Systemic Erythematosus Lupus ( SLE) is an autoimmune chronic disorder. In this, the immune system of the body mistakenly attacks the self healthy tissues of the body that causes inflammation in connective tissues such as lining of blood vessels, and also involve many organs and affects the skin, joints, lungs and hematopoietic system. SLE is a difficult disease to diagnose because of the consequent similarities in between its signs and symptoms. The cure of SLE  is still not known. The term Lupus has been considered as the identification of numerous immune diseases that have similarities in their clinical presentations and laboratory features. People often say Lupus in case they are suffering from Lupus.  Being a chronic disease, it gets worsened over the time until a proper medication is attained. 

Different types of Lupus 

There are different kinds of Lupus but Systemic Erythematosus Lupus is common. Other Lupus is enumerated as follows:- 

DRUG INDUCED LUPUS 

These kinds of Lupus are caused by certain medications. People infected with Drug induced Lupus may include some of the symptoms of Systemic Erythematosus Lupus but that’s a temporary symptom. It can be cured if diagnosed early in its symptoms stage. 

Cutaneous Lupus Erythematosus

Cutaneous Lupus Erythematosus affects the skin as itself the name suggests cutaneous means skin. The infected person may experience some issues like skin burns, skin rashes, sensitivity to the sun etc. Hair loss is also a symptom of this disease. 

Neonatal Lupus

A rare kind of Lupus, spotted among the infants at birth. The infant possesses the antibodies passed from the infected mother or develops the symptoms later in its life. 

Causes of Systemic Erythematosus Lupus 

An autoimmune chronic disease unlikely to occur as a combination of your genetics and certain environmental factors. However the exact cause of Lupus is still unknown. But there are some factors that influence and trigger Lupus. Some of the effective triggers are :+ 

Infection

Certain infections may trigger Lupus due to its alternative effects on the cells. 

Medicines 

Certain medications generally some blood pressure medications may also influence Lupus to affect or Certain anti – seizure medications and antibiotics may also show it’s alternative effects. Symptoms generally disappear after the consumption of medicines are stopped. 

Hormonal Imbalance 

Continued exposure to medications imbalances hormones and an imbalance of hormones may show its adverse sides and trigger Lupus. Sex hormones and a variety of environmental factors that includes viral infections, diet, stress may complex the situation. 

Genetic factors

Lupus can also be inherited from the parents. 

Risk factors

• Age – Lupus affects almost everyone of all ages but it is most commonly Diagnosed between the ages of 15 and 45.
• Sex – lupus is more common in females than in males by the ratio of 10:1 . 
• Race –  It’s  more common in African American, Hispanics, Asian Americans. According to a research conducted  it was found that Lupus had affected nearly 1.5 of million Americans. 

Symptoms

The symptoms of systemic Erythematosus lupus develop slowly. It may be mild or severe or may be temporary or permanent. Most people with SLE  are found to have mild diseases characterized by the presence of Certain episodes called “Flares’ ‘ generally when signs and symptoms get worsened for a while. It may improve or even disappear completely for a mentioned time. Some of the common symptoms of SLE are :- 

• Fatigue
• Fever
• Joint pain, stiffness, swellings. 
• Skin lesions that worsen by overexposure to the sun. 
• Butterfly shaped rash on face that usually covers the checks and bridge of the nose or may be present elsewhere on the body. 
• Fingers and toes turn white or blue during cold or under stressful conditions. 
• Shortness of breath. 
• Dry eyes. 
• Headaches, confusion and memory loss. 
• Chest pain 
• Swollen lymph nodes. 
• Hair loss. 
• Weight loss. 
• Sensitivity to sunlight. 
• Uneasiness or Malaise. 

Other symptoms and signs on different body parts are :- 

• Brain and nervous system – weakness, Numbness, tingling seizures, vision problems, memory and personality changes. 
• Digestive tract- Nausea, Vomiting, abdominal pain. 
• Heart – Inflammation of pericardium, valve problems. 
• Lungs – Pneumonia, difficult breathing, coughing blood. 
• Skin – Sores in mouth. 
• Circulation – Clots in veins or arteries, constriction of blood vessels in response to cold ( Raynaud phenomenon). 
• Anaemia, low white blood cell or low platelet count. 

