Systemic lupus erythematosus

Low urgency
Common-

It is an autoimmune disease. The body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain and other organs.

The autoimmune cause is not completely known, although it can also be caused by certain drugs. It is much more common in women than in men. It can occur at any age.

Its characteristic symptoms are swelling, joint pain, chest pain when breathing deeply, fatigue, fever without any other cause, general malaise, restlessness, hair loss, mouth ulcers, sensitivity to sunlight, skin rash, and swollen lymph nodes. Other symptoms depend on which part of the body is affected, such as headaches, numbness, tingling, seizures, vision problems, and personality changes, abdominal pain, nausea and vomiting, abnormal heart rhythms (arrhythmias), coughing up blood and difficulty breathing, uneven skin color, fingers that change color when it's cold (Raynaud's phenomenon), swelling in the legs, and weight gain.

The diagnosis would be made through medical history, complete physical examination, blood and urine tests with determination of specific markers, chest X-ray, and in some cases kidney tissue analysis will be required.

The treatment will depend on the involvement of organs and systems and the severity of these manifestations. The objective is to maintain general measures (sun protection, balanced diet, physical exercise, no smoking) and control of symptoms with non-steroidal anti-inflammatory drugs, antimalarials, corticosteroids, immunosuppressive drugs, anticoagulants and/or biological drugs.

Bibliographic references
  1. Dafna D Gladman, MD, FRCPC. Overview of the clinical manifestations of systemic lupus erythematosus in adults. Uptodate. Aug 25, 2017.
  2. Daniel J Wallace, MD. Overview of the management and prognosis of systemic lupus erythematosus in adults. Uptodate. Dec 13, 2016.
  3. Van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014; 73:958.
  4. Bevra Hannahs Hahn. Lupus eritematoso sistémico. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición. 2124:2134.
  5. Vilardell M, Ordi J. Lupus eritematoso sistémico. Farreras Rozman. Medicina Interna. Volumen 1. 12º edición. 996:1003.
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Symptoms

    Reddened facial skin


    Reddened skin


    Very severe joint pain


    Reasoning ability is altered


    Skin sensitivity to sunlight

Symptoms to watch out for

A feeling of shortness of breath
Pain in the chest
Headache
Fever (temperature higher than 38 ºC)
If it is accompanied by seizures
History of immunodeficiency (HIV, diabetes mellitus, oncological disorders, long-term corticosteroid consumption).
Pregnancy

Self-care

Avoid excessive sun exposure.
Use sunscreen with SPF 30 or higher.
Engage in regular physical activity, adapted to age and physical condition, at least 3 times a week.
Maintain a balanced diet: increase fruit, vegetable, and white meat consumption and reduce the intake of fatty meals and fritters.
Reduce tobacco consumption.