Systemic lupus erythematosus in women. Lupus erythematosus: symptoms, causes, treatment What causes lupus

The cutaneous form of lupus erythematosus is characterized by predominant damage to the skin and mucous membranes. This form of lupus is the most favorable and relatively benign. With systemic lupus erythematosus, many internal organs are affected, as a result of which this form is more severe than the skin form. Neonatal lupus erythematosus is very rare and occurs in newborns whose mothers suffered from this disease during pregnancy. Drug-induced lupus syndrome is not lupus erythematosus itself, since it is a set of symptoms similar to those of lupus, but provoked by taking certain medications. A characteristic feature of drug-induced lupus syndrome is that it completely resolves after discontinuation of the drug that provoked it.

In general, the forms of lupus erythematosus are cutaneous, systemic and neonatal. A drug-induced lupus syndrome is not a form of lupus erythematosus itself. There are different views regarding the relationship between cutaneous and systemic lupus erythematosus. So, some scientists believe that these are different diseases, but most doctors are inclined to believe that cutaneous and systemic lupus are stages of the same pathology.

Let's look at the forms of lupus erythematosus in more detail.

Cutaneous lupus erythematosus (discoid, subacute)

Discoid lupus erythematosus

It is a limited cutaneous form of the disease, which predominantly affects the skin of the face, neck, scalp, ears and sometimes the upper torso, legs and shoulders. In addition to skin damage, discoid lupus erythematosus can damage the oral mucosa, skin of the lips and tongue. In addition, discoid lupus erythematosus is characterized by involvement of joints in the pathological process with the formation of lupus arthritis. In general, discoid lupus erythematosus manifests itself in two ways: either skin lesions + arthritis, or skin lesions + mucosal lesions + arthritis.

Arthritis in discoid lupus erythematosus has a normal course, the same as in a systemic process. This means that symmetrical small joints are affected, mainly in the hands. The affected joint swells and hurts, takes on a forced bent position, which gives the hand a crooked appearance. However, the pain is migrating, that is, it appears and disappears episodically, and the forced position of the arm with joint deformation is also unstable and passes after the severity of inflammation decreases. The degree of damage to the joints does not progress; with each episode of pain and inflammation, the same dysfunction develops as the last time. Arthritis in discoid cutaneous lupus does not play a big role, because the main burden of damage falls on the skin and mucous membranes. Therefore, we will not further describe lupus arthritis in detail, since full information about it is given in the section “symptoms of lupus” in the subsection “symptoms of lupus from the joint-muscular system.”

The main organ that experiences the full severity of the inflammatory process in discoid lupus is the skin. Therefore, we will consider in more detail the skin manifestations of discoid lupus.

Skin lesions in discoid lupus develops gradually. First, a “butterfly” appears on the face, then rashes form on the forehead, on the red border of the lips, on the scalp and on the ears. Later, rashes may also appear on the back of the lower legs, shoulders, or forearms.

A characteristic feature of rashes on the skin with discoid lupus is their clear staged course. So, at the first (erythematous) stage the elements of the rash look like simply red spots with a clear border, moderate swelling and a clearly visible spider vein in the center. Over time, such elements of the rash increase in size, merge with each other, forming a large “butterfly”-shaped lesion on the face and various shapes on the body. Burning and tingling sensations may appear in the area of ​​the rash. If the rashes are localized on the oral mucosa, they hurt and itch, and these symptoms intensify while eating.

At the second stage (hyperkeratotic) areas of the rash become denser, plaques form on them, covered with small grayish-white scales. When the scales are removed, skin is exposed that looks like a lemon peel. Over time, the compacted elements of the rash become keratinized, and a red rim forms around them.

At the third stage (atrophic) the plaque tissues die, as a result of which the rash takes on the appearance of a saucer with raised edges and a drooping central part. At this stage, each lesion in the center is represented by atrophic scars, which are framed by a border of dense hyperkeratosis. And along the edge of the hearth there is a red border. In addition, dilated blood vessels or spider veins are visible in lupus lesions. Gradually, the focus of atrophy expands and reaches the red border, and as a result, the entire area of ​​​​the lupus rash is replaced by scar tissue.

After the entire lupus lesion is covered with scar tissue, hair falls out in the area of ​​its localization on the head, cracks form on the lips, and erosions and ulcers form on the mucous membranes.

The pathological process progresses, new rashes constantly appear, which go through all three stages. As a result, there are rashes on the skin that are at different stages of development. In the area of ​​rashes on the nose and ears, “black dots” appear and the pores expand.

Relatively rarely, with discoid lupus, rashes are localized on the mucous membrane of the cheeks, lips, palate and tongue. The rashes go through the same stages as those localized on the skin.

