Systemic Lupus Erythematosus
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Definition/Description
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Lupus erythematosus is an autoimmune disease that can manifest itself in several different ways; two of these include discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE).[1] Systemic lupus erythematosus is a chronic, rheumatic, inflammatory disease that can affect a person’s skin, joints, kidneys, lungs, heart, nervous system, blood, and mucous membranes. It does not affect all patients in the same way; patients all experience variable organ involvement.[1] [2]
Prevalence[edit | edit source]
SLE is a disease that occurs in 15-24/100,000 people throughout the world.[3]It is most likely to occur in women of child-bearing age and is more common in those of African American, Hispanic, Asian, and Native American decent than it is in Caucasians. Men and children are sometimes diagnosed with SLE, but the disease is rarely diagnosed in the elderly.[1][3] Although most people are diagnosed with the disease between the ages of 15 and 40, about 15% of people diagnosed with SLE are younger than 18 years old, and when a person is diagnosed at an early age, the disease progresses more quickly and severely than if diagnosed after the age of 18.[2][4]The disease is more prevalent in those who have a family history of SLE than it is in the general population.[1]
Characteristics/Clinical Presentation[edit | edit source]
SLE can affect many organs of the body, but it rarely affects them all. The following list includes common signs and symptoms of SLE in order of the most to least prevalent. All of the below symptoms might not be present at the initial diagnosis of SLE, but as the disease progresses more of a person’s organ systems become involved.
• “Constitutional symptoms (fever, malaise, fatigue, weight loss): most commonly fatigue and a low-grade fever
• Achy joints (arthralgia)
• Arthritis (inflamed joints)
• Arthralgia
• Skin rashes
• Pulmonary involvement (symptoms include: chest pain, difficulty breathing, cough)
• Anemia
• Kidney involvement (lupus nephritis)
• Sensitivity to the sun or light (photosensitivity)
• Hair loss
• Raynaud’s phenomenon
• CNS involvement (seizures, headaches, peripheral neuropathy, cranial neuropathy, cerebral vascular accidents, organic brain syndrome, psychosis)
• Mouth, nose, or vaginal ulcers”[2]
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
• Analgesics: These medications are used to control the pain that a patient has to endure from the pain of arthralgia, arthritis, and ulcers that can be caused by SLE.[3]
• Non-Steroidal Anti-inflammatory Drugs (NSAIDS): These medications help to decrease tissue inflammation, and therefore causing a decrease in the patient’s pain in their joints and muscles.
• Anti-malarials: These medications are used to treat the arthritic, musculocutaneous, and renal symptoms associated with SLE.
o Chloroquine (Aralen)[1][3]
o Hydroxychloroquine (Plaquenil)[3]
• Corticosteroids: These drugs are prescribed to patients with severe SLE whose signs and symptoms are not improving with any other drug therapy. Corticosteroids can give the patient relief from constitutional symptoms, arthritis, and cutaneous problems associated with SLE.
• Immunosuppressant Agents: These drugs are used in the treatment of lupus nephritis by decreasing inflammation, and therefore, decreasing the ability of the immune system to fight infections.
o Azathioprine (Imuran)
o Cyclophosphamide (Cytoxan)[1][3]
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
1. Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd edition. St. Louis, Missouri: Saunders Elsevier, 2009.
2. Goodman CC and Synder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th edition. St. Louis, Missouri: Saunders Elsevier, 2007.
3. Laranzo D. Elderly-onset systemic lupus erythematosus: prevalence, clinical course, and treatment. Drugs and Aging. 2007; 24 (9): 701-715.
4. Tucker LB. Making the diagnosis of systemic lupus erythematosus in children and adolescents. Lupus. 2007; 16: 546-549.
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd edition. St. Louis, Missouri: Saunders Elsevier, 2009.
- ↑ 2.0 2.1 2.2 Goodman CC and Synder TK. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th edition. St. Louis, Missouri: Saunders Elsevier, 2007.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Laranzo D. Elderly-onset systemic lupus erythematosus: prevalence, clinical course, and treatment. Drugs and Aging. 2007; 24 (9): 701-715.
- ↑ Tucker LB. Making the diagnosis of systemic lupus erythematosus in children and adolescents. Lupus. 2007; 16: 546-549.
