Systemic Lupus Erythematosus (SLE) is a connective tissue disorder that affects several systems of the body, causing inflammation and damage. It is an autoimmune disease which means that the body fights itself. This immune system cells (the soldiers of the body) attack the cells in different parts of the body.
WHO IS AFFECTED?
Systemic Lupus Erythematosus (SLE) is not very common but there has been an increase in the number of people diagnosed with SLE in the past 50 years. It is present in about 300 to 1.5 million people in the United States of America. In Africa, a lot of cases go unreported. It is most common in women with over 90% of the people affected being women between the ages of 14 and 64. It is also more common in blacks. SLE may also be inherited. In the past, SLE was considered a killer disease but survival is much better now due to quicker diagnosis, better management and improved medications.
WHAT HAPPENS IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)?
The body’s defences attack cells in some organs of the body. A single definite cause of SLE is not known at present but it may be linked to genetics, environmental exposure, hormones or some medications.
WHAT ORGANS ARE COMMONLY AFFECTED?
Systemic Lupus Erythematosus (SLE) causes death or disability due to the organs it affects. For example, in the kidneys, it causes inflammation (called nephritis) and subsequent renal failure. This leads to an overall poorer quality of life and disability, which may lead to death. It also affects the organs in the cardiovascular, reproductive, and digestive systems among others.
WHAT SIGNS AND SYMPTOMS ARE SEEN?
SLE affects virtually every part of the body including the skin, muscles, bones and joints, lungs, liver, brain, digestive tract, blood, brain, reproductive tract and heart. Symptoms may be mild or severe enough to cause a threat to life. These symptoms often come up (called flares) at certain times and then disappear (called remission) after a while. There are some features seen in people affected with SLE. These may include:
- A rash across the area of the bridge of the nose and cheeks called a butterfly rash. Other types of rashes may also appear.
- Increased sensitivity to sunlight or light (photosensitivity). They may also be rashes on the exposed areas of the body.
- Joint and muscle pains.
- Hypertension and damage to blood vessels.
- Chest pain due to inflammation of the covering of the heart (pericarditis) and/or lungs (called pleuritis).
- Kidney disease or failure. Affected persons may see some deposits in their urine or pass bloody or coke-coloured urine.
- Seizures or psychosis.
- Blood disease. There may be low red cells in the blood or the formation of clots indiscriminately in certain parts of the body.
- Headaches, inflammation of the covering of the brain (called meningitis), inflammation of the brain itself (called encephalitis), blindness or eye disease, depression and problems with memory.
- Antiphospholipid syndrome: causes recurrent pregnancy losses.
- Others: Fever, difficulty swallowing due to mouth ulcers, hair loss, weight loss, fatigue, swelling of the foot etc.
If SLE is not properly managed, complications may set in. These complications limit your physical, mental, and social functioning. They also cause a reduction in the quality of life.
HOW IS SLE DIAGNOSED?
A diagnosis of SLE is made after a consultation session. The doctor will ask questions about your symptoms, carry out an examination and then order a few tests. These tests will determine the level of some chemicals or substances in the immune system (your level of exposure). SLE may be difficult to diagnose initially because the symptoms are very similar to other disease conditions.
HOW IS SLE TREATED?
A specialist doctor called a rheumatologist treats cases of SLE. They will examine your test results and offer medications as appropriate. There is no cure for SLE but medications and lifestyle changes help control it and manage symptoms. Typically, pain relief medications are given to address joint pain while other complaints, such as skin or kidney complaints are managed with different medications as appropriate. The specific dose and drug types are dependent on the organs affected and the severity of the disease.
Sometimes, a procedure called plasmapheresis may be offered. Here, the clear part of the blood called plasma that suspends the blood cells is removed and “washed”, similar to how dialysis is done. This allows the immune cells responsible for the inflammation to be removed. People diagnosed with SLE have to be monitored at intervals of 6 months or longer to prevent complications from occurring or worsening.