The discoid form of lupus erythematosus is relatively benign, since it does not affect internal organs, as a result of which a person has a favorable prognosis for life and health.

Subacute cutaneous lupus erythematosus

It is a disseminated (widespread) form of lupus, in which the rash is localized throughout the skin. In all other respects, the rash occurs in the same way as with the discoid (limited) form of cutaneous lupus erythematosus.

Systemic lupus erythematosus

Neonatal lupus erythematosus

Drug-induced lupus syndrome

Symptoms of lupus erythematosus

General symptoms

As a rule, lupus does not begin acutely., a person is worried about an unreasonable prolonged increase in body temperature, red rashes on the skin, malaise, general weakness and recurrent arthritis, which in its symptoms is similar to rheumatic, but is not. In more rare cases, lupus erythematosus begins acutely, with a sharp increase in temperature, the appearance of severe pain and swelling of the joints, the formation of a “butterfly” on the face, as well as the development of polyserositis or nephritis. Further, after any variant of the first manifestation, lupus erythematosus can occur in two ways. The first option is observed in 30% of cases and is characterized by the fact that within 5–10 years after the manifestation of the disease, a person experiences damage to only one organ system, as a result of which lupus occurs in the form of a single syndrome, for example, arthritis, polyserositis, Raynaud's syndrome, Werlhof's syndrome , epileptoid-like syndrome, etc. But after 5–10 years, various organs are damaged, and systemic lupus erythematosus becomes polysyndromic, when a person has symptoms of disorders of many organs. The second variant of the course of lupus is observed in 70% of cases and is characterized by the development of polysyndromy with vivid clinical symptoms from various organs and systems immediately after the first manifestation of the disease.

Polysyndromicity means that with lupus erythematosus there are numerous and very diverse clinical manifestations caused by damage to different organs and systems. Moreover, these clinical manifestations are present in different people in different combinations and combinations. However Any type of lupus erythematosus is manifested by the following general symptoms:

• Pain and swelling of the joints (especially large ones);
• Prolonged unexplained increase in body temperature;
• Rashes on the skin (on the face, on the neck, on the torso);
• Chest pain that occurs when taking a deep breath or exhaling;
• Hair loss;
• Sharp and severe paleness or blue discoloration of the skin of the toes and hands in the cold or during a stressful situation (Raynaud's syndrome);
• Swelling of the legs and area around the eyes;
• Enlarged and painful lymph nodes;
• Sensitivity to solar radiation;
• Headaches and dizziness;
• Convulsions;
• Depression.

Picture 1– General symptoms of lupus erythematosus from various organs and systems.

In addition, you need to know that the classic triad of symptoms of lupus erythematosus include arthritis (inflammation of the joints), polyserositis - inflammation of the peritoneum (peritonitis), inflammation of the pleura of the lungs (pleurisy), inflammation of the pericardium of the heart (pericarditis) and dermatitis.

For lupus erythematosus clinical symptoms do not appear all at once; their gradual development is typical. That is, first some symptoms appear, then, as the disease progresses, others join them, and the total number of clinical signs increases. Some symptoms appear years after the onset of the disease. This means that the longer a person suffers from systemic lupus erythematosus, the more clinical symptoms he develops.

These general symptoms of lupus erythematosus are very nonspecific and do not reflect the entire spectrum of clinical manifestations that occur when various organs and systems are damaged by the inflammatory process. Therefore, in the subsections below we will consider in detail the entire range of clinical manifestations accompanying systemic lupus erythematosus, grouping the symptoms according to the organ systems from which it develops. It is important to remember that different people may have symptoms from various organs in a wide variety of combinations, as a result of which no two variants of lupus erythematosus are identical. Moreover, symptoms may be present only from two or three organ systems, or from all systems.

Symptoms of systemic lupus erythematosus from the skin and mucous membranes: red spots on the face, scleroderma with lupus erythematosus (photo)

The most specific skin symptom for lupus is the presence and arrangement of red spots on the cheeks, wings and bridge of the nose in such a way that a figure similar to the wings of a butterfly is formed (see Figure 2). Due to this specific location of the spots, this symptom is usually called simply "butterfly".

Figure 2– Butterfly-shaped rashes on the face.

