Medicine lupus erythematosus symptoms. How is lupus erythematosus treated in the hospital and at home? Review of methods of treatment, as well as a description of recipes for the treatment of folk remedies. Damage to the cardiovascular system

All forms of lupus are characterized by a chronic course. They begin at a young age, are especially common at puberty, are painless, heal by scarring, and tend to relapse. In the article we will analyze the topic: lupus, what kind of disease it is with a photo, causes and symptoms.

How to identify lupus erythematosus and diagnose the disease

The diagnosis is characterized by the presence of dirty-brown lupus nodules sitting deep in the skin, especially clearly visible under pressure with a glass plate and yielding under pressure with a probe. Often, especially in the ulcerative form, the nodules are clearly visible only on the periphery of the lupus ulcer. Further, lupus is characterized by: onset at a young age, very slow course, absence of pain, frequent localization on the face, especially on the nose, cartilage damage, serpiginous spread, local reaction to injection of tuberculin.

In addition to fever, in the latter case a very characteristic, inflammatory, curative reaction is obtained, and therefore, in cases of doubt, tuberculin injections must always be resorted to. In general, in the initial cases of the disease, with careful examination, an error in diagnosis is hardly possible. On the contrary, difficulties in the diagnosis can arise in advanced cases.

The cause of lupus is the tuberculosis bacillus. In all likelihood, in lupus, as in all tuberculous diseases, there must be a predisposition depending on constitutional conditions. If there are primary nests in the glands, bones, lungs, etc., tuberculosis bacilli can enter the skin through the blood. Much more often, bacilli penetrate from the outside through barely noticeable damage to the skin.

The general condition, unless there is at the same time tuberculosis of the internal organs, is not at all disturbed by lupus, no matter how long it may exist. It goes without saying that the formation of disfiguring scars can act depressingly on the patient's psyche.

The primary element in lupus vulgaris is the lupus nodules. Yellow-brown or brown-red spots are formed in the skin, up to the size of a pinhead, which are covered with smooth, often somewhat shiny, sometimes also flaky skin.

From the pressure of flat glass, the spots do not disappear, but, on the contrary, sharply appear in the form of dirty, brown-red places among the surrounding, pale skin. Dirt particles adhering to the skin are less likely to give rise to errors than age spots. To distinguish from the latter, the consistency of the lupus nodules is important. The pigmented spot of the skin does not disappear from the pressure of the probe, on the contrary, the tissue of the lupus nodule is so weakly resistant that when pressed, the probe head easily penetrates into it. This is an extremely important sign of a lupus nodule.

However, nodules characteristic of lupus vulgaris are often difficult to find, especially in older cases of the disease. The fact is that the nodules very quickly disintegrate due to curdled degeneration and, forming ulcers or not even forming them, then heal.

On the other hand, the degree and nature of participation in the pathological process of the surrounding tissue are of no small importance due to collateral hyperemia, changes in the skin and epithelium, primary nodules can become difficult to notice. In such cases, diascopic examination plays an important role as a diagnostic aid.

Usually there is only one lesion, or several foci that occupy adjacent areas of the skin. Rarely, separate lupus foci are found on parts of the body that are far from each other, even more rarely, individual foci are scattered throughout the body.

Lupus can develop anywhere in the body; but the face is especially often affected. For the most part, the starting point of development is the circumference of the nostrils, especially the tip of the nose. All forms of lupus are found here:

• Flaky.
• Hypertrophic.
• Ulcerative.

Usually, starting completely imperceptibly, lupus causes the formation of scar tissue on the skin of the nose. Often the process extends deeper and leads to the destruction of the cartilaginous framework of the nose. Although the same changes can be formed due to primary lupus of the mucous membrane.

As a result, the tip of the nose falls back, the nostrils narrow, and often so much that breath through the nose is completely destroyed. From the nose, lupus creeps further onto both cheeks, sometimes forming a butterfly figure here.

Little by little, in this way, the entire skin of the face can be destroyed by lupus, presenting one continuous scar tissue, causing the most terrible disfigurements. Fortunately, involvement of the entire face is extremely rare.

The primary site for the development of lupus, which spreads further to the surrounding skin, can be any other place on the face: cheeks, forehead, ears, eyelids. The photo shows systemic signs:

On the ears, the earlobes are predominantly affected, often undergoing elephantine thickening. With the defeat of the eyelids, their eversion with all its consequences can form.
The scalp is rarely primarily affected by lupus. The neck is somewhat more often affected, and the serpiginous form of lupus is especially often observed here. The initial place of lupus here is often scrofulous fistulas of glands.

Lupus on the skin photo

On the trunk, lupus is extremely rare, it occurs in the inguinal region, and here it is accompanied by strong fungal growths.

On the extremities, lupus develops quite often, especially on the back of the hand and on the shins. There is a slowly serpiginating ulcerative form of lupus. After a long existence, large scar surfaces are formed, which are partly surrounded by semicircular, narrow ulcers covered with crusts.

Warty growths and elephantiasis are often observed on the lower extremities.

Lupus erythematosus and life expectancy

As far as prediction is concerned, lupus vulgaris itself does not pose a great danger to life, as it relatively rarely leads to successive tuberculosis of important organs. If we exclude the dangers associated with the narrowing of the upper respiratory tract due to the development of lupus of the larynx, then the dangers that threaten the organ of vision, then lupus itself has almost only cosmetic value, since it can cause the most terrible disfigurements due to scarring and scarring.

Have you seen lupus, what kind of disease is it? What are the primary symptoms and signs? Share your opinion and leave a review on the forum.

In fact, it is more correct to call it systemic lupus erythematosus or Liebman-Sachs disease, but this is scientific, medical, and the people get by with one word - lupus, but everyone understands what kind of disease they are talking about. It refers to collagenoses or diffuse connective tissue diseases (DBST), and it proceeds with damage to all organs where this tissue is present, in addition, the walls of blood vessels () also become inflamed, so we can say that the whole body suffers.

SLE (systemic lupus erythematosus) has many epithets, unfortunately, disappointing, so this disease cannot be called benign.

It has been proven that lupus has a hereditary predisposition, which arises under the influence of initiating or provoking factors. However, first things first.

Viruses, stress, immune response… Lupus

It is somehow impossible to say unequivocally what causes lupus, since it has no specific causes. However, the prerequisites that contribute to the formation of the pathological process are known reliably.

