SLE is a disease that appears as a result of the pathology of autoimmune actions in the body involving all organs. Systemic lupus erythematosus (according to ICD-10, the disease was assigned a code - M32) is an unpleasant and dangerous disease. The initial indicator of the disease is a distinctive rash on the skin. This is how you can recognize systemic lupus erythematosus. Recommendations for this disease will be given below.
The disease does not differ in prevalence and is quite rare, in 2-3 cases per thousand inhabitants, more often among women of childbearing age. The risk group primarily includes people with a genetic predisposition and identical twins.
Reasons
The causes of systemic lupus erythematosus are not fully understood. It is believed that the provoking factor is the presence of diseased RNA and retroviruses in the body.
Also, another risk factor is the genetic predisposition to this disease. In women, this disease occurs 10 times more often than in men, since there isthe relationship between the occurrence of systemic lupus erythematosus and the hormonal characteristics of the female body (increased estrogen in the blood).
The risk of disease increases in women who are in reproductive or menopausal periods. Men, in turn, are less prone to develop systemic lupus erythematosus, since the male sex hormones androgens have a protective effect on their body.
Things such as having a bacterial infection, taking antibiotics, hormonal, anti-inflammatory and antifungal drugs, viral infections, colds increase the likelihood of getting systemic lupus erythematosus. Smoking can also cause disease and complicate its course due to vascular damage.
Symptoms and signs
The first signs and symptoms of SLE in women and men can appear instantly and unexpectedly, or they can develop gradually. The main common symptoms are decreased performance, lethargy, weight loss, fever.
On the part of the musculoskeletal system, the following symptoms appear:
- Arthritis occurs in 85% of cases. The joints of the hand and knee joints often suffer the most.
- Osteoporosis may occur during treatment with hormonal drugs.
- Muscle pain, lethargy and fatigue during exercise.
The mucosa and skin have the following symptoms of systemic lupus erythematosus (photo below):
- At the heart of everythingpatients, this symptom appears late, and may not appear at all. Only places that are open to the sun are affected. Appears as red, scaly patches that cover the nose and cheeks.
- Hair loss, but it does not happen often in patients, and even if it happens, then in a certain area.
- More than half of patients become sensitive to sunlight.
- The mucosa suffers. Mouth ulcers, decreased pigmentation and redness.
Respiratory system. The defeat of the respiratory system appears in the bulk of patients. Most often it is:
- pleurisy;
- pneumonia;
- pulmonary hypertension;
- lung infections may also develop.
Cardiovascular system. This disease can adversely affect all structures of the heart:
- The most common is pericarditis - an inflammation of the membranes that cover the heart muscle. Main symptom: dull, constant chest pain.
- Myocarditis is an inflammation of the heart muscle. Main symptom: heart failure, heart rhythm disorder.
- Heart valves and coronary vessels suffer. Can lead to a heart attack, even at a fairly young age.
Kidneys. The symptoms of SLE with kidney damage are as follows: protein in the blood decreases sharply and sharply, edema appears, and there is more protein in the urine. Often this symptom does not appear at the beginning of the disease, but later.
Blood. color indicator of bloodbecomes lower than normal, leukocytes in the blood decrease, rarely, but there is a decrease in platelets in the blood. Also, in most cases, there is an increase in the lymph nodes and spleen.
Central nervous system. The effect on the central nervous system is often due to damage to the vessels of the brain. Common symptoms of systemic lupus erythematosus:
- migraine;
- headaches;
- damage to brain structures;
- hallucinations;
- cerebral stroke;
- inflammation of the lining of the brain;
- violation of the formation of the vessel membrane.
Without symptoms SLE resolves only in rare cases and at the initial stage. At the slightest suspicion of a disease, you should contact the clinic.