The “butterfly” for systemic lupus erythematosus comes in four varieties:

• Vasculitic "butterfly" is a diffuse, pulsating redness with a bluish tint, localized on the nose and cheeks. This redness is unstable, it intensifies when the skin is exposed to frost, wind, sun or excitement, and, on the contrary, decreases when exposed to favorable environmental conditions (see Figure 3).
• "Butterfly" type centrifugal erythema (erythema of Biette) is a collection of persistent red, swollen spots located on the cheeks and nose. Moreover, on the cheeks, most often the spots are not located near the nose, but, on the contrary, in the area of ​​the temples and along the imaginary line of beard growth (see Figure 4). These spots do not go away and their intensity does not decrease under favorable environmental conditions. On the surface of the spots there is moderate hyperkeratosis (peeling and thickening of the skin).
• "Butterfly" Kaposi is a collection of bright pink, dense and swollen spots located on the cheeks and nose against a background of a generally red face. A characteristic feature of this “butterfly” shape is that the spots are located on the swollen and red skin of the face (see Figure 5).
• "Butterfly" made of discoid type elements is a collection of bright red, swollen, inflamed, flaky spots located on the cheeks and nose. The spots with this “butterfly” shape are at first simply red, then they become swollen and inflamed, as a result of which the skin in this area thickens, begins to peel off and die. Further, when the inflammatory process passes, scars and areas of atrophy remain on the skin (see Figure 6).

Figure 4– “Butterfly” type of centrifugal erythema.

Figure 5- “Butterfly” by Kaposi.

Figure 6– “Butterfly” with discoid elements.

In addition to the “butterfly” on the face, skin lesions in systemic lupus erythematosus can manifest as rashes on the earlobes, neck, forehead, scalp, red border of the lips, torso (most often in the décolleté), on the legs and arms, as well as above elbow, ankle and knee joints. Skin rashes look like red spots, blisters or nodules of various shapes and sizes, having a clear border with healthy skin, located isolated or merging with each other. Spots, blisters and nodules are swollen, very brightly colored, slightly protruding above the surface of the skin. In rare cases, skin rashes associated with systemic lupus may appear as nodules, large bullae (blisters), red dots, or a mesh pattern with areas of ulceration.

With long-term lupus erythematosus, rashes on the skin can become dense, flaky and cracking. If the rashes become denser and begin to peel and crack, then after the inflammation has stopped, scars will form in their place due to skin atrophy.

Also skin damage in lupus erythematosus can occur as lupus cheilitis, in which the lips become bright red, ulcerate and become covered with grayish scales, crusts and numerous erosions. After some time, foci of atrophy form at the site of damage along the red border of the lips.

Finally, another characteristic skin symptom of lupus erythematosus is capillarites, which are red, swollen spots with spider veins and scars on them, located in the area of ​​the fingertips, palms and soles (see Figure 6).

Figure 7– Capillaritis of the fingertips and palms with lupus erythematosus.

In addition to the above symptoms (butterfly on the face, skin rashes, lupus cheilitis, capillaritis), skin lesions with lupus erythematosus are manifested by hair loss, brittleness and deformation of nails, the formation of ulcers and bedsores on the surface of the skin.

Skin syndrome in lupus erythematosus also includes damage to the mucous membranes and “dryness syndrome.” Damage to the mucous membranes with lupus erythematosus can occur in the following forms:

• Aphthous stomatitis;
• Enanthema of the oral mucosa (areas of the mucous membrane with hemorrhages and erosions);
• Oral candidiasis;
• Erosions, ulcers and whitish plaques on the mucous membrane of the mouth and nose.

With systemic lupus erythematosus, a person may have all of the listed manifestations of the skin syndrome in various combinations and in any quantity. Some people with lupus develop, for example, only a “butterfly”, others develop several skin manifestations of the disease (for example, “butterfly” + lupus cheilitis), and others have the whole spectrum of manifestations of the skin syndrome - both “butterfly” and capillaritis , and skin rashes, and lupus cheilitis, etc.

Symptoms of systemic lupus erythematosus in bones, muscles and joints (lupus arthritis)

• Prolonged pain in one or more joints of high intensity.
• Polyarthritis involving the symmetrical interphalangeal joints of the fingers, metacarpophalangeal, wrist, and knee joints.
• Morning stiffness of the affected joints (in the morning, immediately after waking up, it is difficult and painful to move the joints, but after a while, after “warming up,” the joints begin to function almost normally).
• Flexion contractures of the fingers due to inflammation of the ligaments and tendons (the fingers freeze in a bent position, and it is impossible to straighten them due to the fact that the ligaments and tendons have shortened). Contractures are rare, occurring in no more than 1.5–3% of cases.
• Rheumatoid-like appearance of the hands (swollen joints with bent, non-extending fingers).
• Aseptic necrosis of the head of the femur, humerus and other bones.
• Muscle weakness.
• Polymyositis.

However, most often, joint-muscular syndrome in lupus erythematosus occurs in the form of arthritis and accompanying myositis with intense muscle pain. Let's take a closer look at lupus arthritis.