Lupus is autoimmune disease , that is, accompanied by the production of specific proteins (immunoglobulins of various classes, called antibodies) to their own tissues and cell components (autoantibodies). This variant of the immune response in relation to one's own body is called autoimmunization and underlies the development of autoimmune processes. This type of functioning of the immune system is due to certain genetic abnormalities, that is, SLE has a hereditary predisposition, as indicated by family cases of the disease.

Infection plays an important role in the origin of the disease., while its variety is completely unimportant, since the main point is the tension of immunity and the production of antibodies. And since in acute viral infections destructive changes occur at the site of the pathogen (for example, the mucous membrane of the respiratory tract with influenza), a pronounced immune response is formed, conditions are created for the formation of immunoglobulins, including autoantibodies.

Other contributing factors include:

• Insolation (stay in the sun);
• Fluctuations in hormone levels (therefore, the disease is more characteristic of the female sex);
• Abortion and childbirth also affect women;
• Psycho-emotional stress, stress;
• Taking certain medications (salicylates).

The combination of these causes aggravates the situation and contributes to the development of such a bad disease as lupus, which, however, can proceed differently, exist in several different forms and, accordingly, give diverse clinical manifestations.

Depending on the predominant lesion of a particular organ and on the causes of occurrence, several varieties of lupus lesion are distinguished.

Is skin involvement only a separate form of lupus?

discoid form or discoid lupus erythematosus(DKV) is considered the lot of dermatologists, characterized by the appearance of erythematous rashes, which can affect the face, cheekbones, nose and spread to the cheeks, forming a "butterfly" (this is the name of the rash, since it is very reminiscent of this insect in its outlines).

The severity of the "butterfly" and the persistence of inflammatory manifestations are very significant in establishing the diagnosis and determine DKV options:

1. Intermittent redness with cyanosis of the middle zone of the face, which pulsates and intensifies under the influence of weather conditions (low ambient temperature, ultraviolet exposure, strong wind) or psycho-emotional state (excitement);
2. The appearance of persistent erythematous spots with edema, accompanied by a thickening of the epidermis at the site of their formation (hyperkeratosis);
3. Severely swollen eyelids, swelling of the entire face, the presence of bright pink spots on it, dense and swollen;
4. Distinct cicatricial atrophy is noted in the discoid elements.

In other cases, rashes can move to other parts of the body: earlobes, forehead, neck, torso, scalp, limbs, or appear non-specifically - purpura, nodules (erythema polymorphism).

Rash on the mucous membrane is typical for lupus

For the diagnosis of DKV, a special role is given to the presence of a rash on the oral mucosa, as well as the presence of lupus cheilitis, which is manifested by swelling and a red border of the lips, covered with gray, dryish scales or crusts and erosions, which subsequently undergo cicatricial atrophy.

The butterfly equivalent, capillaritis (vasculitis), which is characterized by the formation of small, slightly edematous spots, with the development of mild atrophy, is another option. In this case, the fingers of the upper and lower extremities, the surface of the palms and soles are affected, trophic changes in the skin are observed (fragility of the nails and their deformation, the formation of ulcers and bedsores, increased hair loss).

It should be noted that DKV is not excluded with generalized lupus erythematosus, but there she comes as a symptom, not as a separate form of the disease.

Other isolated forms of lupus

As for other variants of lupus, even though they look like a classic form (“butterfly”, erythematous rashes, etc.), they have other causes, require specific treatment and differ in prognosis (tuberculous and medicinal).

Tuberculous lupus, also known as skin tuberculosis or lupus vulgaris, the beginning of which gives Koch's bacillus, which is the causative agent of tuberculosis (Tbc) of any type and localization. The disease is called lupus because its symptoms closely resemble those of DLE.

Treatment of tuberculous (vulgar) lupus is aimed at eliminating the underlying disease (Tbc) and the consequences of lupus activity (ulcers, tubercles, nodules). However, to cure tuberculosis is to get rid of lupus.

Cannot be considered as a separate symptom of SLE and drug-induced lupus resulting from taking certain medications (oral contraceptives, salicylates, sulfonamides, etc.), since it is reversible and disappears after drug withdrawal.

Classification by the nature of the flow

Having considered isolated variants of lupus erythematosus, in the future there will be a description of SLE - generalized form diseases with a variety of symptoms and manifestations. The working classification of pathology considers clinical variants of the course, taking into account:

• The degree of severity of the initial period;
• Symptoms of the onset of the disease;
• The nature of the flow;
• Activity of the pathological process;
• Progression rates;
• The effect of the use of hormones;
• The length of the period.
• Morphological features of the lesion of the body.

Concerning It is customary to distinguish three types of flow:

1. spicy variant, characterized by a sudden onset, so sudden that the patient can even indicate for an hour when his illness overtook him, a rapid increase in body temperature, the appearance of a "butterfly", the development of polyarthritis and serositis. Multiple organ damage and rapid involvement of the excretory (kidney) and nervous systems in the process leads to a sharp deterioration in the condition, which can last up to 2 years. However, treatment with glucocorticosteroids can lengthen the initial period up to 5 years and even achieve a stable remission;
2. Subacute undulating course, which is characterized by the gradual development of the disease, where the joints and skin are usually the first to suffer, and the remaining organs (more and more) join the process with each relapse. The disease develops slowly (5-6 years), after which it has a multisyndromic clinical picture;
3. A gradual, imperceptible even for the patient onset, the presence of only one syndrome, the rest join only after many years, characterizes chronic course of SLE.

Clinical picture of SLE - symptoms, syndromes, variants

In most cases The following signs are the signal for the onset of SLE:

• Joint damage - recurrent polyarthritis, which is very similar to rheumatic;
• Increased body temperature;
• Skin rash;
• Weakness, feeling tired, loss of interest in life;
• Weight loss.

Start from acute manifestations the disease is less common, it is characterized by symptoms:

1. fever;
2. polyarthritis;
3. Severe skin lesions;
4. Jade;
5. Polyserositis.

Clinic chronic course , as a rule, is limited to one syndrome for a long time, for example:

• Recurrent arthritis;
• Polyserositis;
• or Werlhof, epileptiform syndrome or discoid lupus.

Manifestations and complications of systemic lupus. Based on the individual course of the disease, the localization of lesions can vary greatly. (More on this later).

However, sooner or later, perhaps in 10 years, as a result of the uncontrollable progression of the pathological process, other organs are still affected. Polymorphic symptoms of the disease can lead to the development of functional insufficiency of some organ, which ends in the death of the patient.

SLE. Damage to the skin, joints, heart, blood vessels

Symptoms skin lesions in SLE discussed above (description of DLE), which in the form of a skin syndrome are present in a generalized pathological process and are characterized by analogy with the symptoms of discoid lupus.

