What Is Chronic Lupus Erythematosus?
Chronic lupus erythematosus is an autoimmune disorder where one’s body’s immune system attacks its organs and tissues. It can attack any body part, like joints, kidneys, lungs, brain, blood, and skin. This leads to widespread inflammation causing damage to the body parts.
What Are the Symptoms of Chronic Lupus Erythematosus?
Signs and symptoms of chronic lupus erythematosus often match with the other diseases of the body. Therefore, patients may experience different symptoms; no two patients have similar symptoms. But some of the common symptoms include:
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A butterfly rash is the main characteristic of lupus where patients have a flat red rash on the cheeks and across the bridge of the nose.
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Fatigue, fever, headache.
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Chest pain and shortness of breath.
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Pain, stiffness, and swelling in the joints.
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When exposed to cold or stressful conditions, toes and fingers turn blue or white.
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Skin rashes or lesions newly appear or worsen when exposed to sunlight, including the butterfly rash.
What Are the Causes of Chronic Lupus Erythematosus?
Lupus attacks the own body's immune system and damages tissues and cells, and the cause is a combination of genetics and environmental, other factors, which are:
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Genes: Variations and mutations in genes can develop the risk of lupus erythematosus. Most of the genes that show mutations in their DNA (deoxyribose nucleic acid) work for the body's immune system, and when changes occur in these genes, proper targeting and control of the body's immune system are lost. This causes one’s immune system to act differently against healthy tissues and organs of the body.
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Sunlight: Exposure to sunlight might trigger the condition, and it also might lead to the formation of new skin lesions.
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Certain Medications: Lupus erythematosus gets triggered by using medications for certain conditions like hypertension, seizures, and antibiotics. Patients stop showing symptoms once the drug is stopped.
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Infections: Sex hormones, age, diet, and stress can also act as triggering agents or causing agents of lupus.
How Does the Immune System Attack One’s Own Body Tissues and Organs?
Normally cells undergo apoptosis (cell death) in the process of repair or damage, and these dead cells are not cleared away correctly by the body. These uncleared dead cells release certain chemicals or substances that cause the immune system to react abnormally and attack one’s body tissues, causing chronic lupus erythematosus symptoms.
What Are the Risk Factors of Chronic Lupus Erythematosus?
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Age: Lupus can attack people of all ages, including children. Women, especially those in the reproductive age group (15 to 45), are more likely to get affected by lupus.
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Sex: Lupus is seen more in women when compared to men.
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Race: It mainly affects Asian Americans.
Can Women With Lupus Have a Safe Pregnancy and Healthy Baby?
Yes, women with lupus can have safe pregnancies and healthy babies, but these women are considered “high-risk pregnancies.” Because treating lupus erythematosus involves using solid immunosuppressant medications, which show serious side effects on patients. Hence women under the childbearing age group should stop taking these medications before and during pregnancy to protect the unborn child from harm.
What Are the Complications of Chronic Lupus Erythematosus?
Inflammation which is caused by lupus, is the main factor to cause complications in the body, which include:
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Kidney Disorders: More than half of the patients with lupus develop kidney problems, especially nephritis (inflammation of kidneys). The failure of kidneys is considered the most common cause of death in lupus patients.
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Heart Problems: Inflammation, the most common characteristic of lupus erythematosus, causes inflammation in heart vessels (arteries and veins) and membranes (pericarditis-inflammation of the pericardium). Atherosclerosis (deposition of fatty tissue along the inner walls of blood vessels) is common in patients with heart diseases, but atherosclerosis is even more common in patients with lupus.
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Central Nervous Systemand Brain: Lupus can damage the central nervous system and can cause loss of memory, difficulty in remembering things, seizures, stroke, and peripheral neuropathy (abnormal sensation in limbs). Children may exhibit difficulty in learning, processing, and remembering. Anxiety, depression, vision blurring, behavioral changes, and dizziness are common.
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Skin: Calcium deposits are seen under the skin (calcinosis), damaged blood vessels (vasculitis), and skin shows tiny red spots called petechiae. Hair loss and ulcerations in the oral cavity, nose, and genital regions are also seen.
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Blood: Anemia (decreased red blood cells) is seen in patients with lupus; bleeding time and clotting time are also increased.
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Infections: Patients with lupus are more prone to infections due to weak immune systems.
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Cancer: The risk of cancer is more in patients with lupus due to compromised immunity.
How To Diagnose Lupus?
Diagnosis depends on the signs and symptoms of the patient, and it differs from patient to patient. Laboratory tests such as blood tests and imaging tests are used in diagnostic procedures.
What Is the Treatment for Chronic Lupus Erythematosus?
Treatment options mainly depend on the patient's signs and symptoms and the affected organs. Because lupus shows intervals of flare-ups and remissions, the patient must discuss the medications and their doses with the doctor.
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NSAIDS (Non-steroidal Anti-inflammatory Drugs): Over-the-counter NSAIDS, such as Naproxen Sodium, Ibuprofen, and many other medications, are used to treat inflammation, fever, pain, and swelling caused by lupus erythematosus.
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Immunosuppressant Drugs: They are used to reduce the activity of the immune system. Drugs like Methotrexate, and Cyclosporin, are helpful in serious cases of lupus. However, side effects include liver damage, risk of cancer and infections, and decreased fertility.
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Corticosteroids: Prednisone and Methylprednisolone are given to reduce inflammation. Side effects include weight gain, hypertension, diabetes, thin bones.
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Antimalarial Drugs: Drugs that treat malaria, like Hydroxychloroquine, help reduce lupus flare-ups. Very rarely, retinal eye damage is also noted. Henc, regular eye checkups are advised for the patients.
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Biologics: Medications like Belimumab, which is FDA (Food and Drug Administration) approved, has been used since 2011 in treating lupus. It is given intravenously.
Conclusion:
Chronic lupus erythematosus is an autoimmune disorder that shows periods of flare-ups and remissions, sometimes symptoms remaining subsided for years together. However, overall chronic lupus erythematosus gets severe and worsens over a period of time and can be life threatening due to multiple organ failure.
