Systemic Lupus Erythematosus

Introduction

Systemic Lupus Erythematosus (SLE) is an autoimmune disease. The exact cause is still unknown, and the severity can vary person-to-person. Because the cause is still unknown, treatment is still difficult. Research is ongoing to develop better treatment options.

What is SLE?

SLE is an autoimmune disease that affects multiple organ systems. While the exact cause is still unknown, scientists believe it is related to genetic, hormonal, and environmental factors. In particular, the genes HLA-DR2 and HLA-DR3 are commonly present in people with SLE. Certain proteins, like C1q, C2, and C4 are also deficient in 10% of people with SLE. Scientists have found that certain hormones increase the likelihood of developing SLE. People with more estrogen due to oral contraceptive use, postmenopausal hormonal replacement therapy, and endometriosis have an increased risk of SLE. Lastly, environmental factors may play a role in developing this condition. UV light, bacterial and viral infections, and certain medications are associated with an increased risk of SLE. Certain populations are affected more by this condition than others. In particular, SLE is ten times more likely to affect women than men, occurs most often from ages 20-40 years of age, and is highest in African-American, Hispanic, and Asian women.

What are the symptoms?

As stated above, SLE affects many organ systems. It affects the skin, joints, muscles, kidneys, heart, lungs, gastrointestinal tract, and other various systems. The most common systems affected are the skin and joints. One of the most recognizable symptoms is called the malar rash, also known as the butterfly rash. It is a rash in the shape of a butterfly spanning over the bridge of the nose with the wings ending underneath the eyes. People may also become more sensitive to UV light. They may also develop mouth ulcers, hair loss, and changes to the vessels under their tongue. More than 90% of people with SLE experience joint inflammation and pain. Additionally, fever is associated with more than 50% of cases, fatigue with more than 80%, and generalized weight loss.

There are certain organs that are affected by SLE that do not happen to everyone but are devastating when they do. One of the major systems affected is the kidneys. Lupus nephritis is inflammation to the kidneys. Scientists believe that immune complexes form and attack the vessels in the kidney, causing damage. Some people with lupus nephritis need kidney transplants.

Another important organ affected by SLE is the heart. Libman-Sacks Endocarditis is a very serious condition in which immune complexes attach to the valves of the heart. This causes the valve to malfunction and blood cannot be properly pumped through the heart.

How is it diagnosed?

There are many ways to diagnose lupus using both symptoms and lab values. Certain immune screening tests indicate SLE. These include a positive ANA, anti-dsDNA antibody, and anti-Sm antibody testing. However, a negative or positive does not necessarily rule out or rule in SLE respectively.

To be diagnosed with SLE, there are certain criteria that must be met. Specifically, four of eleven criteria must be met. These criteria fall into dermatologic, internal organs, and laboratory test categories. To be diagnosed with SLE, four of the following eleven signs or symptoms must be present.

Dermatological
1) Malar rash
2) Discoid rash
3) Photosensitivity
4) Oral or nasopharyngeal ulcers

Internal Organs
1) Nonerosive arthritis
2) Serositis
3) Renal disorder
4) Neurologic disorder

Laboratory tests
1) Hematologic disorders
2) Immunological findings
3) Antinuclear antibodies

What is the treatment?

The treatment for SLE depends on the symptoms. First, all SLE patients should avoid exposure to sunlight, quit tobacco use, and should be fully immunized and vaccinated before beginning treatments. The treatment for SLE is generally immunosuppression. Because SLE is caused by the immune system forming complexes that damage the body, current treatments act by weakening the immune system. These could include immunosuppressive pills, steroids, or more significant immunosuppressive agents.

How do I learn more?

Stem cell therapy has been found to be beneficial to patients suffering from SLE. At the Stem Cell Transplant Institute, we believe in delivering care according to the latest scientific research findings. If you would like to learn more about how stem cell therapy can help you reach your goals, contact us today.

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