What is SLE?
Systemic lupus erythematosus (SLE), often simply called "lupus," is a type of arthritis that affects the joints, muscles and other parts of the body. Lupus involves swelling that may affect many parts of the body including the heart, lungs, skin, joints, kidneys, nervous system and blood-forming organs. Symptoms of lupus may include the following:
- a butterfly-shaped rash over the cheeks and across the bridge of the nose,
- sensitivity to sunlight,
- mouth ulcers,
- pain and stiffness in joints and muscles,
- swelling of the lining around the heart, lungs or abdomen causing difficulty breathing,
- disk-shaped sores on the face, neck and/or chest,
- kidney and/or nervous system problems,
- extreme fatigue,
- unexplained fevers,
- unusual hair loss,
- poor circulation in the fingers and toes, and
- weight loss.
What causes SLE?
The cause of systemic lupus erythematosus is unknown. The immune system of a person with lupus does not work as it should and attacks healthy cells and tissue. There may be a combination of genetic, environmental and possibly hormonal factors that work together to cause the disease.
Who is at risk?
Women are at higher risk of getting lupus than men. Lupus usually occurs during a woman's child-bearing years. Lupus is more common among African-American, Native American, Chinese, Hispanic and Filipino populations.
In some families, inherited factors play a role in a person’s risk for developing arthritis. If a parent or other close relative has been diagnosed with arthritis, it is important to share this history with a health care provider. Early diagnosis and treatment is the key to successful management of arthritis.
How is it diagnosed?
Lupus may be difficult to diagnose because there are many different symptoms. Diagnosis of lupus is based on medical history, physical examination and medical tests. A blood test called an ANA, a urinalysis, X-rays and other blood tests may be done to help the doctor diagnose lupus.
How is it treated?
There is no cure for lupus, but proper medical treatment can help persons with lupus live long, active lives. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) can help control joint pain and swelling and reduce fever as well as reduce swelling of the lung and heart linings. Corticosteroids such as prednisone also can help reduce swelling in the joints, kidneys and other organs. Antimalarial drugs can be useful to reduce joint pain and swelling, skin and mouth sores and sun sensitivity. They also may prevent flare-ups of the disease. Because the immune system is overactive in persons with lupus, drugs that suppress the immune system, such as methotrexate, often are used. Many of the drugs used to treat lupus have potentially severe side effects, and patients should be monitored closely.
Successfully dealing with lupus requires self-management skills. It is important for patients to learn about the disease and to take part in their own care. Working with health care professionals allows a person to share in decision making and gain a sense of control. Getting adequate rest and regular exercise, limiting alcohol use and eating a balanced diet can improve immune system function. Because ultraviolet light can trigger a flare-up of lupus, it is important to use sunscreen with a sun protection factor (SPF) of 15 or higher and to avoid tanning beds.
- Exercise can help increase independence, improve mood, decrease pain, increase flexibility, improve blood flow, maintain proper weight and promote general physical fitness. Exercise in a warm water pool is an excellent choice. Physical/ occupational therapy can help restore joint movement and increase strength. A therapist can help design an exercise program to meet a person's specific needs.
- Rest also is important. Arthritis may cause tiredness and muscle weakness. A rest or short nap that does not interfere with nighttime sleep may help. Relaxation techniques can be useful in coping with symptoms and staying healthy. Some people find stress reduction and biofeedback helpful.
- Assistive devices can be used to reduce stress on certain joints. For example, braces or canes may help reduce stress on the knees. Jar grippers or other gadgets may help reduce stress on the small joints of the hands.
Research shows that patients who take part in their own care report less pain and make fewer doctor visits, as well as enjoy a better quality of life.
When should a person get help?
A person with an unexplained rash, fever or extreme fatigue should see a doctor. Once the diagnosis of lupus has been made, it is important to receive regular medical care to allow the doctor to note changes and possibly predict flare-ups. If symptoms are identified early, treatment may be more effective. Lupus poses an increased risk of miscarriage and complications during pregnancy. Women diagnosed with lupus who are considering pregnancy should seek medical advice to determine what steps can be taken to ensure the safest possible pregnancy and reduce risks to the baby.