Arthritis due to lupus erythematosus (lupus arthritis)

The inflammatory process most often involves small joints of the hands, wrists and ankles. Arthritis of large joints (knees, elbows, hips, etc.) rarely develops with lupus erythematosus. As a rule, simultaneous damage to symmetrical joints is observed. That is, lupus arthritis simultaneously affects the joints of both the right and left hand, ankle and wrist. In other words, a person usually has the same joints of the left and right limbs affected.

Arthritis causes pain, swelling, and morning stiffness in the affected joints. The pain is most often migratory - that is, it lasts several hours or days, after which it disappears, then reappears for a certain period of time. Swelling of the affected joints persists constantly. Morning stiffness means that immediately after waking up, movement in the joints is difficult, but after the person “disperses”, the joints begin to function almost normally. In addition, arthritis with lupus erythematosus is always accompanied by pain in the bones and muscles, myositis (inflammation of the muscles) and tenosynovitis (inflammation of the tendons). Moreover, myositis and tendovaginitis, as a rule, develop in the muscles and tendons adjacent to the affected joint.

Due to the inflammatory process, lupus arthritis can lead to joint deformation and disruption of their functioning. Joint deformity is usually represented by painful flexion contractures, resulting from severe pain and inflammation in the ligaments and muscles surrounding the joint. Due to pain, muscles and ligaments reflexively contract, keeping the joint in a bent position, but due to inflammation, it becomes fixed and extension does not occur. Contractures, which deform the joints, give the fingers and hands a characteristic crooked appearance.

However, a characteristic feature of lupus arthritis is that these contractures are reversible, since they are caused by inflammation of the ligaments and muscles surrounding the joint, and are not a consequence of erosion of the articular surfaces of the bones. This means that joint contractures, even if they have formed, can be eliminated with adequate treatment.

Persistent and irreversible joint deformities in lupus arthritis are very rare. But if they develop, then in appearance they resemble those seen in rheumatoid arthritis, for example, “swan neck”, fusiform deformation of the fingers, etc.

In addition to arthritis, muscular-articular syndrome in lupus erythematosus can manifest as aseptic necrosis of the heads of bones, most often the femur. Necrosis of the bone heads occurs in approximately 25% of all lupus sufferers, more often in men than in women. The formation of necrosis is caused by damage to the vessels passing inside the bone and supplying its cells with oxygen and nutrients. A characteristic feature of necrosis is that there is a delay in the restoration of normal tissue structure, as a result of which deforming osteoarthritis develops in the joint that includes the affected bone.

Lupus erythematosus and rheumatoid arthritis

With systemic lupus erythematosus, lupus arthritis can develop, which in its clinical manifestations is similar to rheumatoid arthritis, resulting in difficulties in distinguishing them. However, rheumatoid and lupus arthritis are completely different diseases that have different courses, prognosis and approaches to treatment. In practice, it is necessary to distinguish between rheumatoid and lupus arthritis, since the first is an independent autoimmune disease affecting only the joints, and the second is one of the syndromes of a systemic disease in which damage occurs not only to the joints, but also to other organs. For a person facing joint disease, it is important to be able to distinguish rheumatoid arthritis from lupus in order to begin adequate therapy in a timely manner.

To distinguish between lupus and rheumatoid arthritis, it is necessary to compare the key clinical symptoms of joint disease, which have different manifestations:

• With systemic lupus erythematosus, joint damage is migrating (arthritis of the same joint appears and disappears), and with rheumatoid arthritis, it is progressive (the same affected joint hurts constantly, and its condition worsens over time);
• Morning stiffness in systemic lupus erythematosus is moderate and is observed only during the period of active arthritis, and in rheumatoid arthritis it is constant, present even during the period of remission, and very intense;
• Transient flexion contractures (the joint is deformed during a period of active inflammation, and then restores its normal structure in remission) are characteristic of lupus erythematosus and are absent in rheumatoid arthritis;
• Irreversible contractures and joint deformities almost never occur with lupus erythematosus and are characteristic of rheumatoid arthritis;
• The dysfunction of joints in lupus erythematosus is insignificant, and in rheumatoid arthritis it is pronounced;
• Bone erosions are absent in lupus erythematosus, but are present in rheumatoid arthritis;
• Rheumatoid factor in lupus erythematosus is not always detected, and only in 5–25% of people, and in rheumatoid arthritis it is always present in the blood serum in 80%;
• A positive LE test for lupus erythematosus occurs in 85%, and for rheumatoid arthritis only in 5–15%.

