Lupus: What is it, Causes, Symptoms and Treatment

Systemic lupus erythrematosus (SLE), or simply lupus; It is a condition in which the immune system perceives some substances in the body as foreign and initiates a chronic inflammatory reaction that can affect almost every system throughout the body.

The immune system has important duties and functions in protecting and improving the health of our body. The immune elements in our body are specialized to fight against elements that can negatively affect health, such as microorganisms or tumor cells, and to remove harmful factors from the body. However, as a result of research, it has been revealed that some diseases seen in the clinic develop because the immune system sees its own body cells as a threat and attacks them (autoimmune diseases). One of these diseases is lupus.

What is Lupus?

Systemic lupus erythrematosus (SLE), or simply lupus; It is a condition in which the immune system perceives some substances in the body as foreign and initiates a chronic inflammatory reaction that can affect almost every system throughout the body. Lupus disease, which is considered among rheumatological and autoimmune disorders, can cause clinical symptoms and health problems in almost every body part, such as the hematological system, joints, kidney, heart, lung, nervous system and digestive system. However, the most common form of lupus in the clinic is limited inflammation to a specific body area.

Since lupus disease is a chronic disease that progresses with intermittent exacerbations, it is a health problem that can lead to permanent damage to organs and serious complications if appropriate treatment is not given. In this sense, it is extremely important for patients to have accurate and sufficient information about their illness and to comply with the treatment.

What Causes Lupus?

Although it is not known exactly why the immune system perceives body tissues as a threat, which is the underlying mechanism of lupus; It is known that some factors facilitate the development of lupus. In this regard, the following conditions are considered risk factors for lupus disease:

• Genetics: Studies have shown that lupus symptoms are more likely to occur in people with certain genetic characteristics. In this context, more than 50 risky genes have been identified.
• Environmental factors: It is known that environmental factors such as smoking, stressful lifestyle, exposure to silica and similar toxic substances trigger the development of lupus.
• Hormones: There are studies showing that imbalances in some hormone levels, such as estrogen hormone, may affect the development of lupus.
• Infections: After some viral infections such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV), the development of lupus may occur as a result of the immune system perceiving the body as a threat.
• Drug side effects: Lupus-like symptoms may occur in people due to hydralazine, quinidine or biological agents used in rheumatological disorders.
• Apart from these, the probability of developing lupus is especially high in people between the ages of 15 and 44, women, black people and people with a family history of lupus, compared to the rest of the society.

What are the Symptoms of Lupus?

Since lupus disease can affect almost every tissue in the body, the clinical picture can vary greatly from patient to patient. Again, symptoms may disappear or worsen intermittently due to fluctuations during the course of the disease. In this context, the following symptoms may be observed in the course of lupus:

• High fever
• Weakness – fatigue
• Muscle weakness and widespread muscle aches
• Traveling joint pain, especially in small joints such as finger joints
• Typical butterfly-shaped redness on the face
• Skin redness, rash, or swelling
• Sensitivity to the sun; Exacerbation of skin symptoms, especially with exposure to sunlight
• Hair loss and baldness development
• Variable digestive system problems such as recurrent aphtha or sores in the mouth, nausea, vomiting, diarrhea or constipation
• Bruising or paleness of the fingertips, especially in cases of stress or exposure to cold
• Shortness of breath
• Dryness in the eyes or mouth
• chest pain
• Headache
• Psychological symptoms such as confusion, depression, psychosis
• Loss of memory

In addition, if lupus disease is not controlled with effective treatment in the early stages, it may cause permanent damage to some organs in the long term, resulting in serious complications. These include kidney failure with kidney damage, anemia due to bone marrow damage and immune system failure, lung damage with problems such as permanent shortness of breath and cough.

How to Diagnose Lupus?

Since Lupus disease can affect almost every tissue in the body and has common symptoms with many diseases, a detailed evaluation by a specialist physician is required to diagnose it. In this regard, additional imaging and laboratory tests may be performed if deemed necessary as a result of the disease history taken by the physician and the detailed physical examination. In the light of all these examinations, the disease can be diagnosed based on the data obtained.

Certain laboratory tests are especially important in the diagnosis of lupus. In this context, complete blood count, sedimentation, liver and kidney function tests, urine analysis and antinuclear antibody test (ANA) are among the frequently performed examinations. In addition, imaging tests such as direct chest radiography and echocardiography can be used to determine whether lupus affects the internal organs. Determining the damage caused by lupus, especially in the kidneys, may require a kidney biopsy.

According to research, lupus can be diagnosed in the presence of 4 of the following 11 criteria:

1. Butterfly-shaped rash on the face (malar rash)
2. Disc-shaped rash on the skin or scalp (discoid rash)
3. sun sensitivity
4. Recurrent ulcers in the mouth
5. Recurrent joint inflammations that do not damage the joints
6. Inflammation and fluid accumulation of the outer membranes of the lungs or heart (pleuritis or pericarditis)
7. Signs indicating kidney damage, such as protein loss in urine
8. Signs indicating involvement of the nervous system, such as epileptic seizures or psychological findings
9. Signs that the hematological system is affected, such as anemia or a decrease in white blood cells
10. Presence of certain antibodies indicating lupus according to immunological examinations (such as anti-ds DNA, anti-Sm)
11. ANA positivity

How to Treat Lupus?

In the current clinical approach, there is no definitive treatment for lupus disease. However, the main goal of treatment is to control lupus disease, prevent exacerbation of symptoms and prevent the development of complications. In this sense, treatment should continue throughout life and the patient’s compliance with the treatment can directly affect the success of the treatment.

Since Lupus disease is a chronic and fluctuating health problem, the treatment approach follows a dynamic course. In this regard, the treatment method or frequency may change depending on the physician’s decision, and new medications may need to be added. In addition, intermittent examinations and examinations may be considered to monitor whether complications develop during the disease.

The following treatment methods are frequently used in the treatment of lupus:

• Lifestyle changes: In addition to clinical treatments, it is very important for patients to maintain certain lifestyle changes for the success of the treatment. In this regard, patients are advised to comply with the following issues:

  • Direct contact with sunlight should be avoided; Sun protection creams and sunglasses should be used when going outdoors.

  • Adequate and balanced eating habits should be acquired.

  • The amount of salt taken in the daily diet should be reduced.

  • Certain vitamins and minerals, such as vitamin D, calcium and phosphorus, should be supplemented.

  • Regular exercise should be done.

  • Habits such as smoking should be stopped.

• Medication: The medications used in lupus disease are directly related to the severity of the disease. The main goal of these drugs is to relieve disease symptoms, prevent exacerbations by suppressing the immune system, and prevent the development of complications. Accordingly, patients may be prescribed non-steroidal anti-inflammatory drugs (such as ibuprofen, naproxen), steroids (such as prednisone), anti-malarial drugs (such as hydroxychloroquine), immunosuppressants (such as methotrexate) and biological agents (such as anti-TNF blockers). .