At articular syndrome almost all patients report migratory pain, limitation of mobility in the joints, often small (lupus arthritis). In some cases, these symptoms are added:

• Fusiform deformity of the fingers;
• Atrophic muscle changes;
• Painful myalgia (muscle pain);
• Myositis (muscle inflammation);
• Ossalgia (bone pain).

Pericarditis is one form of lupus' effect on the heart.

Serositis (inflammatory lesions of the serous membranes)- a rather serious component of SLE, including the diagnostic triad:

• , bilateral pleurisy, sometimes peritonitis;
• Dermatitis;
• Arthritis.

serosites have a tendency to relapse, forming adhesions in the pericardial cavity and pleura. The symptomatology of serositis is quite common: the patient feels pain, the doctor hears the friction noise of the pleura, pericardium, peritoneum.

With systemic lupus erythematosus damage to the cardiovascular system is not limited to pericarditis. The endocardium, valvular apparatus (mitral and tricuspid valves - in the first place), myocardium and large vessels suffer, and thus, in the state of the heart and vessels in SLE, pathology may be present in the form of:

• Atypical warty Liebman-Sachs;
• Raynaud's syndrome, the likelihood of developing which in SLE increases several times;

Myocarditis in lupus has a rather pronounced clinical picture:

1. Persistent increase in rhythm (tachycardia);
2. Heart pain, which the patient finds it difficult to describe, because "it is somehow indefinite";
3. Shortness of breath, especially on exertion;
4. Muffled tones, the appearance of noise on the pulmonary artery or at the apex of the heart (auscultatively);
5. In the case of a diffuse process: cyanosis of the skin, low blood pressure, gallop rhythm;
6. Characteristic changes on the ECG.

It can be noted that almost all pathological processes in any of the organs do not leave the vessels indifferent. Small and large, arterial and venous trunks are affected with development and For example, Raynaud's syndrome can noticeably outpace the clinical picture of the disease and form long before the appearance of other manifestations.

Lupus and body functions: breathing, digestion, neuropsychic activity and protection

The inflammatory process in lupus finds connective tissue in the respiratory organs , spreading around the bronchi, pulmonary vessels, between the lobules of the lungs, and sometimes even affecting the alveolar septa. These changes lead to the formation lupus pneumonitis with the development of foci of inflammatory infiltration in the lungs, the main clinical sign of which is dyspnea that slowly increases over time.

However, the inflammatory process in the lungs with lupus can behave differently and give an acute course, in which there are:

• Shortness of breath, quite pronounced;
• Painful cough, asthma attacks;
• Hemoptysis;
• Bluish discoloration of the skin of the face, arms and legs;
• Formation (maybe).

Damage to the gastrointestinal tract (gastrointestinal tract) differs in the brightness of the clinical picture and many symptoms:

• Complete lack of appetite (anorexia);
• Dyspeptic disorders;
• Almost constant, but of an indefinite nature, pain in the abdomen;
• Frequent diarrhea.

The most common culprit is lupus lesions of the gastrointestinal tract:

1. Vasomotor mesenteric disorders;
2. Hemorrhagic edema of the mesentery and intestinal wall;
3. Segmental ileitis (recurrent obstruction of the small intestine);

In some cases, the lupus inflammatory process in the gastrointestinal tract can lead to ulcerative necrotic changes and give aphthous stomatitis, esophagitis, gastroenterocolitis, which can be complicated by ulcer perforation and the development of peritonitis or pancreatitis.

The most common and dangerous complications of systemic lupus erythematosus

Approximately half of patients with SLE kidneys are affected with the development of pyelonephritis, lupus nephritis (lupus nephritis), nephrotic syndrome with and impaired renal excretory function. Rarely, lupus may begin with a pathology resembling nephropathy of pregnancy or acute nephrotic syndrome.

Nervous system disorder and mental activity is also observed in approximately 50% of cases at all stages of systemic lupus erythematosus. The initial phase is characterized by:

• General weakness;
• Fast fatiguability;
• Adynamia;
• Irritability and irascibility;
• Depressed mood;
• Decrease in the general emotional background, apathy;
• Sleep disturbance;
• Hyperhidrosis (excessive sweating);
• Heaviness in the head, headache.

Due to the involvement of the brain and spinal cord, meninges, nerve roots and peripheral nerves in the midst of the disease, certain neurological symptoms appear, which develop into syndromes:

1. Cerebral (meningoencephalitis);
2. Cerebro-spinal (encephalomyelitis);
3. Diffuse (meningoencephalomyelopolyradiculoneuritis).

Shifts in the emotional sphere at this stage not only do not go away, but are exacerbated:

• Unstable mood (depression is replaced by euphoria);
• Insomnia;
• Intellectual-mnestic disorders (memory and intellect suffer);
• Sometimes delirium and hallucinations (visual and auditory);
• Convulsive seizures;
• Decrease in criticism, inadequacy of judgments, inability to correctly assess one's own capabilities.

In addition, it should be borne in mind that such disorders in neuropsychic activity are sometimes caused by hormone treatment (steroid psychoses).

Reticuloendothelial system(macrophage system) reacts to SLE with an increase in all groups of lymph nodes, which indicates an early generalization of the disease. In addition, there is an increase in the spleen and liver. Symptoms of liver damage (hepatitis accompanied by jaundice, fatty hepatosis) often occur against the background of heart failure due to diffuse myocarditis or pulmonary hypertension, and resemble acute viral hepatitis.

Lupus in children and pregnant women

A general description of lupus for all age groups, gender and conditions may not satisfy certain categories of patients who are interested in questions:

1. Do children get SLE?
2. How does pregnancy proceed in a woman with lupus, what are her chances for a happy motherhood?
3. Is SLE contagious, is it not transmitted in the home?

Question one. Unfortunately, the lupus process does not spare the children's body either. Primary schoolchildren and adolescents are more susceptible to the disease, and even at this age, lupus prefers girls, they get sick 3 times more often than boys.

The causes, the development of the disease, the nature of the course, the clinical picture and therapeutic measures, in general, are no different from those in adults, so it is hardly worth repeating.

Second question: systemic lupus erythematosus during pregnancy. Of course, given that SLE is predominantly a disease of women, this issue cannot but worry, especially since pregnancy can provoke the onset of the disease or its exacerbation. However, it is possible that with the progression of pregnancy as a result of a decrease in the activity of the immune system, the woman's condition, on the contrary, may improve, and the risk of complications will decrease. Thanks to modern medicine, such women are no longer offered artificial interruption right off the bat. On the contrary, the expectant mother is surrounded by attention and care by gynecologists and rheumatologists, who have close contact with each other and coordinate their actions on the tactics of managing the patient.