Symptoms of systemic lupus erythematosus from the lungs

Pulmonary syndrome in lupus erythematosus can occur in the following clinical forms:

• Lupus pneumonitis (pulmonary vasculitis)– is an inflammation of the lungs, occurring with high body temperature, shortness of breath, silent moist rales and a dry cough, sometimes accompanied by hemoptysis. In lupus pneumonitis, inflammation does not affect the alveoli of the lungs, but the intercellular tissues (interstitium), as a result of which the process is similar to atypical pneumonia. X-rays with lupus pneumonitis reveal disc-shaped atelectasis (expansion), shadows of infiltrates and increased pulmonary pattern;
• Pulmonary syndrome hypertension (increased pressure in the pulmonary vein system) - manifested by severe shortness of breath and systemic hypoxia of organs and tissues. With lupus pulmonary hypertension, there are no changes on X-ray of the lungs;
• Pleurisy(inflammation of the pleural membrane of the lungs) - manifested by severe chest pain, severe shortness of breath and accumulation of fluid in the lungs;
• Hemorrhages in the lungs;
• Fibrosis of the diaphragm;
• Lung dystrophy;
• Polyserositis– is a migratory inflammation of the pleura of the lungs, pericardium of the heart and peritoneum. That is, a person alternately periodically experiences inflammation of the pleura, pericardium and peritoneum. These serosites are manifested by pain in the abdomen or chest, friction rub of the pericardium, peritoneum or pleura. But due to the low severity of clinical symptoms, polyserositis is often overlooked by doctors and patients themselves, who consider their condition to be a consequence of the disease. Each relapse of polyserositis leads to the formation of adhesions in the chambers of the heart, on the pleura and in the abdominal cavity, which are clearly visible on x-rays. Due to adhesive disease, an inflammatory process may occur in the spleen and liver.

Symptoms of systemic lupus erythematosus from the kidneys

Lupus nephritis can occur in different ways, as a result of which this syndrome is characterized by a wide range of renal symptoms. Most often, the only symptoms of lupus nephritis are proteinuria (protein in the urine) and hematuria (blood in the urine), which are not accompanied by any pain. Less commonly, proteinuria and hematuria are combined with the appearance of casts (hyaline and erythrocyte) in the urine, as well as various urination disorders, such as a decrease in the volume of urine excreted, pain during urination, etc. In rare cases, lupus nephritis acquires a rapid course with rapid damage to the glomeruli and development of renal failure.

According to the classification of M.M. Ivanova, lupus nephritis can occur in the following clinical forms:

• Rapidly progressing lupus nephritis - manifested by severe nephrotic syndrome (edema, protein in the urine, bleeding disorders and a decrease in the level of total protein in the blood), malignant arterial hypertension and the rapid development of renal failure;
• Nephrotic form of glomerulonephritis (manifested by protein and blood in the urine in combination with arterial hypertension);
• Active lupus nephritis with urinary syndrome (manifested by protein in the urine more than 0.5 g per day, a small amount of blood in the urine and leukocytes in the urine);
• Nephritis with minimal urinary syndrome (manifested by protein in the urine less than 0.5 g per day, single erythrocytes and leukocytes in the urine).

• I class– the kidneys contain normal, unchanged glomeruli.
• II class– in the kidneys there are only mesangial changes.
• III class– in less than half of the glomeruli there is infiltration of neutrophils and proliferation (increase in the number) of mesangial and endothelial cells, narrowing the lumen of blood vessels. If necrosis processes occur in the glomeruli, then destruction of the basement membrane, disintegration of cell nuclei, hematoxylin bodies and blood clots in the capillaries are also detected.
• IV class– changes in the structure of the kidneys are of the same nature as in class III, but they affect most of the glomeruli, which corresponds to diffuse glomerulonephritis.
• V class– in the kidneys, thickening of the walls of the glomerular capillaries with expansion of the mesangial matrix and an increase in the number of mesangial cells is detected, which corresponds to diffuse membranous glomerulonephritis.
• VI class– in the kidneys, sclerosis of the glomeruli and fibrosis of the intercellular spaces are detected, which corresponds to sclerosing glomerulonephritis.

Symptoms of systemic lupus erythematosus from the central nervous system

In the initial stages, damage to the nervous system is manifested by asthenovegetative syndrome with frequent headaches, dizziness, convulsions, memory, attention and thinking disorders. But damage to the nervous system with lupus erythematosus, if it manifests itself, steadily progresses, as a result of which, over time, increasingly deeper and more severe neurological disorders appear, such as polyneuritis, pain along the nerve trunks, decreased severity of reflexes, deterioration and impairment of sensitivity, meningoencephalitis , epileptiform syndrome, acute psychosis (delirium, delirious oneiroid), myelitis. In addition, due to vasculitis in lupus erythematosus, severe strokes can develop with poor outcomes.

The severity of disorders of the nervous system depends on the degree of involvement of other organs in the pathological process, and reflects the high activity of the disease.

