What is Lupus Erythematosus?
Systemic lupus erythematosus is a chronic autoimmune disease that can damage any part of the body (especially skin, joints and organs in the body). Chronic term means that the signs and symptoms of lupus tend to last more than six weeks and often for many years.
In lupus, something goes wrong with the immune system, which is a part of the body that fights off viruses, bacteria and germs (“foreign invaders” like the flu). Normally our immune system to produce proteins called antibodies, which protect the body against these invaders. Autoimmune disease, the immune system can not tell the difference between these foreign invaders and the body healthy tissues (“auto”, which means “self”) and creates auto-antibodies that attack and destroy healthy tissue. These auto-antibodies cause inflammation, pain, and damage to various body parts i_e skin, joints and organs of the body.
Lupus (systemic lupus erythematosus) is a widespread and chronic autoimmune disease that, for unknown reasons, the immune system causes damage the body’s tissues and organs. Currently there is no cure for lupus erythomatosus.
Types of Lupus Erythematosus.
There are four types.
Discoid lupus erythematosus:
This type affects the skin and is also known as cutaneous lupus.
Drug-induced lupus erythematosus:
the drug-induced lupus erythematosus can occur as a side effect of certain medications, such as beta-blockers, which are commonly used to treat heart disease and hypertension.
Neonatal lupus erythematosus :
It’s a rare form of lupus in newborns whose mothers have lupus, and can cause problems at birth or in rare cases, severe heart defect.
Systemic lupus erythematosus:
systemic lupus causes inflammation in various organs and many body systems.
What Causes Lupus Erythmatosus?
First, it is important to know that lupus is not contagious.Secondly, it is a fact that even medical professionals and researchers can not say with certainty what causes lupus. Most of those in the medical and research professionals will agree that a number of factors probability of an individual to determine lupus.
Following are some causes of lupus erythmatosus.
Genetics: While a family history of lupus does not mean that an individual will get lupus, it may be likely to fix a person to the disease.
Environment: Research is being done in relation to environmental factors that may play a role in being a trigger for lupus erythematosus. Exposure to UV light (term called photosensitivity), smoking, stress or toxins or not contributed.
Medications: Some medications are suspected triggers of lupus erythematosus and lupus can cause flares. Drug-induced lupus is based on this theory. Often, once a patient with drug-induced lupus stop the drugs suspected of inducing lupus, symptoms may decline rapidly.
Hormones and Disease: Due to the fact that women in their childbearing years are the most common demographic suffering from lupus, the research suggests that higher levels of hormones such as estrogen and progesterone, are associated with autoimmune diseases such as lupus. People affected with viruses and bacteria, such as parvovirus, hepatitis C, Epstein-Barr virus (EBV) may develop lupus, but a direct causal link has not been established.
A combination of factors: A number of medical applications and research believe that a combination of all the above factors are likely more susceptible to lupus than someone with perhaps only one of the factors.
So, Lupus is caused by a complex interplay of genetic, hormonal and environmental factors. When patients present for the first signs of lupus, they often ask if they are a family î_é a mother, aunt, sister, or other relative with lupus or other autoimmune disease. Researchers were first attention to the link between genes and lupus because of the clustering of lupus in families and the increased prevalence of the disease among certain ethnic groups. For example, the risk of developing lupus siblings of individuals with the disease, about 20 times higher than that of the general population. Moreover, even healthy relatives of people with lupus are more likely to various lupus-related medical tests, including ANA and the false-positive test to test positive for syphilis. However, the presence of genes that predispose a person lupus not necessarily mean that the individual will develop the disease.
Signs And Symptoms of Lupus Erythmatosus.
Lupus erythematosusis one of several diseases known as “the great imitators” because it often mimics or is confused with other diseases. Systemic lupus erythematosus is a classic element in the differential diagnosis because the symptoms of lupus vary widely and come and go unpredictably. Diagnosis can be difficult, with some people suffering unexplained symptoms untreated erythematosus for year lupus.
Common initial and chronic complaints include fever, malaise, joint pain, muscle pain and fatigue. Because these symptoms are so often seen in association with other diseases, these signs and symptoms are not part of the diagnostic criteria for lupus.
While systemic lupus erythematosus may occur in both males and females, the symptoms associated with each gender are different. Females tend to have more advanced, low white blood cell count, the more arthritis, Raynaud’s phenomenon, and psychiatric symptoms. Men tend to have more seizures, kidney disease, Serositis (inflammation of the tissues lining the lungs and heart, skin problems, and peripheral neuropathy.
Photomicrograph showing vacuolar interface dermatitis, as can be seen in systemic lupus erythematosus.
Up to 70% of people with lupus have certain dermatological symptoms. The three main categories of chronic skin lesions are erythematosus, subcutaneous lupus, skin and severe lupus. People with discoid lupus may have thick, red scaly patches on the skin. Similarly, subcutaneous lupus manifest by scaly red patches on the skin, but with distinct edges. Acute cutaneous lupus is characterized by a rash. Some suffer from the classic malar rash (or butterfly rash) associated with the disease. Hair loss, mouth, nose, urinary tract and vaginal ulcers and lesions on the skin are other possible events. In the delicate tissue around the eyes tiny tears can occur even after minimal friction.
