Lupus, better known as Systemic Lupus Erythematosus (hereafter SLE), is an autoimmune disease, i.e. it is characterized among other things by the presence of auto-antibodies (antibodies directed against proteins of our own organism). It affects all races, although the black race suffers most severely from SLE.
The disease has a clear predilection for the female sex, with 9 females for every male. The age of onset is also characteristic since, although it can begin at any age, it usually starts at the end of the first decade or in the second or third decade (18 to 35 years).
Causes of Lupus
Like all autoimmune diseases, there is no single factor that causes Lupus. Genetic, infectious, hormonal, and probably exogenous (environmental) factors are involved in the origin of SLE. The disease develops when several of these coincide in the predisposed person.
Symptoms of Lupus
SLE can affect multiple organs or systems, so the symptoms will depend on which organ is affected. For example:
- The skin, following sun exposure is one of the systems that is frequently affected. The patient usually consults after the appearance of a skin rash on the face, arms, trunk or thighs. However, skin lesions do not always appear after exposure to the sun.
- The locomotor system is also very often affected. The patient may have an arthritis very similar to rheumatoid arthritis.
- There may be general symptoms in flare-ups, the most significant of which are high fever, fatigue and muscle aches.
- The kidney (both kidneys) is one of the organs that can be affected and requires aggressive treatment to avoid renal failure. Many times the patient does not have renal involvement or it is so small that it does not require significant treatment, except for close follow-up.
- Neurological involvement is another of the serious affectations of SLE. It can have a wide variety of manifestations, from psychiatric disorders to diseases that cause neurological deficits.
- Another frequent manifestation is usually the presence of repeated miscarriages. In these cases it is usually associated with the presence in the blood of antibodies called anti-phospholipids.
Diagnosis of Lupus
The diagnosis of lupus is based on the clinical picture and the presence in the blood of a series of fairly characteristic antibodies: ANA (in Spain they are usually called AAN: antinuclear antibodies), which can be present in many other processes: native anti-DNA (characteristic of SLE); anti-Sm (specific to SLE but which appears in a very low frequency -20 to 30%-); anti-Ro and anti-La, also present in other autoimmune diseases.
Treatment of Lupus
The treatment of Lupus will depend on the clinical situation of the patients and the organs affected. Therefore, by no means can a standard therapeutic pattern be established to combat the disease.
A high percentage of SLE have a very benign course (especially in our environment) and treatment only requires chronic administration of hydroxychloroquine – (Dolquine is the trade name). This very old drug has become an essential product for the control of the disease, when it does not present serious manifestations. If the patient has general symptoms or arthritis, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids at low doses can be associated.
When the disease has serious complications (e.g. kidney), corticosteroids at medium or even high doses and eventually immunosuppressants should be used.
Can Lupus be prevented?
The answer is no doubt: NO. There is currently no medical protocol aimed at preventing the disease.