Special attention in the antenatal clinic, enhanced control over the course of pregnancy and the necessary treatment help half of the sick women safely reach childbirth and become a mother. Although a quarter of pregnant women with lupus still have complications in the form of bleeding, thrombosis and fetal death.

Finally, third question Q: Is lupus contagious? The answer is ambiguous, because, if we are talking about skin tuberculosis, then, of course, this disease is contagious, like other forms of Tbc. In this regard, all preventive measures should be directed not against lupus, but against tuberculosis, the danger of which is undeniable. It refers to a rather serious, difficult to treat infections. Probably, people can also be reassured by the fact that lupus erythematosus just doesn’t “walk around” the streets, since patients are subject to treatment in specialized hospitals and can be discharged only when they no longer pose any danger to others.

Other variants of lupus erythematosus are not contagious. and are not transmitted even with close contact, so you can not be afraid and not shy away from patients at home, in a team and under other circumstances.

Diagnosis of SLE

It is possible to suspect systemic lupus erythematosus with severe clinical manifestations already at the initial examination of the patient and to preliminarily establish a diagnosis in the presence of:

• "Butterflies";
• discoid rash;
• Dermatitis, aggravated by exposure to ultraviolet radiation;
• Ulcers in the mouth or nasopharynx;
• nonerosive arthritis;
• Pericarditis or pleurisy (serositis);
• Convulsions and psychosis (CNS damage).

Additional diagnosis of SLE consists in laboratory clinical and biochemical (traditional blood and urine tests) and immunomorphological (immunological test, histological analysis of biopsy material of the kidneys and skin) studies. Lupus is indirectly indicated by the appearance of:

1. Protein in the urine above 0.5 g / day or cylindruria (renal pathology);
2. , or (hematological disorders).
3. The final diagnosis can be established by identifying immunological disorders, which are indicated by:
   • AvailabilityLE-cells with absorbed nuclear material of destroyed tissues;
   • Presence of antibodies to nuclear components and antinuclear antibodies;
   • False-positive Wasserman reaction (analysis for syphilis).

However, the diagnosis of systemic lupus erythematosus is not as simple as it might seem at first glance, since there are atypical variants of the disease (combined or borderline forms with other connective tissue pathology), which is especially characteristic of the early stages of SLE. For example, the same LE cells are sometimes found in low concentrations in other pathologies.

Treatment process for systemic lupus erythematosus

The greatest success can be achieved if treatment is started at an early stage in the development of the pathological process. Both the onset of the disease and its exacerbation require a stay in the hospital walls, therefore, during such periods, a hospital cannot be avoided.

Initial subacute and chronic, predominantly articular forms are treated with non-steroidal anti-inflammatory drugs (NSAIDs): voltaren or brufen.

If the skin is more affected in the chronic course of the disease, then preference is given to quinoline drugs: delagil, chloroquine, etc., which, however, can have a side effect in the form of dyspeptic disorders, dermatitis, tinnitus, headache.

Diffuse lupus nephritis is treated with Plaquenil (hydroxychloroquine).

The main drugs for the treatment of SLE are glucocorticoids, which are used depending on the form, nature of the course, the activity of the process and the clinical picture of the disease. But if the hormones do not have the desired effect, they resort to the appointment of cytotoxic immunosuppressants.

In addition to the use of specific drugs, with SLE, the patient needs a special diet and the appointment of symptomatic treatment (antiulcer and antibacterial drugs, vitamins, etc.).

Exercise therapy and massage can be recommended only after the inflammatory process subsides in the parenchymal organs and always under the control of their condition. Physiotherapy and spa treatment for lupus is not indicated at all. Insolation, radon baths, ultraviolet irradiation of the joints very well provoke an exacerbation of the disease, which should not be forgotten.

Forecast and prevention of SLE

The prognosis depends on the form and course of SLE in direct proportion.

• Absolutely favorable prognosis - only with drug lupus.
• The discoid variant has a 40% chance of being cured.
• As for the generalized form, with early diagnosis and adequate therapy, remission occurs in 90% of cases, which significantly lengthens life and improves its quality. The remaining 10%, unfortunately, can hardly count on a successful outcome, and with the early formation of lupus nephritis, the prognosis becomes even more unfavorable.

Lupus is a serious disease and in order to prolong life, more attention should be paid to preventing exacerbations and preventing the progression of the process.

The preventive complex includes:

1. Timely, rational complex treatment (hormone therapy);
2. Strict adherence to dosages of drugs;
3. Regular visits to the doctor;
4. dispensary examination;
5. Establishment of an optimal sleep regimen (quiet hour during the daytime - 1-2 hours) and wakefulness;
6. Compliance with the diet (limiting the amount of carbohydrates and salt, enriching the diet with protein and vitamin products);
7. In case of damage to the skin - the use of sunscreen (ointment, cream, powder with salol, photoprotective film) before going outside;
8. Strict bed rest, antibacterial and desensitizing treatment for various infectious diseases (ARVI, etc.).

Patients should remember that lupus does not “like” surgical interventions, vaccinations (unless they are simply vital), hypothermia and does not accept “chocolate” tan. Patients with SLE are contraindicated in treatment with ultraviolet light and gold preparations. The desire to spend a summer vacation in the southern latitudes will also be inappropriate.

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Currently answering questions: A. Olesya Valerievna, candidate of medical sciences, lecturer at a medical university

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Systemic lupus erythematosus is a chronic autoimmune disease characterized by damage to the connective tissue and blood vessels and, as a result, the involvement of almost all organs and systems of the body in the pathological process.

In the development of systemic lupus erythematosus, hormonal disorders play a certain role, in particular, an increase in the amount of estrogens. This explains the fact that the disease is more often recorded in young women and adolescent girls. According to some data, viral infections and chemical intoxication play an important role in the occurrence of pathology.

This disease is classified as an autoimmune disease. Its essence lies in the fact that the immune system begins to produce antibodies to some kind of irritant. They adversely affect healthy cells, as they damage their DNA structure. Thus, due to antibodies, a negative change in the connective tissue and blood vessels occurs.

Causes

What causes contribute to the development of systemic lupus erythematosus, and what is this disease? The etiology of the disease is unknown. In its development, the role of a viral infection, as well as genetic, endocrine and metabolic factors, is suggested.

In patients and their relatives, lymphocytotoxic antibodies and antibodies to double-stranded RNA are found, which are markers of persistent viral infection. In the endothelium of the capillaries of damaged tissues (kidneys, skin), virus-like inclusions are detected; the virus was identified in experimental models.

