Lupus is a chronic multi-systemic inflammatory disease of the connective tissue of an autoimmune nature, affecting the joints, kidneys, skin, mucous membranes, and walls of blood vessels. In addition, it often mimics the symptoms of other diseases, for example, fatigue, joint pain, swelling, rash, or fever. Sometimes the symptoms of the disease vary greatly depending on the weakest link in a person. One shows it more externally (on the skin), while others show it up internally. The most common cases are women of childbearing age (from 15 to 45 years), and in this age group, the ratio of cases among women and men is 9 to 1 (Isenberg, 2016). The disease is more common in African-American, Spanish, Asian, and Native American people.
A common symptom indicating lupus is general fatigue and episodic temperatures. Typically, there are skin problems; 80% of patients have a classic butterfly rash on their face, which worsens in the sun (Isenberg, 2016). Ulcers and itching may appear on the skin and mucous membrane. 90% of patients have pain in the muscles and joints (Isenberg, 2016). From intermittent joint pain to sudden inflammation of several joints, symptoms of joint damage are observed in approximately 90% of patients and can last for many years before other symptoms appear (Isenberg, 2016). The rash includes redness around the nose and on the cheeks in the shape of a butterfly (lupus butterfly), convex bumps or spots of thinned skin, and flat or convex areas of redness on exposed areas of the face and neck, upper chest, and elbows.
Ulcers are often found on the mucous membranes, especially on the palate of the mouth, the inner surface of the cheeks, gums, and the nasal cavity. Generalized or focal hair loss (alopecia) is a common phenomenon with relapses. There may be spotty reddened areas on the side surfaces of the palms and fingers, redness and swelling around the nails, and flat reddish-purple spots between the knuckles on the inner surface of the fingers.
The diagnosis of lupus is quite complex and has a complex character. Immunological disorders are a characteristic feature of this disease, and laboratory tests are part of the diagnostic algorithm. Currently, the classification criteria of the American College of Rheumatology (ACR) of 1997 are most often used for the diagnosis of lupus (Isenberg, 2016). They include clinical signs, blood tests, and immunological disorders (a total of 11 criteria).
To date, the basis for the treatment of lupus is vitamin D and hydroxychloroquine. Anti-inflammatory (glucocorticoid) hormones should be used in most cases of active lupus. Still, they are not required for all patients and, in many cases, can be canceled when stable remission is achieved. When the kidneys and the central nervous system are affected, immunosuppressants (drugs that suppress the immune system) and cytostatic drugs (drugs that disrupt the growth, development, and division of all cells of the body, thereby causing their death) are used. In some cases, genetically engineered drugs are used to treat systemic lupus erythematosus.
If the diagnosis is made early and the patient receives proper treatment at an early stage, the disease usually recedes and can go into remission. They can cause side effects, such as discomfort in the stomach, and increased bleeding; in rarer cases, there may be disorders in the kidneys or liver. The outcome of the disease is significantly improved if the fight against the condition begins at an early stage and is conducted for a long time and consistently.
Reference
Isenberg, D. (2016). Systemic lupus erythematosus. Oxford University Press.