Symptoms of lupus erythematosus from the nervous system can be very diverse depending on which part of the central nervous system is damaged. Currently, doctors identify the following possible forms of clinical manifestations of damage to the nervous system in lupus erythematosus:

• Migraine-type headaches that are not relieved by non-narcotic and narcotic painkillers;
• Transient ischemic attacks;
• Cerebrovascular accident;
• Convulsive seizures;
• Chorea;
• Cerebral ataxia (disorder of coordination of movements, the appearance of uncontrolled movements, tics, etc.);
• Neuritis of the cranial nerves (visual, olfactory, auditory, etc.);
• Optic neuritis with impaired or complete loss of vision;
• Transverse myelitis;
• Peripheral neuropathy (damage to sensory and motor fibers of nerve trunks with the development of neuritis);
• Impaired sensitivity – paresthesia (feeling of “pins and needles”, numbness, tingling);
• Organic brain damage, manifested by emotional instability, periods of depression, as well as significant deterioration of memory, attention and thinking;
• Psychomotor agitation;
• Encephalitis, meningoencephalitis;
• Persistent insomnia with short periods of sleep, during which a person sees colorful dreams;
• Affective disorders:
  • Anxious depression with vocal hallucinations of condemnatory content, fragmentary ideas and unstable, unsystematized delusions;
  • Manic-euphoric state with elevated mood, carelessness, self-satisfaction and lack of awareness of the severity of the disease;
• Delirious-oneiric clouding of consciousness (manifested by alternating dreams on fantastic themes with colorful visual hallucinations. Often people associate themselves as observers of hallucinatory scenes or victims of violence. Psychomotor agitation is confused and fussy, accompanied by immobility with muscle tension and a prolonged cry);
• Delirious clouding of consciousness (manifested by a feeling of fear, as well as vivid nightmares during the period of falling asleep and multiple colored visual and speech hallucinations of a threatening nature during waking moments);
• Strokes.

Symptoms of systemic lupus erythematosus from the gastrointestinal tract and liver

Damage to the digestive tract and liver with lupus erythematosus can occur in the following clinical forms:

• Aphthous stomatitis and ulceration of the tongue;
• Dyspeptic syndrome, manifested by nausea, vomiting, lack of appetite, bloating, flatulence, heartburn and stool disorder (diarrhea);
• Anorexia, which occurs as a result of unpleasant dyspeptic symptoms that appear after eating;
• Expansion of the lumen and ulceration of the mucous membrane of the esophagus;
• Ulceration of the mucous membrane of the stomach and duodenum;
• Abdominal pain syndrome (abdominal pain), which can be caused by both vasculitis of large vessels of the abdominal cavity (splenic, mesenteric arteries, etc.), and inflammation of the intestines (colitis, enteritis, ileitis, etc.), liver (hepatitis) , spleen (splenitis) or peritoneum (peritonitis). The pain is usually localized in the navel area, and is combined with rigidity of the muscles of the anterior abdominal wall;
• Enlarged abdominal lymph nodes;
• An increase in the size of the liver and spleen with the possible development of hepatitis, fatty hepatosis or splenitis;
• Lupus hepatitis, manifested by an increase in the size of the liver, yellowing of the skin and mucous membranes, as well as an increase in the activity of AST and ALT in the blood;
• Vasculitis of abdominal vessels with bleeding from the digestive tract;
• Ascites (accumulation of free fluid in the abdominal cavity);
• Serositis (inflammation of the peritoneum), which is accompanied by severe pain, simulating the picture of an “acute abdomen”.

Symptoms of systemic lupus erythematosus from the cardiovascular system

Damage to the heart and blood vessels in lupus erythematosus can occur in the following clinical forms:

• Pericarditis– is an inflammation of the pericardium (the outer lining of the heart), in which a person experiences chest pain, shortness of breath, dull heart sounds, and he takes a forced sitting position (a person cannot lie down, it is easier for him to sit, so he even sleeps on a high pillow) . In some cases, you can hear a pericardial friction rub, which occurs when there is effusion in the chest cavity. The main method for diagnosing pericarditis is an ECG, which reveals a decrease in T wave voltage and a shift in the ST segment.
• Myocarditis is an inflammation of the heart muscle (myocardium), which very often accompanies pericarditis. Isolated myocarditis in lupus erythematosus is rare. With myocarditis, a person develops heart failure and is bothered by chest pain.
• Endocarditis is an inflammation of the lining of the chambers of the heart, and is manifested by atypical verrucous Libman-Sachs endocarditis. In lupus endocarditis, the mitral, tricuspid and aortic valves are involved in the inflammatory process with the formation of their insufficiency. Most often, mitral valve insufficiency occurs. Endocarditis and damage to the valvular apparatus of the heart usually occur without clinical symptoms, and therefore they are detected only during echocardiography or ECG.
• Phlebitis and thrombophlebitis - are inflammation of the walls of blood vessels with the formation of blood clots in them and, accordingly, thrombosis in various organs and tissues. Clinically, these conditions are manifested by pulmonary hypertension, arterial hypertension, endocarditis, myocardial infarction, chorea, myelitis, liver hyperplasia, thrombosis of small vessels with the formation of foci of necrosis in various organs and tissues, as well as infarction of the abdominal organs (liver, spleen, adrenal glands, kidneys) and cerebrovascular accidents. Phlebitis and thrombophlebitis are caused by antiphospholipid syndrome, which develops in lupus erythematosus.
• Coronaritis(inflammation of the heart vessels) and atherosclerosis of the coronary vessels.
• Coronary heart disease and strokes.
• Raynaud's syndrome– is a microcirculation disorder, manifested by a sharp whitening or blue discoloration of the skin of the fingers in response to cold or stress.
• Marble pattern of the skin ( livedo reticularis) due to impaired microcirculation.
• Necrosis of the fingertips(blue fingertips).
• Retinal vasculitis, conjunctivitis and episcleritis.

Course of lupus erythematosus

Depending on the severity of clinical symptoms, the rate of progression of the disease, the number of affected organs and the degree of irreversible changes in them, there are three variants of the course of lupus erythematosus (acute, subacute and chronic) and three degrees of activity of the pathological process (I, II, III). Let us consider the variants of the course and degree of activity of lupus erythematosus in more detail.

Variants of the course of lupus erythematosus:

• Acute course– lupus erythematosus begins abruptly, with a sudden increase in body temperature. A few hours after the temperature rises, arthritis of several joints appears at once with sharp pain in them and rashes on the skin, including a “butterfly”. Then, within just a few months (3 – 6), arthritis, dermatitis and fever are joined by polyserositis (inflammation of the pleura, pericardium and peritoneum), lupus nephritis, meningoencephalitis, myelitis, radiculoneuritis, severe weight loss and tissue malnutrition. The disease progresses rapidly due to the high activity of the pathological process; irreversible changes appear in all organs, as a result of which, 1–2 years after the onset of lupus, in the absence of therapy, multiple organ failure develops, ending in death. The acute course of lupus erythematosus is the most unfavorable, since pathological changes in organs develop too quickly.
• Subacute course– lupus erythematosus manifests itself gradually, first pain appears in the joints, then arthritis is accompanied by skin syndrome (butterfly on the face, rashes on the skin of the body) and body temperature rises moderately. For a long time, the activity of the pathological process is low, as a result of which the disease progresses slowly, and organ damage remains minimal for a long time. For a long time, there are injuries and clinical symptoms in only 1–3 organs. However, over time, all organs are still involved in the pathological process, and with each exacerbation, an organ that was not previously affected is damaged. Subacute lupus is characterized by long-term remissions – up to six months. The subacute course of the disease is due to the average activity of the pathological process.
• Chronic course– lupus erythematosus manifests itself gradually, with arthritis and skin changes appearing first. Further, due to the low activity of the pathological process over many years, a person has damage to only 1–3 organs and, accordingly, clinical symptoms only on their part. After years (10–15 years), lupus erythematosus still leads to damage to all organs and the appearance of corresponding clinical symptoms.

• I degree of activity– the pathological process is inactive, organ damage develops extremely slowly (it takes up to 15 years for failure to form). For a long time, inflammation affects only the joints and skin, and the involvement of undamaged organs in the pathological process occurs slowly and gradually. The first degree of activity is characteristic of the chronic course of lupus erythematosus.
• II degree of activity– the pathological process is moderately active, organ damage develops relatively slowly (it takes up to 5–10 years for failure to form), the involvement of unaffected organs in the inflammatory process occurs only with relapses (on average, once every 4–6 months). The second degree of activity of the pathological process is characteristic of the subacute course of lupus erythematosus.
• III degree of activity– the pathological process is very active, organ damage and inflammation spreads very quickly. The third degree of activity of the pathological process is characteristic of the acute course of lupus erythematosus.

With high activity of the pathological process (III degree of activity), critical conditions may develop, in which failure of one or another affected organ appears. Such critical conditions are called lupus crises. Regardless of the fact that lupus crises can affect various organs, they are always caused by necrosis of small blood vessels in them (capillaries, arterioles, arteries) and are accompanied by severe intoxication (high body temperature, anorexia, weight loss, palpitations). Depending on which organ failure occurs, renal, pulmonary, cerebral, hemolytic, cardiac, abdominal, renal-abdominal, renal-cardiac and cerebrocardial lupus crises are distinguished. During a lupus crisis of any organ, there is also damage to other organs, but they do not have such severe dysfunction as in crisis tissue.