SLE occurs predominantly in young (20-30 years old) women, but cases of the disease are not uncommon in adolescents and older people (over 40-50 years old). Among the sick, only 10% of men are noted, but the disease is more severe in them than in women. Provoking factors are often insolation, drug intolerance, stress; in women - childbirth or abortion.

Classification

The disease is classified according to the stages of the course of the disease:

1. Acute systemic lupus erythematosus. The most malignant form of the disease, characterized by a continuously progressive course, a sharp increase and a multiplicity of symptoms, resistance to therapy. This type of systemic lupus erythematosus often occurs in children.
2. The subacute form is characterized by the frequency of exacerbations, however, with a lesser degree of symptomatology than in the acute course of SLE. Organ damage develops during the first 12 months of the disease.
3. Chronic form characterized by a long-term manifestation of one or more symptoms. The combination of SLE with antiphospholipid syndrome in the chronic form of the disease is especially characteristic.

Also, during the course of the disease, three main stages are distinguished:

1. Minimum . There are minor headaches and joint pains, periodic fever, malaise, as well as initial skin signs of the disease.
2. Moderate. Significant damage to the face and body, involvement in the pathological process of blood vessels, joints, internal organs.
3. Expressed. There are complications from the internal organs, brain, circulatory system, musculoskeletal system.

Systemic lupus erythematosus is characterized by lupus crises, in which the activity of the disease is maximum. The duration of the crisis can be from one day to two weeks.

Symptoms of lupus erythematosus

In adults, systemic lupus erythematosus manifests itself in a large number of symptoms, which is due to damage to the tissues of almost all organs and systems. In some cases, the manifestations of the disease are limited exclusively to skin symptoms, and then the disease is called discoid lupus erythematosus, but in most cases there are multiple lesions of the internal organs, and then they talk about the systemic nature of the disease.

In the initial stages of the disease, lupus erythematosus is characterized by a continuous course with periodic remissions, but almost always goes into a systemic form. More often there is erythematous dermatitis on the face like a butterfly - erythema on the cheeks, cheekbones and always on the back of the nose. Hypersensitivity to solar radiation appears - photodermatoses are usually round in shape, are of a multiple nature.

Joint damage occurs in 90% of patients with SLE. The pathological process involves small joints, usually fingers. The lesion is symmetrical, patients are concerned about pain and stiffness. Joint deformity rarely develops. Aseptic (without an inflammatory component) bone necrosis is common. The head of the femur and the knee joint are affected. The clinic is dominated by symptoms of functional insufficiency of the lower limb. When the ligamentous apparatus is involved in the pathological process, non-permanent contractures develop, in severe cases, dislocations and subluxations.

Common symptoms of SLE:

• Soreness and swelling of the joints, muscle pain;
• unexplained fever;
• chronic fatigue syndrome;
• Rashes on the skin of the face of red color or a change in the color of the skin;
• Pain in the chest with deep breathing;
• Increased hair loss;
• Whitening or blueness of the skin of the fingers or feet in the cold or under stress (Raynaud's syndrome);
• Increased sensitivity to the sun;
• Swelling (swelling) of the legs and/or around the eyes;
• Enlarged lymph nodes.

For dermatological signs diseases include:

• Classic rash on the bridge of the nose and cheeks;
• Spots on limbs, trunk;
• Baldness;
• Brittle nails;
• Trophic ulcers.

Mucous membranes:

• Redness and ulceration (appearance of ulcers) of the red border of the lips.
• Erosions (surface defects - "corrosion" of the mucous membrane) and ulcers on the oral mucosa.
• Lupus-cheilitis is a pronounced dense swelling of the lips, with grayish scales tightly adjacent to each other.

Damage to the cardiovascular system:

• Lupus myocarditis.
• Pericarditis.
• Libman-Sachs endocarditis.
• Damage to the coronary arteries and the development of myocardial infarction.
• Vasculitis.

With damage to the nervous system The most common manifestation is asthenic syndrome:

• Weakness, insomnia, irritability, depression, headaches.

With further progression, the development of epileptic seizures, impaired memory and intelligence, psychosis is possible. Some patients develop serous meningitis, optic neuritis, intracranial hypertension.

Nephrological manifestations of SLE:

• Lupus nephritis is an inflammatory disease of the kidneys, in which the glomerular membrane thickens, fibrin is deposited, and hyaline blood clots form. In the absence of adequate treatment, the patient may develop a persistent decrease in kidney function.
• Hematuria or proteinuria, which is not accompanied by pain and does not bother the person. Often this is the only manifestation of lupus from the urinary system. Since SLE is diagnosed in a timely manner and effective treatment begins, acute renal failure develops in only 5% of cases.

Gastrointestinal tract:

• Erosive and ulcerative lesions - patients are concerned about lack of appetite, nausea, vomiting, heartburn, pain in various parts of the abdomen.
• Intestinal infarction due to inflammation of the vessels supplying the intestines - a picture of an "acute abdomen" develops with high-intensity pains, localized more often around the navel and in the lower abdomen.
• Lupus hepatitis - jaundice, enlarged liver.

Lung damage:

• Pleurisy.
• Acute lupus pneumonitis.
• The defeat of the connective tissue of the lungs with the formation of multiple foci of necrosis.
• Pulmonary hypertension.
• Pulmonary embolism.
• Bronchitis and pneumonia.

It is almost impossible to assume that you have lupus before a visit to the doctor. Seek advice if you develop an unusual rash, fever, joint pain, fatigue.

Systemic lupus erythematosus: photos in adults

What systemic lupus erythematosus looks like, we offer detailed photos for viewing.

Diagnostics

If systemic lupus erythematosus is suspected, the patient is referred for a consultation with a rheumatologist and dermatologist. Several systems of diagnostic signs have been developed for the diagnosis of systemic lupus erythematosus.
At present, the system developed by the American Rheumatic Association is preferred as more modern.

The system includes the following criteria:

• butterfly sign:
• discoid rash;
• the formation of ulcers on the mucous membranes;
• kidney damage - protein in the urine, casts in the urine;
• brain damage, convulsions, psychosis;
• increased sensitivity of the skin to light - the appearance of a rash after exposure to the sun;
• arthritis - damage to two or more joints;
• polyserositis;
• a decrease in the number of erythrocytes, leukocytes and platelets in a clinical blood test;
• detection of antinuclear antibodies (ANA) in the blood.
• the appearance of specific antibodies in the blood: anti-DNA antibodies, anti-Sm antibodies, false-positive Wassermann reaction, anticardiolipin antibodies, lupus anticoagulant, positive test for LE cells.

