What is SLE?
Systemic Lupus Erythematosus (SLE); also known by names such as Lupus; Disseminated Lupus Erythematosus; and Discoid Lupus is an autoimmune disease.
It is a chronic inflammatory condition where the body’s immune system attacks its healthy tissue and organs. Inflammation caused by lupus can affect different body systems- including joints, skin, kidneys, blood cells, brain, heart and lungs.
Systemic Lupus Erythematosus (SLE) can be difficult to diagnose because its signs and symptoms due to its complex picture and involvement of various organ systems. The diagnostic and distinctive characteristic of lupus is a facial rash that resembles the wings of a butterfly unfolding across both cheeks, which occurs in many but not all cases of lupus.
Who is more prone to SLE?
Most common in women between ages of 15 to 40 years.
Lupus is more prevalent in Africans and Hispanics.
What is the classification of SLE?
The various classifications of SLE are as follows :
- Systemic lupus erythematous: It is also known as SLE. It can be any organ or system of the body. In most people only skin and joints are affected but occasionally in some cases there was involvement kidney, lungs, heart, blood vessels and brain.
- Discoid lupus: It is known as chronic cutaneous lupus erythematosus, it is generally milder than SLE. It usually appears as a red scaly rash on sun-exposed areas such as the face, scalp, arms, legs or trunk. People who encounter discoid lupus have symptoms only on their skin. Only a few cases of discoid lupus develop SLE.
- Subacute cutaneous lupus: It is a milder form of lupus with symptoms of skin rash, sun sensitivity and joint pain.
- Drug-induced lupus: It is usually a transient form that develops as a reaction to certain medications and clears up when the medication is ceased.
What are the causes of SLE?
The exact causes of SLE are still unknown, but several factors have been associated with the disease. These are :
- Hormonal factor (women of childbearing age have peak incidence as hormonal changes are higher).
- Any genetic abnormality.
- Environmental factors like sun or virus.
- Immune complex formation.
- Abnormal apoptosis.
- Drug-induced lupus syndrome.
What are the signs and symptoms of SLE?
SLE can be manifested as various signs and symptoms as it affects multiple organ systems such as the heart, joints, skin, kidneys etc.
These symptoms vary from patient to patient, some of the symptoms may also stay for a longer duration.
These symptoms are
- Pain in joints
- Butterfly rash is seen over the cheeks and bridge over the nose and gets worse in the sunlight.
- Fever with no other apparent cause
- Mouth sores
- Blood clotting problems
- Chest pain when taking deep breaths
- Swollen lymph nodes
- Hair loss
- Constant fatiqueness
Systems affected:
Heart and lungs: Inflammation of the outer lining of the lungs may cause chest pain and shortness of breath. Inflammation of the outer lining of the heart causes chest pain and leads to other problems like heart rhythm disturbance, damage to the heart muscles and heart failure. There may also be inflammation of the arteries that supply blood to the heart, affecting the amount of blood reaching the heart and causing chest pain i.e. angina or shortness of breath.
Kidney: People with SLE can experience inflammation that can damage the delicate filtering structures within the kidney, which reduces the ability to filter blood and an alteration in kidney functioning and may also result in kidney failure.
Gastrointestinal tract: People with SLE may experience nausea, vomiting, diarrhoea or abdominal pain due to inflammation of the structure and organs within the abdomen.
Nervous system: SLE can affect the brain or central nervous system in some people causing headaches, seizures, vision problems and dizziness. Personality changes and depression can also occur.
Blood and blood vessels: There may be anaemia or leucopenia presenting symptoms of fatigue and ill health. Inflammation of the blood vessels may also occur which can result in a high risk of blood clotting.
Musculoskeletal system: Arthritic pains, stiffness and swelling of the joints especially of small joints of the hand and feet. Muscle pains are common and there may be distortion of hands due to inflammation in the tendons. There may also be osteoporosis.
What are the investigations advised for SLE?
There are various diagnostic assessment which can help in making the diagnosis of SLE.
Results of the ANA panel are used to help make a diagnosis. The tests alone however do not make a diagnosis but must be used along with your medical history, physical examination and other tests.
Nearly all people with Lupus have a positive test for Antinuclear Antibody (ANA). A positive ANA test can also be a sign of other autoimmune diseases.
Correct diagnosis can be made after thorough analysis which include various test such as
- Complete case history.
- Complete blood count.
- Renal/liver function test.
- Erythrocyte sedimentation rate (ESR).
- Antinuclear antibody test (ANA).
- Anti-dsDNA.
- Skin or kidney biopsy.
- Syphilis test.
- Uranalysis.
- Chest x-ray.
- Echocardiogram.
- Other antibody tests.
What is non-medicinal management of SLE?
The overall treatment protocol depends on various factors such as severity of the disease, duration of the disease
• Physiotherapy as an alternate treatment.
• Psychiatric counseling.
What is the prognosis of SLE?
The prognosis for lupus is mixed and varies with the severity of the disease. The prognosis of mild to moderate lupus is good if detected an early age.
What is the complication of SLE?
As SLE affects various organs of the system, There are many complications related to different systems in the body. These can be :
• Deep vein thrombosis
• Pulmonary embolism
• Hemolytic or anaemia of chronic disease.
• Pericarditis, Endocarditis, Myocarditis
• Pleural effusions
• Miscarriage
• Stroke
• Thrombocytopenia
• Inflamed blood vessels.
What is the differential diagnosis of SLE?
• Scleroderma
• Rheumatoid arthritis
• Sjogren syndrome
• Mixed connective tissue disorder
• Rosacea
• Seborrheic dermatitis
• Lichen planus
• Dermatomyositis
• Lyme disease
How we can manage SLE through diet and management?
There are many steps which can help in symptomatic management and relief of the disease. These measures are :
- Take proper rest.
- Practice yoga and stress-managing techniques.
- Education about lupus and self-care.
- Regular dental care.
- Regular eye examination.
- Avoid going in the sun.
- Regular moderate exercise.
- Keep away from people who have known infection.
- Quit smoking.
- Avoid alcohol.
- Maintain a healthy diet.
- Eat much of antioxidant-rich foods.
- Vitamin D supplements help a lot.
- Avoid coffee or caffeine-containing ingredients.
- Join a support group.
- Counselling by psychiatrist for depression, or if overstressed.
- Take proper medicine and maintain a proper chart of medication.
- Preventive heart care.
- Regular immunization.
- Screening for bone thinning.
What are the commonly indicated Homeopathic medication of SLE?
- Arsenicum Album: When there is an interstitial disease of the lungs or any other involvement of the lungs. Expectoration is white, frothy, and scanty. Anxiety and restlessness are common accompanying symptoms.
- Apis Mellifica: This remedy is indicated when there is the involvement of the kidneys, It causes inflammation of the kidneys and the urine is scanty. Burning and stinging pain while urinating is often present. Oedema of various body parts is also seen.
- Hydrocotyle asiatica: This medicine is indicated when there is dryness of the skin and even the eruptions on the skin are dry. Exfoliation of the skin is common.
- Sepia: here are hot flashes with weakness and increased sweating. The patient may tend to faint easily. Commonly indicated around the time of menopause
- Belladonna : When intense fever is present,The skin is red, hot, and flushed. There is throbbing pain in the carotid arteries.