Diagnosis
To establish an accurate diagnosis of systemic lupus erythematosus, it is necessary to undergo a comprehensive examination. If there is a possibility of this disease, first of all the patient turns to a rheumatologist. Doctor prescribes:
- complete blood count (this disease is characterized by an increased ESR, platelets, leukocytes, erythrocytes decrease);
- urine (hematuria, proteinuria observed);
- ECG (pericardial friction rub);
- Ultrasound of the abdominal organs (kidneys - fibrinoid of glomerular capillaries, hyaline blood clots);
- radiography of bones and joints (epiphyseal osteoporosis, most often of the hand);
- lung X-ray;
- antinuclear factor analysis.
At the doctor's appointmentexamination based on diagnostic criteria for systemic lupus erythematosus according to V. A. Nasonova:
- Temperature over 37.5 degrees for several days.
- "Butterfly" - a rash on the cheekbones and in the nasolabial region.
- Photosensitivity is a rash that occurs as a result of skin contact with sunlight.
- Ulcers on the mucous membranes of the oral cavity.
- Dramatic weight loss in a short time.
- Hair loss.
- Fatigue during physical exertion.
After the examination, the patient is sent for a consultation with such specialists as a psychiatrist, neurologist, nephrologist, ophthalmologist. And only after performing a full range of diagnostics can a correct diagnosis be made.
Pregnancy lupus erythematosus
Lupus erythematosus is a chronic autoimmune disease characterized by pathologies of the connective tissues and vascular system. At the same time, pathological processes occur in the organs and systems of the body, which are subjected to additional stress during pregnancy and childbirth (musculoskeletal system, genitourinary system, respiratory and cardiovascular systems, skin, blood vessels).
It is especially important to pay attention to this problem, since women of childbearing age are susceptible to lupus erythematosus, which is facilitated by the hormonal background and the menstrual cycle.
Symptomatic of lupus erythematosus in pregnant women is characterized by such mild phenomena as:
- weight loss;
- gainpuffiness;
- pain in the joints;
- fatigue;
- general weakness;
- reaction to ultraviolet light.
These manifestations may increase during the period of exacerbation and not be observed during the period of remission. Of course, ideally, a woman diagnosed with lupus erythematosus should consult with a specialist about the risks and threats before planning a pregnancy.
The presence of systemic lupus erythematosus (a photo of the symptoms is presented in the article) in some cases can lead to such pathologies of pregnancy and childbirth:
- pregnant women with kidney disease (nephritis) may experience increased protein in the urine and increased blood pressure;
- miscarriage (spontaneous abortion);
- treatment of lupus erythematosus with special drugs can lead to premature birth and the birth of a premature baby;
- intrauterine disorders of fetal development;
- appearance of blood clots in the placenta.
Such negative factors can be avoided if, together with the doctor, plan conception and pregnancy for the period of remission of lupus erythematosus. A pregnant woman with a diagnosis of "systemic lupus erythematosus" should undergo an examination by a rheumatologist (at least three consultations at different times), the development of the fetus should be controlled using modern studies such as ultrasound, fetal monitoring, doplerometry. Regular blood sampling is also important.
The use of drugs for lupus erythematosus during pregnancy is carried out taking into account their effecton fetal development and pregnancy. To date, lupus erythematosus is not a sentence for a woman who wants to have children. Subject to the recommendations of the doctor, careful monitoring of the course of pregnancy, there is every chance to endure and give birth to a he althy baby.
Lupus erythematosus in children
Systemic lupus erythematosus in children is an autoimmune inflammation in which the immune system produces antibodies that affect the DNA of its own normal cells. As a result of lupus erythematosus, specific systemic changes occur in the body as a whole.
This disease, which cannot be cured, often affects girls at puberty. Only 5% of cases are boys. Systemic lupus erythematosus in children is difficult to identify, as its manifestation is very similar to other ailments common to children.
Causes of SLE in children
There are a lot of theories why such a disease appears in children. The disease has not yet been fully investigated, since no one can indicate its definite causes. Yet a large number of doctors tend to believe that this disorder is caused by some kind of virus or a specific infection.