The main goal of treating systemic lupus erythematosus is to suppress the body's autoimmune reaction, which underlies all symptoms. Patients are prescribed various types of drugs.

Treatment of systemic lupus erythematosus

Unfortunately, there is no complete cure for lupus. Therefore, therapy is selected in such a way as to reduce the manifestations of symptoms, stop the inflammatory, as well as autoimmune processes.

The treatment of SLE is strictly individual and may change with the course of the disease. Diagnosis and treatment of lupus is often a joint effort of the patient and physicians of various specialties.

Modern drugs for the treatment of lupus:

1. Glucocorticosteroids (prednisolone or others) are powerful drugs that fight inflammation in lupus.
2. Cytostatic immunosuppressants (azathioprine, cyclophosphamide, etc.) - drugs that suppress the immune system can be very helpful in lupus and other autoimmune diseases.
3. TNF-α blockers (Infliximab, Adalimumab, Etanercept).
4. Extracorporeal detoxification (plasmapheresis, hemosorption, cryoplasmosorption).
5. Pulse therapy with high doses of glucocorticosteroids and / or cytostatics.
6. Non-steroidal anti-inflammatory drugs - may be used to treat the inflammation, swelling, and pain caused by lupus.
7. symptomatic treatment.

If you suffer from lupus, there are several steps you can take to help yourself. Simple measures can make flare-ups less frequent and improve your quality of life:

1. Quit smoking.
2. Exercise regularly.
3. Stick to a healthy diet.
4. Watch out for the sun.
5. Adequate rest.

The prognosis for life in systemic lupus is unfavorable, but recent advances in medicine and the use of modern drugs give a chance to prolong life. Already more than 70% of patients live more than 20 years after the initial manifestations of the disease.

At the same time, doctors warn that the course of the disease is individual, and if some patients develop SLE slowly, then in other cases, the disease can develop rapidly. Another feature of systemic lupus erythematosus is the unpredictability of exacerbations, which can occur suddenly and spontaneously, which threatens with serious consequences.

Lupus erythematosus (erythematosis) is a chronic disease in which the human immune system attacks connective tissue cells as hostile. This pathology occurs in 0.25-1% of cases of all dermatological diseases. The exact etiology of the disease is not yet known to science. Many experts tend to assume that the reason lies in the genetic disorders of the immune system.

Types of disease

Lupus erythematosus is a complex disease that is not always possible to diagnose in time. There are two forms of it: discoid (chronic) and systemic lupus erythematosus (SLE). According to statistics, mostly women aged 20-45 get sick.

Systemic lupus erythematosus

Severe systemic disease. The perception by the immune system of its own cells as foreign leads to inflammatory processes and damage to various organs and tissues of the body. SLE can manifest itself in several forms and cause inflammation of the muscles and joints. In this case, temperature, adynamia, joint and muscle pain may occur.

With systemic lupus erythematosus, the mucous membrane undergoes changes in 60% of patients. On the gums, cheeks, palate, hyperemia and swelling of the tissues are noticeable. Edematous spots may have vesicles that turn into erosion. A plaque of purulent-bloody contents appears on them. Skin changes are the earliest symptoms of SLE. Usually, the neck, limbs, and face are the sites of lesions.

Systemic lupus erythematosus is characterized by the progression of manifestations, as well as the gradual involvement of other organs and tissues in the inflammatory process.

Discoid (chronic) lupus erythematosus

It is a relatively benign form. Its beginning in most cases is characterized by erythema on the face (nose, cheeks, forehead), head, ear shells, red border of the lips and other areas of the body. Inflammation of the red labial border can develop separately. And the oral membrane itself becomes inflamed in exceptional cases.

There are stages of the disease:

• erythematous;
• hyperkeratosis-infiltrative;
• atrophic.

Discoid lupus erythematosus proceeds for many years, aggravated in the summer. The affected red border of the lips causes a burning sensation, which can intensify during eating or talking.

Causes

The causes of lupus erythematosus are not fully understood. It is considered a polyetiological pathology. It is assumed that there are a number of factors that can indirectly affect the occurrence of SLE.

• exposure to ultraviolet radiation from sunlight;
• female sex hormones (including taking oral contraceptives);
• smoking;
• taking certain drugs, usually containing ACE inhibitors, calcium channel blockers, terbinafine;
• the presence of parvovirus, hepatitis C, cytomegalovirus;
• chemicals (eg, trichlorethylene, some insecticides, eosin)

Symptoms of the disease

In the presence of lupus erythematosus, the patient may have complaints that are associated with signs of the disease:

• characteristic skin rashes;
• chronic fatigue;
• bouts of fever;
• swelling and pain in the joints;
• pain when taking a deep breath;
• increased sensitivity to ultraviolet;
• swelling of the legs, eyes;
• enlarged lymph nodes;
• cyanosis or whitening of the fingers in the cold or in stressful situations;
• increased hair loss.

Some people experience headaches, dizziness, and depression at the time of illness. It happens that new signs appear within a few years after the detection of the disease. Manifestations are individual. In some, one body system is affected (skin, joints, etc.), while others suffer from multiple organ inflammations.

The following pathologies may occur:

• disorders of the brain and central nervous system that provoke psychosis, paralysis, memory impairment, convulsions, eye diseases;
• inflammatory processes in the kidneys (nephritis);
• blood diseases (anemia, thrombosis, leukopenia);
• heart disease (myocarditis, pericarditis);
• pneumonia.

Diagnosis of the disease

The assumption of the presence of lupus erythematosus can be made on the basis of red foci of inflammation on the skin. External signs of erythematosis may change over time, so it is difficult to make an accurate diagnosis on them. It is necessary to use a complex of additional examinations:

• general blood and urine tests;
• determination of the level of liver enzymes;
• analysis for antinuclear bodies (ANA);
• chest x-ray;
• echocardiography;
• biopsy.

A differential diagnosis of lupus erythematosus with photodermatosis, seborrheic dermatitis, rosacea, psoriasis should be made.

Treatment of the disease

The treatment of erythematosis is long and complicated. It depends on the degree of manifestation of the disease, and requires detailed consultation with a specialist. He will help evaluate all the risks and benefits of using certain drugs, and should constantly keep the treatment process under control. With the subsidence of symptoms, the dose of drugs may decrease, with an exacerbation - increase.

Any form of lupus erythematosus requires the exclusion of radiation therapy, too high and low temperature conditions, skin irritations (both chemical and physical).

