Lupus erythematosus in adults
This is lupus. Fans of the series House M.D. have heard this diagnosis in almost every episode. And no wonder, because the symptoms of lupus are characteristic of many diseases. How to recognize and treat lupus erythematosus in adults, learn from experts

What is lupus erythematosus

– Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Autoimmune means that the body begins to produce antibodies in response to this disease and, in doing so, begins to affect other organs and tissues. Most often – the skin, kidneys, lungs, heart, blood vessels. The body begins to work against itself, to destroy itself, – explains general practitioner, cardiologist, head of the Department of Cardiology, GKB named after A.I. V.V. Vinogradova Denis Medvedev.

According to him, lupus erythematosus affects mainly young women from 20 to 40 years old. In this category of patients, the disease occurs 80% more often than, for example, in men.

– The disease is quite rare, according to world statistics, it affects about 50 people per 100 people. For seven years of work in our hospital, I have come across five such patients, – explains the doctor.

Causes of lupus erythematosus in adults

Why this disease occurs, science has not figured out exactly until now.

“Most often it is believed that lupus erythematosus in adults is caused by genetic causes, but it can be a hormonal failure or a past infection,” explains cardiologist Denis Medvedev. – The most common predisposing environmental factor, which is noted by medical statistics, is excessive solar ultraviolet radiation.

According to the expert, the risk of developing the disease is directly related to how protected you are from the sun. If you do not use sunscreen while relaxing in hot countries, then the likelihood of experiencing SLE increases significantly.

Often a provoking factor for the development of lupus is pregnancy or abortion.

Symptoms of lupus erythematosus in adults

Recognizing lupus erythematosus in adults is not easy, as its symptoms are characteristic of various diseases.

– In 60-70% of cases, there is a “classic” rash on the cheeks in the shape of a butterfly, which resembles wolf bites in outline, hence, by the way, the name “lupus erythematosus” appeared. Also, on the arms and torso, many patients have thick red scaly spots, which can subsequently lead to atrophy of the skin of the face, limbs and torso, – explains cardiologist Denis Medvedev.

Another particular and typical symptom of lupus erythematosus is joint pain.

– Unlike arthritis, when one joint is affected, which, for example, has a large load, an autoimmune disease such as lupus is characterized by symmetrical damage to the joints, more often the knees. But it can be any other, – says the specialist.

The onset of the disease is often accompanied by high fever, the fever can be up to 40 ° C, so lupus erythematosus in adults can initially be mistaken for SARS.

Lupus is characterized by common symptoms of inflammation: headaches, malaise, inflammation of the lymph nodes. One of the classic symptoms of lupus is kidney damage. They lose their filtering function, and this leads to the appearance of edema.
Denis MedvedevCardiologist

Thus, the main symptoms of lupus erythematosus in adults are:

  • butterfly-shaped rash on the cheeks;
  • joint pain, usually symmetrical;
  • fever, headache, malaise;
  • edema due to kidney damage.

Treatment of lupus erythematosus in adults

Until now, science has not come up with a remedy that would give a complete recovery from systemic lupus erythematosus. The task of doctors is to quickly remove an acute condition, achieve remission and continue to maintain a certain stable state of the body, in which a person can live to a ripe old age, the specialist clarifies.

Treatment of lupus erythematosus in adults involves, firstly, minimizing exposure to provoking factors, such as sunlight. If pregnancy was such a factor, as a last resort, the doctor may recommend interrupting it, but before that, experts will weigh all the risks. Secondly, patients with lupus erythematosus receive mandatory drug treatment.

Diagnostics

Suspecting and confirming lupus erythematosus in adults can be difficult. Half of the success depends on how complete the history can be collected by the doctor, whether he will talk to the patient about all the factors that can provoke SLE.

If such factors took place, then special tests will help confirm the doctor’s fears, they allow you to diagnose lupus with a probability of up to 90%.

Two tests can help diagnose lupus. The first is a blood test for ANA – antinuclear antibodies. The second is a blood test for anti-ENA – anti-extractable nuclear antigen.
Denis MedvedevCardiologist

Modern treatments

Four groups of drugs are mainly used to treat systemic lupus erythematosus in adults:

  • hormones;
  • cytostatics – in severe forms of the disease;
  • non-steroidal anti-inflammatory drugs;
  • Hydroxychloroquine – for mild to moderate disease.

“The latest antimalarial drug is now quite well known due to its successful use in the case of a coronavirus infection,” says physician, cardiologist Denis Medvedev.

Prevention of lupus erythematosus in adults at home

Since there is no single answer to the question of what causes SLE, there is no universal recipe for the prevention of this disease.

– The main prevention is regular medical examination and attentive attitude to one’s health. In this case, the disease can be diagnosed in the early stages and prevent the hurricane development of complications, the doctor explains.

Disease history

Olga Papko, 21 years old, diagnosed with systemic lupus erythematosus.

– I encountered the first manifestations of lupus in December 2019. It all started with a nagging pain in the knee. The sensations are comparable to stretching a muscle while running. Later, I noticed that my fingers began to swell a lot, I stopped wearing rings because they were too small for me, – the girl recalls.

Soon Olga’s condition deteriorated sharply:

– The joints in the hands ached, it was problematic to bend the fingers. For the first hour or two after waking up, I couldn’t hold objects in my hands, I couldn’t unplug my phone’s charging plug, I couldn’t zip up my jeans, I couldn’t squeeze toothpaste out of a tube. The pain was accompanied by severe fatigue, apathy, and occasional fever up to 37,2°C.

It took two months and about two dozen tests to establish an accurate diagnosis.

“When I was diagnosed, I was happy. I understood that now the doctors knew how to treat me and relieve the pain that had tormented me for weeks. Now I am receiving genetic engineering therapy free of charge in one of the medical centers dealing with the treatment of rheumatic diseases. Treatment is with monthly injections of a drug that blocks the production of lupus antibodies. In addition, glucocorticosteroids are used for treatment, which suppress the immune system and prevent the disease from progressing, says Olga.

To all those who care about their health, the girl advises to be checked regularly by doctors.

– The main danger of this disease is its systemic nature. This means that any organ can be affected, so it is very important to control metabolic processes and donate blood. Listen to your body and, even if nothing bothers you, get tested regularly, the girl urges.

Popular questions and answers

Who is at risk for developing lupus erythematosus?

In addition to those who like to spend a lot of time in the sun without adequate protection, as well as pregnant women and those who have terminated pregnancies, people whose close relatives suffer from systemic lupus erythematosus are at risk. They should think about the prevention of the disease in advance, especially if they have persistent leukopenia (lack of leukocytes), an increased erythrocyte sedimentation rate, etc.

Why is lupus erythematosus dangerous?

Systemic lupus erythematosus is dangerous because it can lead to the development of heart, kidney, liver failure. All this can happen very quickly, even lightning fast. And here it is very important to correctly diagnose and start the right treatment as soon as possible in order to avoid the development of complications.

What are the complications of lupus erythematosus?

With lupus erythematosus, as a rule, the cardiovascular system is affected, pericarditis, myocarditis, and endocarditis develop. The digestive organs suffer, nephrotic syndrome develops with renal failure and arterial hypertension. The nervous system may be affected.

When to call a doctor for lupus erythematosus?

You should consult a doctor if you notice a rash on the face in the area of ​​the cheekbones and nose in the form of a “butterfly”, if you feel pain in the joints, most often in the joints of the hands, ankle, and knees. If fever and general malaise, as well as swelling, are added to these alarming “calls”, you should immediately consult a doctor. The sooner a correct diagnosis is made, the lower the risk of developing dangerous complications.

Leave a Reply