Not overlooked is also the effect of drugs on the state of the immune system. As practice shows, they are the trigger mechanism for lupus erythematosus in children with high sensitivity to various external factors. The provocateurs of the disease (not the cause) are:
- sun exposure;
- hypothermia;
- stress;
- great fatigue;
- injuries, both psychological and physical.
These circumstances are very significant at a time when there are hormonal changes in the body, its physiological allergization. Heredity plays a huge role in the occurrence of this disease. The nature of the disease of a genetic nature is evidenced by “family” cases of the disease, as well as cases of rheumatism, arteritis and other pathologies of a diffuse nature that are very often noted among relatives.
Consequences
Systemic lupus erythematosus is a disease of the immune system and connective tissues. It is characterized by a negative reaction of the immune system to the connective tissue of human capillaries.
Violation of autoimmune processes is localized in almost all organ systems, such as:
- skin;
- kidneys;
- heart;
- blood;
- cortex;
- light.
The first sign and symptom of SLE is the appearance of a small red rash on the face. The coverage area resembles a butterfly with open wings. To date, the global treatment of SLE is ineffective, but he alth monitoring can reduce the negative effects of symptoms to a minimum.
Main complications
The main secondary adverse events of SLE symptoms include:
- Kidney disorders.
- Mental he alth disorders(delusions, hallucinations, memory impairment).
- Circulatory diseases (anemia, vasculitis).
- Disorders of the respiratory system (inflammation of the pleura).
- Disorders of the heart and blood vessels (heart attacks, pericarditis, myocarditis).
- Severe pregnancy in women (30% higher chance of miscarriage).
- Oncological diseases.
Medicated treatment
Etiotropic therapy is permissible only in cases where the disease factor is known, i.e. with pharmaceutical LE syndrome. Already after the abolition of the provoking medication, the symptoms disappear for a couple of months. In all other situations, it is recommended to beware of drugs that can lead to the development of LE cells and exacerbation of the disease. Anti-inflammatory drugs: salicylates and phenylbutazone - have no independent significance.
Corticoids. Due to the diverse influence on the body in specific situations, they provide a decisive effect. Main indications for their use:
- Relatively simple course of the disease, in which it is possible to exclude immunosuppressants: the daily dose should not exceed 10 mg of prednisolone.
- Acute period of illness, as immunosuppressants do not start working immediately. In these cases, large doses (100 mg of prednisolone or more) are taken, most often in combination with immunosuppressive agents. With the onset of remission, the dose of these substances is reduced, and therapy is continued until the process stabilizes. In severe cases, methylprednisolone is used repeatedly at a dose of 1 g.
- Specific medical manifestations of the disease. On the one hand, due to the threat of irreversible changes in the kidneys, active therapy should be started immediately, and on the other hand, the use of immunosuppressants is associated with the risk of developing a number of complications, for this reason, corticosteroids are preferred.
Antimalarial drugs. Chingamine is most often prescribed. The initial portion of it reaches 300-500 mg. Already after the onset of improvement, the dose is reduced to maintenance (100-200 mg) and used for a couple of months. The drug is more effective in dermatological than in visceral forms of the disease. Due to possible complications, hingamin is constantly combined with corticoids, the doses of which are also reduced to maintenance doses over time.
Immunosuppressive treatment. Opinions on the value of this method will differ. Some authors believe that suppression should not be general, but deliberately affect the impaired element of immunoregulation. In principle, immunosuppressants should be prescribed only at a time when therapy with the above medicines has become ineffective, especially with damage to the kidneys, CNS, serous membranes or heart. On the one hand, the use of these substances should not be rushed, and on the other hand, only their timely exposure can eliminate the progressive damage to organs (kidneys).
Folk treatment
Treatment of systemic lupus erythematosus (SLE) with traditional medicine provides remedies for bothexternal use, and for oral administration. Most used herbs:
- birch buds;
- horse chestnut flowers;
- tarragon;
- nettle leaves;
- mistletoe;
- burdock roots;
- celandine;
- white willow bark.