Medical treatment

For the treatment of erythematosis, the doctor prescribes a complex of drugs with a different spectrum of action.

Non-steroidal anti-inflammatory drugs (NSAIDs):

• naproxen;
• ibuprofen;
• diclofenac (by prescription).

Side effects of these medications can include stomach pain, kidney problems, and heart complications.

Antimalarial drugs (hydroxychloroquine) control the symptoms of the disease. Reception may be accompanied by discomfort in the stomach, sometimes damage to the retina.

Corticosteroids:

• prednisolone;
• dexamethasone;
• methylprednisolone.

Side effects (osteoporosis, hypertension, weight gain, and others) are characterized by a long duration of their course. With an increase in the dosage of corticosteroids, the risk of side effects increases.

Immunosuppressants are often used for various autoimmune diseases:

• methotrexate;
• cyclophosphamide (cytoxan);
• azathioprine (imuran);
• belimumab;
• mycophenolate and others.

Folk methods

Folk remedies for lupus erythematosus can be effectively used along with traditional medicines. (necessarily under the supervision of a physician). They help mitigate the effect of hormonal drugs. You can not use means that stimulate the immune system.

• Make an infusion of dried mistletoe leaves. It is best to collect it from birch. Pour 2 teaspoons of the workpiece with a glass of boiling water. Keep on fire for 1 minute, insist 30 minutes. Drink after meals three times a day for 1/3 cup.
• Pour 50 g of hemlock with 0.5 liters of alcohol. Insist 14 days in a dark place. Strain the tincture. Drink on an empty stomach, starting with 1 drop per day. Every day increase the dose by 1 drop up to 40 days. Then take it in descending order, reaching 1 drop. After eating, you can not eat for 1 hour.
• Put 200 ml of olive oil on a small fire, add 1 tablespoon of string and violets. Simmer for 5 minutes, stirring constantly. Leave for a day to infuse. Strain the oil and treat it with foci of inflammation 3 times a day.
• Grind 1 tablespoon of licorice root, add 0.5 liters of water. Simmer over low heat for 15 minutes. Cooled strained broth drink 1-2 sips throughout the day.

Illness in children

In children, this pathology is directly associated with the functioning of the immune system. 20% of all patients with erythematosis are children. Lupus erythematosus in children is more difficult to treat than in adults. There are frequent cases of death. Full-fledged lupus begins to manifest itself by 9-10 years. It is rarely possible to identify it immediately. There are no clinical signs of the disease. First, some organ is affected, with time the inflammation fades. Then other symptoms appear, with signs of damage to another organ.

In addition to clinical examination, other methods of examination are used to make a diagnosis. Immunological examinations are of great importance, which make it possible to identify signs specific to erythematosis. Additionally, clinical analyzes of urine and blood are carried out. Ultrasound of the heart, abdominal cavity, electrocardiogram can be shown. There are no laboratory specific tests to detect lupus, but based on their results, together with data from a clinical examination, the diagnosis can be simplified.

Children undergo complex therapy in a hospital. They need special treatment. Sick children should not be vaccinated. It is necessary to follow a diet, limit the intake of carbohydrates, exclude juice products. The basis should be proteins and potassium salts. You need to take vitamins C, B.

Among the drugs prescribed:

• corticosteroids;
• cytostatics;
• immunosuppressants;
• steroid-quinoline drugs.

How the disease is transmitted

Since the direct causes of the disease have not been precisely established, there is no consensus on whether it is contagious. It is believed that lupus can be passed from person to person. But the route of infection is not clear and found no confirmation.

Often people do not want to contact patients with erythematosis, they are afraid to touch the affected areas. Such precautionary measures may well be justified, since the mechanisms of transmission of the disease are not known.

Many agree that since the disease is similar in nature to allergies, then it is carried only through genes.

To prevent the disease, it is necessary to include general preventive measures from childhood, especially for people at risk:

• do not be exposed to ultraviolet rays, use sunscreen;
• avoid strong overvoltages;
• follow a healthy diet;
• exclude smoking.

With systemic lupus erythematosus, the prognosis in most cases is unfavorable, since it can last for many years and complete recovery does not occur. But with timely therapy, periods of remission become significantly longer. Patients with this pathology need to provide constant favorable conditions for work and life. Systematic medical supervision is required.

Elena Malysheva and the TV show "Live Healthy" about systemic lupus erythematosus:

Systemic lupus erythematosus (SLE) is a disease in which inflammatory reactions develop in various organs and tissues due to a malfunction of the immune system.

The disease proceeds with periods of exacerbation and remission, the occurrence of which is difficult to predict. In the end, systemic lupus erythematosus leads to the formation of insufficiency of one or another organ, or several organs.

Women suffer from systemic lupus erythematosus 10 times more often than men. The disease is most common at the age of 15-25 years. Most often, the disease manifests itself during puberty, during pregnancy and in the postpartum period.

Causes of systemic lupus erythematosus

The cause of systemic lupus erythematosus is not known. The indirect influence of a number of factors of the external and internal environment, such as heredity, viral and bacterial infection, hormonal changes, and environmental factors, is discussed.

Genetic predisposition plays a role in the occurrence of the disease. It has been proven that if one of the twins has lupus, then the risk that the second one can get sick increases by 2 times. Opponents of this theory point out that the gene responsible for the development of the disease has not yet been found. In addition, in children, one of whose parents is sick with systemic lupus erythematosus, only 5% develop the disease.

The frequent detection of the Epstein-Barr virus in patients with systemic lupus erythematosus speaks in favor of the viral and bacterial theory. In addition, it has been proven that the DNA of some bacteria is able to stimulate the synthesis of antinuclear autoantibodies.

In women with SLE, there is often an increase in hormones such as estrogen and prolactin in the blood. Often the disease manifests itself during pregnancy or after childbirth. All this speaks in favor of the hormonal theory of the development of the disease.

It is known that ultraviolet rays in a number of predisposed individuals can trigger the production of autoantibodies by skin cells, which can lead to the onset or exacerbation of an existing disease.

Unfortunately, none of the theories reliably explains the cause of the development of the disease. Therefore, at present, systemic lupus erythematosus is considered a polyetiological disease.

Symptoms of systemic lupus erythematosus

Under the influence of one or more of the above factors, under conditions of improper functioning of the immune system, the DNA of various cells is “exposed”. Such cells are perceived by the body as foreign (antigens), and special proteins-antibodies specific to these cells are produced to protect against them. When antibodies and antigens interact, immune complexes are formed, which are fixed in various organs. These complexes lead to the development of immune inflammation and cell damage. Connective tissue cells are especially often affected. Given the wide distribution of connective tissue in the body, with systemic lupus erythematosus, almost all organs and tissues of the body are involved in the pathological process. Immune complexes, fixing on the wall of blood vessels, can provoke thrombosis. Circulating antibodies due to their toxic action lead to the development of anemia and thrombocytopenia.

