Systemic Lupus
Erythematosus
(SLE or Lupus)
Medical Author: William C. Shiel Jr., MD, FACP, FACR
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A Lupus Widower Laments to Friends
By Mr. D.R.
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
So many people have had comments like, "I had no idea Susan was so sick."
That was because Susan did not want anybody to know.
Because lupus is such a crafty disease and flies under the general public's
radar, this is a good opportunity to clear things up.
Lupus is an autoimmune disease, not an infectious disease like HIV. People
with lupus have an overactive immune system. The body's defenses actually attack
healthy tissue. This has been happening to Susan for 30 years or more.
She was diagnosed around 1990, but she had symptoms way before then.
Originally, the disease would manifest itself as flu-like symptoms for about
three weeks out of every three months, with fatigue extending a month after
every flare-up.
In 2000, lupus attacked her central nervous system and involved her brain.
The original result of this new development was pain. From late in January 2000
until the day before she died, she was in pain. On the scale of 1 to 10, there
was no day that she didn't feel pain on an 8 to 10 level. (With 10 being
all-encompassing.)
Lupus attacked her lungs, causing shortness of breath, sleeping problems, and
more pain in the form of pleurisy. In addition to Hashimoto's thyroiditis
(causing cold extremities) and Sjogren's syndrome (extremely dry eyes) and a few
more isms that I have forgotten, life was getting difficult.
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What is lupus? What are the types of lupus?
Lupus
is a condition characterized by chronic inflammation of body tissues caused by autoimmune
disease. Autoimmune diseases are illnesses that occur when the body's
tissues are attacked by its own immune system.
The immune system is a complex system within the
body that is designed to fight infectious agents, for example, bacteria, and other
foreign invaders. One of the mechanisms that the immune system uses to fight
infections is the production of antibodies. Patients with lupus produce abnormal antibodies
in their blood that target tissues within their own body
rather than foreign infectious agents. Because the antibodies and accompanying cells of inflammation can involve tissues anywhere in the body, lupus has the potential to affect a variety of areas of the body. Sometimes lupus can cause disease of the skin,
heart, lungs, kidneys, joints, and/or nervous system. When only
the skin is involved, the condition is called discoid lupus. When
internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Both discoid and systemic lupus are more common in women
than men (about eight times more common). The disease can affect
all ages but most commonly begins from age 20 to 45 years. It
is more frequent in African-Americans and people of Chinese and
Japanese descent.
What causes lupus? Is it hereditary?
The precise reason for the abnormal autoimmunity that causes
lupus is not known. Inherited genes, viruses, ultraviolet light, and
drugs may all play some role. Genetic factors increase the tendency
of developing autoimmune diseases, and autoimmune diseases
such as lupus, rheumatoid arthritis, and immune
thyroid disorders are more common among relatives of patients with lupus
than the general population. Some scientists believe that the immune
system in lupus is more easily stimulated by external factors like
viruses or ultraviolet light. Sometimes, symptoms of lupus can
be precipitated or aggravated by only a brief period of sun
exposure.
It also
is known that some women with SLE can experience
worsening of their symptoms prior to their menstrual periods.
This phenomenon, together with the female predominance of SLE, suggest
that female hormones play an important role in the expression of
SLE. This hormonal relationship is an active area of ongoing
study by scientists.
More recently, research has demonstrated evidence that a key enzyme's failure to dispose of dying cells may contribute the development of SLE. The enzyme, DNase1, normally eliminates what is called "garbage DNA" and other cellular debris by chopping them into tiny fragments for easier disposal. The researchers turned off the DNase1 gene in mice. The mice appeared healthy at birth but after six to eight months, the majority of mice without DNase1 showed signs of SLE. Thus, a genetic mutation in a gene that could disrupt the body's cellular waste disposal may be involved in the initiation of SLE.
What is drug-induced lupus?
Dozens of medications have been reported to trigger
SLE; however, more than 90% of this "drug-induced lupus" occurs as a side
effect of one of the following six drugs: hydralazine (used
for high blood pressure), quinidine and procainamide (used for
abnormal heart
rhythm), phenytoin (used for
epilepsy),
isoniazid [(Nydrazid,
Laniazid), used for tuberculosis], d-penicillamine (used
for rheumatoid arthritis). These drugs are known to stimulate the immune
system and cause SLE. Fortunately, drug-induced SLE is infrequent (accounting
for
less than 5% of SLE among all patients with SLE) and usually resolves
when the
medications are discontinued.
Next: What are the symptoms and signs of lupus? »
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From the Doctors at MedicineNet.com  |
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- Complete Blood Count - A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures the concentration of white blood cells, red blood cells, and platelets in the blood. Source:MedicineNet
- MRI (Magnetic Resonance Imaging Scan) - Medical information on magnetic resonance imaging (MRI) used in detecting structural abnormalities of the body. Learn uses, risks, and how to prepare for an MRI scan Source:MedicineNet
- Antinuclear Antibody Test - Read about antinuclear antibodies (ANAs), unusual antibodies that can bind to certain structures within the nucleus of the cells, are found in patients whose immune system may be predisposed to cause inflammation against their own body tissues. ANAs are indicative of the potential presence of an autoimmune illness. Source:MedicineNet
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