Muscles and bones
The most commonly sought medical attention is for joint pain, small joints of the hand and wrist usually affected, although all joints are at risk. The Lupus Foundation of America estimates that more than 90 percent of those affected suffer from joint pain and muscle at some point during their illness. Unlike rheumatoid arthritis, lupus arthritis is less disabling and usually do not cause severe joint destruction. Less than ten percent of people with lupus arthritis will develop deformities of the hands and feet. Lupus patients are particularly at risk of developing musculoskeletal tuberculosis.
Anemia is common in children with systemic lupus erythematosus and develops in about 50% of cases. Low platelets and white blood cells may be due to the disease or a side effect of pharmacological treatment. People with Lupus may have a connection with the antiphospholipid antibody syndrome (a thrombotic disorder), in which the phospholipid autoantibodies are present in their serum. Abnormalities associated with antiphospholipid syndrome include an extension of the partial thromboplastin time paradoxical (which usually occurs in hemorrhagic disorders) and a positive test for antiphospholipid antibodies; the combination of these findings have earned the term “lupus anticoagulant positive.” Another autoantibodies found in lupus erythematosus is the anticardiolipin antibodies, which can cause a false positive test for syphilis.
A person suffering from systemic lupus erythematosus may have inflammation of various parts of the heart, such as inflammation of the fibrous sac surrounding the heart, the heart muscle, and the inner wall of the heart. Endocarditis of Lupus is noninfectious characteristic (Libman-Sacks endocarditis), and involves either the mitral valve or the tricuspid valve. Atherosclerosis also tends to occur more often and advance more rapidly than in the general population.
Lung and pleura inflammation can cause pleuritis, pleural effusion, lupus pneumonitis, chronic diffuse interstitial lung disease, pulmonary hypertension, pulmonary emboli, pulmonary hemorrhage, and shrinking lung syndrome.
Neural symptoms contribute to a significant percentage of morbidity and mortality in lupus patients. Consequently, lupus neural side is under study in the hope of reducing morbidity and mortality. Neurological manifestation of neuropsychiatric lupus is known as systemic lupus erythematosus (NPSLE). One aspect of this disease is of serious damage to the epithelial cells of the blood-brain barrier.
Lupus has a wide range of symptoms which extend over the body. Neurological symptoms include headaches, depression, seizures, cognitive dysfunction, mood disorder, cerebrovascular disease, polyneuropathy, anxiety disorder, psychosis and, in extreme cases, personality disorders. In some areas, depression affects up to have 60% of women with lupus.
Painless passing blood or protein in the urine can often be a sign that the presentation of renal impairment. Acute or chronic renal failure may develop with lupus nephritis, leading to acute kidney failure or end-stage. Due to the early recognition and management of lupus, end stage renal failure occurs in less than 5%  cases.
Of lupus is a histologic characteristic membranous glomerulonephritis abnormalities “of the wire loop.” This result is due to immune complex deposition along the glomerular basement membrane, leading to a typical granular appearance in immunofluorescence tests.
Neuropsychiatric syndromes may occur when lupus erythematosus affects the central or peripheral nervous system. The American College of Rheumatology defines 19 neuropsychiatric syndromes in systemic lupus erythematosus.  The diagnosis of neuropsychiatric syndromes concurrent with SLE is one of the most difficult challenges in medicine, because it can be so many different models of symptoms, some of which may be mistaken for signs of infectious disease or stroke.
The most common neuropsychiatric disorder people with lupus have is headache, although the existence of a sore lupus specific head and the optimal approach to headache in cases of lupus remains controversial. Another common neuropsychiatric manifestation of lupus include cognitive dysfunction, mood disorder, cerebrovascular disease, seizures, neuropathy, anxiety disorder, and psychosis. It may rarely present with the syndrome of intracranial hypertension, characterized by high intracranial pressure, papilledema, and headache with occasional paresis of the abducens nerve, the absence of a lesion occupying the space or the ventricular enlargement and chemical normal cerebrospinal fluid and haematological constituents.
Rare events are acute confusional state, Guillain-Barre syndrome, aseptic meningitis, autonomic disorders, demyelinating syndrome, mononeuropathy (which could manifest as mononeuritis), movement disorder (specifically, chorea), myasthenia serious myelopathy, cranial neuropathy and plexopathy.
Additional information: Systemic lupus erythematosus and pregnancy
lupus erythematosus causes an increase in fetal death rate in utero and spontaneous abortion (miscarriage). The overall rate of live births in lupus patients has been estimated at 72%. Pregnancy outcome seems to be worse in patients with lupus erythematosus whose disease flares during pregnancy.
Neonatal lupus is the appearance of symptoms of systemic lupus erythematosus in an infant born to a mother with lupus, usually with a rash resembling discoid lupus erythematosus, and sometimes systemic abnormalities such as heart block or the ‘enlarged liver and spleen. Neonatal lupus is usually mild and self-limited.
Fatigue in lupus erythomatosus is probably multifactorial and has been linked to not only the activity of the disease or complications such as anemia or hypothyroidism but also to pain, depression, poor sleep quality, poor physical condition and lack of social support.