seizures. Glomerulonephritis, inflammation of the part of the kidney that forms urine, may occur. There may be recurrent miscarriages.

Treatment. This may be only be suppportive. A local support group can be found at your local hospital. Skin lesions may be treated with topical corticosteroids. Sun block should be worn outdoors. More serious symptoms should be treated with prednisone at the lowest dose that gives improvement.

Course and prognosis. This disease has an episodic course, with exacerbations
usually responding to increase dosages of medications. The 10 year survival is 85%. Unfortunatley there are some that have a more virulent course causing major damage to body organs which may lead to death. With improved control of lupus activity, morbidity and mortality rates are decreasing.