Systemic lupus erythematosus is a chronic disease with periods of exacerbation and remission. Depending on the initial manifestations, the following variants of the course of the disease are distinguished:

acute course of SLE- Manifested by fever, weakness, fatigue, joint pain. Very often, patients indicate the day of onset of the disease. Within 1-2 months, a detailed clinical picture of damage to vital organs is formed. With a rapidly progressive course, patients usually die within 1-2 years.
subacute course of SLE- the first symptoms of the disease are not so pronounced. From manifestation to organ damage, an average of 1-1.5 years passes.
chronic course of SLE- one or more symptoms have been present for many years. In the chronic course, periods of exacerbation are rare, without disrupting the functioning of vital organs. Often, minimal doses of drugs are required to treat the disease.

As a rule, the initial manifestations of the disease are nonspecific; when taking anti-inflammatory drugs or spontaneously, they disappear without a trace. Often, the first sign of the disease is the appearance of redness on the face in the form of butterfly wings, which also disappears with time. The period of remission, depending on the type of course, can be quite long. Then, under the influence of some predisposing factor (prolonged exposure to the sun, pregnancy), an exacerbation of the disease occurs, which is also subsequently replaced by a remission phase. Over time, symptoms of organ damage join nonspecific manifestations. For a detailed clinical picture, damage to the following organs is characteristic.

1. Skin, nails and hair. Skin lesions are one of the most common symptoms of the disease. Often the symptoms appear or intensify after prolonged exposure to the sun, frost, with psycho-emotional shock. A characteristic sign of SLE is the appearance of reddening of the skin in the form of butterfly wings in the cheeks and nose.

Butterfly type erythema

Also, as a rule, on open areas of the skin (face, upper limbs, “décolleté” area) there are redness of the skin of various shapes and sizes, prone to peripheral growth - Biett's centrifugal erythema. Discoid lupus erythematosus is characterized by the appearance of redness on the skin, which is then replaced by inflammatory edema, then the skin in this area thickens, and finally, areas of atrophy with scarring are formed.

Foci of discoid lupus can occur in various areas, in this case they speak of dissemination of the process. Another striking manifestation of skin lesions is capillaritis - redness and swelling and numerous small-point hemorrhages on the fingertips, palms, soles. Hair loss in systemic lupus erythematosus is manifested by baldness. Changes in the structure of the nails, up to atrophy of the periungual ridge, occur during the period of exacerbation of the disease.

2. mucous membranes. The mucous membrane of the mouth and nose is usually affected. The pathological process is characterized by the appearance of redness, the formation of erosions of the mucous membrane (enanthema), as well as small ulcers of the oral cavity (aphthous stomatitis).

Aphthous stomatitis

With the appearance of cracks, erosions and ulcers of the red border of the lips, lupus-cheilitis is diagnosed.

3. Musculoskeletal system. Joint damage occurs in 90% of patients with SLE.

The pathological process involves small joints, usually fingers. The lesion is symmetrical, patients are concerned about pain and stiffness. Joint deformity rarely develops. Aseptic (without an inflammatory component) bone necrosis is common. The head of the femur and the knee joint are affected. The clinic is dominated by symptoms of functional insufficiency of the lower limb. When the ligamentous apparatus is involved in the pathological process, non-permanent contractures develop, in severe cases, dislocations and subluxations.

4. Respiratory system. The most common lesion is the lungs. Pleurisy (accumulation of fluid in the pleural cavity), usually bilateral, accompanied by chest pain and shortness of breath. Acute lupus pneumonitis and pulmonary hemorrhages are life-threatening conditions and, if untreated, lead to the development of respiratory distress syndrome.

5. The cardiovascular system. The most common is Libman-Sachs endocarditis, with frequent involvement of the mitral valve. In this case, as a result of inflammation, the cusps of the valve grow together and the formation of heart disease by the type of stenosis occurs. With pericarditis, the layers of the pericardium thicken, and fluid may also appear between them. Myocarditis is manifested by pain in the chest area, an increase in the heart. SLE often affects small and medium-sized vessels, including the coronary arteries and cerebral arteries. Therefore, stroke, coronary heart disease are the main cause of death in patients with SLE.

6. kidneys. In patients with SLE, with a high activity of the process, lupus nephritis is formed.

7. Nervous system. Depending on the affected area, a wide range of neurological symptoms are detected in SLE patients, ranging from migraine-type headaches to transient ischemic attacks and strokes. During the period of high activity of the process, epileptic seizures, chorea, and cerebral ataxia may occur. Peripheral neuropathy occurs in 20% of cases. Its most dramatic manifestation is optic neuritis with loss of vision.

Diagnosis of systemic lupus erythematosus

SLE is diagnosed when 4 or more of 11 criteria are met (American Rheumatological Association, 1982).

Immunological tests play an important role in the diagnosis of SLE. The absence of antinuclear factor in the blood serum casts doubt on the diagnosis of SLE. Based on laboratory data, the degree of disease activity is determined.

With an increase in the degree of activity, the risk of damage to new organs and systems increases, as well as the aggravation of existing diseases.

Treatment of systemic lupus erythematosus

Treatment should be as appropriate as possible for the individual patient. Hospitalization is necessary in the following cases:

With persistent fever for no apparent reason;
in the event of life-threatening conditions: rapidly progressive renal failure, acute pneumonitis or pulmonary hemorrhage.
with neurological complications.
with a significant decrease in the number of platelets, erythrocytes or blood lymphocytes.
in the case when the exacerbation of SLE cannot be cured on an outpatient basis.

For the treatment of systemic lupus erythematosus during an exacerbation, hormonal drugs (prednisolone) and cytostatics (cyclophosphamide) are widely used according to a certain scheme. With damage to the organs of the musculoskeletal system, as well as with an increase in temperature, non-steroidal anti-inflammatory drugs (diclofenac) are prescribed.

For adequate treatment of a disease of a particular organ, it is necessary to consult a specialist in this field.

The prognosis for life in SLE with timely and proper treatment is favorable. The five-year survival rate for these patients is about 90%. But, nevertheless, the mortality of patients with SLE is three times higher than the general population. The factors of an unfavorable prognosis are the early onset of the disease, male sex, the development of lupus nephritis, high activity of the process, and infection.

Therapist Sirotkina E.V.