All plants relieve inflammation, have wound healing and diuretic properties. They also enrich the body with missing trace elements and vitamins.
Some recipes are recognized in traditional medicine as the most effective for SLE. For example, for external use, compresses with tincture of celandine are recommended. They are applied directly to the affected area. In order to prepare the tincture, you will need alcohol (0.5 l) and celandine (fresh, 100 grams). Celandine is poured with alcohol and infused for 7 days. After that, it is necessary to strain the tincture and send it to storage in a dark place. Effective celandine and as an ointment. For its manufacture, pork fat and celandine juice itself will be required (proportions 10: 1). It is necessary to add celandine juice to the melted fat. Stir until smooth and refrigerate. The affected areas should be treated with ointment 3 r. per day.
In addition to celandine, an ointment with the addition of tarragon is often used for TFR. As a rule, interior fat is taken for it, which is also melted in a steam bath, and dry tarragon is added (proportions 5: 1). After connection, the mixture is placed in the oven for 5-6 hours, maintaining a low temperature (up to 30 degrees). At the end, everyone is filtered, and after cooling, put in the refrigerator, where the ointment canstored for 2-3 months.
Compresses and ointments have a beneficial effect on the skin manifestations of the disease. In turn, oral preparations increase the protective reaction of the whole organism and support overall well-being, such as mistletoe infusion or white willow decoction.
For mistletoe infusion, it is important that its leaves are harvested in advance during the cold season. They must be washed well, dried and chopped. Dried raw materials are poured with water (2 tsp per 1 glass of water), brought to a boil, and then infused for about half an hour. The finished infusion is filtered, divided into three doses and taken after meals.
If a decoction of white willow was chosen for the treatment of SLE, then only its dried bark should be brewed. For 500 ml of boiling water, take 1 tbsp. a spoonful of raw materials. After that, the composition must be boiled again, make the fire weak and boil for 25 minutes. After the broth is removed from the fire, it is placed for 5 hours in a warm place. It is necessary to take the finished drug 3 r. 100 ml per day.
Food
For systemic lupus erythematosus, adjusting the foods you eat can go a long way in improving the effectiveness of your treatment. The body, weakened by disease and repeated medication, will be better able to cope with its functions if certain dietary rules are followed.
The strictness of the diet and control over food intake largely depend on the degree of the disease. First of all, smoked foods, canned food should be eliminated from the diet and s alt should be minimized. Products listedonly provoke metabolic disorders. Among the possible undesirable consequences of SLE is the likelihood of developing diabetes.
When dieting, it is recommended to stop eating sweets and switch to a sweetener. If it is not possible to give up sweets, then you can use honey as a sweetener. Given that non-steroidal anti-inflammatory drugs and hormone therapy can cause irritation of the gastrointestinal tract, accumulate fluid in the body and increase appetite, food should be sparing. This means avoiding fatty foods and reducing carbohydrate intake.
Foods such as fatty fish and meats also have a hepatotoxic effect on the liver. Therefore, it is advisable to start eating lean meat, lean fish when diagnosing SLE. To avoid many problems with the intestines, taking bifid drugs and fermented milk products will help. Most useful milk protein in cottage cheese and kefir. Foods containing fiber (buckwheat, wheat, pearl barley and whole grain bread) have a beneficial effect on the functioning of the digestive tract.
For systemic lupus erythematosus, clinical recommendations include eating chicken eggs, all fruits and vegetables (both raw, stewed, and boiled). Do not forget about the correct drinking regimen. The body needs to get enough fluid in systemic lupus erythematosus, but its volume should not overload the work of the kidneys.
Acceptance of any alcohol is prohibited, as it causes an exacerbation of the disease. ShouldIt should be noted that SLE is very individual for each person, and in each case of exacerbation and remission, the rigidity of recommendations regarding nutrition may vary.