Possible complications 

• Kidney – Systemic Erythematosus lupus causes abnormal immune deposits in the kidney cells that leads to a condition caused as Lupus nephritis. This is in severe cases also causes kidney failures. And it frequently demands dialysis or kidney transplant. 
• Cancer : Being affected with Lupus , increases your chance of cancer but this is a rare incident if symptoms are taken under control. 
• Bone tissue death- Bone tissue death occurs when the blood supply to bone decreases, leading to micro fractures in bones even leading to bone collapse. 
• Pregnancy complications-  Lupus having a higher chance of infection in females also increases their chance of miscarriage among them. It increases the chances of high blood pressure during pregnancy and preterm birth. It has been suggested by the nephrologists that females should delay her pregnancy till her symptoms are taken under proper control otherwise, it may pass to the fetus. 

Tests and examinations 

Lupus diagnosis is preceded when the infected person is spotted with minimum 4 out of 11 common signs of the disease. Almost all of the infected people have a positive test for antinuclear antibody (ANA). But alone ANA cannot provide the evidence for lupus. Your body undergoes complete physical exams for the check up. 

There are different tests that are used to diagnose systemic Erythematosus lupus and these may include :- 

• Antinuclear antibody test. 
• Complete blood count. 
• Chest X- ray. 
• Urinalysis. 
• Serum Creatinine. 

There are some cases where the above mentioned diagnosis are still incomplete to find the accurate proof for SLE. So, the nephrologists or the specialist attend some additional tests to find the accurate results. Some of these are :- 

• Coombs test – direct. 
• Erythrocyte sedimentation rate ( ESR)  and C- reactive protein (CRP) . 
• Kidney function blood test. 
• Liver function blood test. 
• Rheumatoid factor. 
• Kidney biopsy. 
• Imaging tests for heart, brain, lungs , joints, muscles or intestines. 

Treatment

There is no accurate cure found for SLE. But the main goal is to control the symptoms as severe symptoms are difficult to control and symptoms that control the heart, lungs, kidneys or the organs may make the situation worse. 

Before proceeding for the treatment, each person needs to evaluate the following by the specialist to move further for the cure accurately:- 

What part of the body is affected? 

How active the disease is. 

What degree  of treatment is required. 

The mild forms of the disease may be treated by some certain medications:-

• Low doses of corticosteroid for skin and arthritis symptoms. 
• Corticosteroid for skin rashes. 
• Hydroxychloroquine which is also used to treat Malaria. 
• Methotrexate may be prescribed to reduce the doses of corticosteroid. 
• Non steroidal anti inflammatory drugs ( NSAID) for joint symptoms and pleurisy. But you must consult a specialist before taking medicines. 
• Belimumab. 

Severe symptoms of SLE includes the following treatments :- 

• High dose or concentration of corticosteroid. 
• Immunosuppressive medicines. These medicines are generally recommended in case of severe lupus which are eventually affecting the nervous system, kidney or other organs. 
• Most common medicines which are recommended are mycophenolate, azathioprine, and cyclophosphamide. Cyclophosphamide is generally favoured for 3 to 6 months due to its toxicity. 

Rituximab ( Rituxan ) is also used in some cases. 

• Warfarin ( coumadin) is also used in some cases. Warfarin the blood thinners are also used for clotting disorders such as antiphospholipid syndrome. 

Precautions 

While taking proper medications , you also need to put an effort by yourself to control the symptoms and cure it as early as possible. 

• Use sunglasses, protective clothing and sunscreen while exposing in the sun. 
• Stay up to date with immunization. 
• Get preventive heart care. 
• Get regular tests for the screening for thinning of bones. 
• Avoid tobacco and minimise the uptake of alcohol. 
• Do regular exercises and yoga. 
• Do not stress yourself. 
• Get some counseling if you are emotionally weak. 
• Listen to some music and chill.