Systemic Lupus Erythematosus (SLE) is a chronic and autoimmune disease, which means that the immune system attacks healthy tissues and cells of the body by identifying them as foreign, damaging different organs, joints, and systems, so following a multidisciplinary treatment is key for the patient. In this opportunity, Dr. Oscar Chigne, a rheumatologist at Clínica Ricardo Palma, gives us more information about this disease.

Symptoms and signs

The symptoms and signs of SLE can vary widely from person to person, as well as change over time. Some of the most common are:

• Fatigue
• Fever
• General malaise and weight loss
• Skin rash on the face in the form of butterfly wings that may reach the cheeks and bridge of the nose, and may also reach other parts of the body, including mucosa and skin adnexa, causing oral ulcers and hair loss
• Joint pain, stiffness, and swelling.
• Photosensitivity
• Kidney problems
• Pulmonary and cardiac problems,
• Neuropsychiatric problems, headache, seizures, psychiatric disorders, and neurological involvement in extremities.
• Abnormal blood findings, low blood cell counts, leukocytes, platelets, or anemia

It should be clarified that such symptoms may be associated with other diseases, so it is important to have a proper medical evaluation to make an accurate diagnosis.

Causes

The exact cause of SLE is not yet fully understood, although it is thought to be a combination of genetic, environmental, and hormonal factors.

Risk factors

There are several risk factors associated with the development of this disease:

• Sex; being more common in women
• Age; it can develop at any age. Although it is most common between the ages of 15 to 45 years.
• Family history. It is more common in families with a history of autoimmune disease.
• Race; is more frequent in blacks, Asians, and Hispanics.
• Exposure to ultraviolet light, from sunlight and fluorescent and halogen light bulbs.
• Viral infections
• Physical or emotional stress
• Medications such as certain antibiotics, antihypertensives, and anticonvulsants, among others.

Diagnosis

SLE is a disease of heterogeneous presentation among patients, i.e., no two patients have the same clinical features, often making diagnosis difficult; in addition, its symptoms may reflect other diseases. The diagnosis of Lupus is usually based on a combination of symptoms, physical findings, and laboratory test results, including blood tests, urine tests, immunological markers, as well as imaging tests and biopsies if necessary.

Treatment

The pharmacological treatment of SLE will depend on the individual pattern of organs and systems affected by the disease in each patient, both in extent and severity. Its objective is to control the symptoms and activity of the disease, preventing new outbreaks and its progression to the final damage of the involved organs. Such treatment may include:

• Medications, which include non-steroidal anti-inflammatory drugs, corticosteroids, immunosuppressants, and biologic agents
• Healthy lifestyle, such as a balanced diet, proper rest, regular exercise, avoiding exposure to direct sunlight
• Psychotherapy, helps to improve stress and anxiety associated with the disease.
• Occupational and physical therapy in cases of joint involvement, helping to reduce pain and improve its function
• Surgery, in some cases required to repair or replace damaged organs.

Patients’ communication with the medical team is invaluable, making them active participants in their treatment and follow-up, ultimately contributing to achieving effective control of the disease and a better quality of life.

Dr. Oscar Chigne
Rheumatologist at Clínica Ricardo Palma