Lupus crisis of any organ requires immediate medical intervention, since in the absence of adequate therapy the risk of death is very high.

In renal crisis nephrotic syndrome develops (swelling, protein in the urine, bleeding disorders and a decrease in the level of total protein in the blood), blood pressure rises, acute renal failure develops and blood appears in the urine.

In cerebral crisis convulsions, acute psychosis (hallucinations, delirium, psychomotor agitation, etc.), hemiplegia (unilateral paresis of the left or right limbs), paraplegia (paresis of only the arms or only the legs), muscle rigidity, hyperkinesis (uncontrolled movements), impaired consciousness appear and etc.

Cardiac crisis manifests itself as cardiac tamponade, arrhythmia, myocardial infarction and acute heart failure.

Abdominal crisis occurs with severe acute pain and a general picture of an “acute abdomen”. Most often, an abdominal crisis is caused by intestinal damage such as ischemic enteritis or enterocolitis with ulceration and hemorrhage or, in rare cases, with infarction. In some cases, intestinal paresis or perforation develops, leading to peritonitis and intestinal bleeding.

Vascular crisis manifested by damage to the skin, on which large blisters and small red rashes form.

Symptoms of lupus erythematosus in women

Lupus erythematosus in children

In children and adolescents, lupus erythematosus, as a rule, is systemic and is much more severe than in adults, due to the characteristics of the immune system and connective tissue. Involvement of all organs and tissues in the pathological process occurs much faster than in adults. As a result, the mortality rate among children and adolescents from lupus erythematosus is much higher than among adults.

In the initial stages of the disease, children and adolescents, more often than adults, complain of joint pain, general weakness, malaise and elevated body temperature. Children lose weight very quickly, which sometimes reaches a state of cachexia (extreme exhaustion).

Skin lesions in children it usually occurs over the entire surface of the body, and not in limited areas of a certain localization (on the face, neck, head, ears), as in adults. The specific “butterfly” on the face is often absent. A measles-like rash, a mesh pattern, bruises and hemorrhages are visible on the skin, hair falls out rapidly and breaks off at the roots.

In children with lupus erythematosus serositis almost always develops, and most often they are represented by pleurisy and pericarditis. Splenitis and peritonitis develop less frequently. Adolescents often develop carditis (inflammation of all three linings of the heart - pericardium, endocardium and myocardium), and its presence in combination with arthritis is a characteristic sign of lupus.

Pneumonitis and other lung injuries with lupus in children they are rare, but are severe, leading to respiratory failure.

Lupus nephritis develops in children in 70% of cases, which is much more common than in adults. Kidney damage is severe, almost always leading to renal failure.

Damage to the nervous system in children, as a rule, it occurs in the form of chorea.

Damage to the digestive tract lupus in children also often develops, and most often the pathological process is manifested by inflammation of the intestines, peritonitis, splenitis, hepatitis, pancreatitis.

In approximately 70% of cases, lupus erythematosus in children occurs in acute or subacute form. In the acute form, generalization of the process with damage to all internal organs occurs literally within 1 - 2 months, and within 9 months multiple organ failure develops with a fatal outcome. In the subacute form of lupus, all organs are involved in the process within 3–6 months, after which the disease progresses with alternating periods of remissions and exacerbations, during which failure of one or another organ develops relatively quickly.

In 30% of cases, lupus erythematosus in children has a chronic course. In this case, the signs and course of the disease are the same as in adults.

Lupus erythematosus: symptoms of various forms and types of disease (systemic, discoid, disseminated, neonatal). Symptoms of lupus in children - video

Lupus is an almost mysterious disease, the causes of which scientists are still arguing about. It manifests itself in a variety of ways, from mild skin rashes to severe internal organ damage and death, and it is difficult to predict how the disease will behave. It is difficult to say whether a particular symptom is a sign of a mysterious illness or not, and sometimes it takes months to make a diagnosis. So what is lupus and can it be cured?

Such as lupus is more common called systemic lupus erythematosus. This is severe and related to autoimmune diseases. With this disease, the immune system of the human body begins to behave inappropriately, perceiving “its” cells and tissues as foreign and attacking them. Thus, it causes serious damage to those areas and tissues of the body that seem foreign to it.

The “attack” process is accompanied by inflammation, which provokes pain, swelling in the areas affected by the disease, and if it is particularly acute, the appearance of other diseases can also be provoked.

Lupus can manifest itself in different parts of the human body and affects not only the skin, but also joints and even internal organs.

Lupus is incurable and, although it often occurs almost unnoticed by a person, it constantly threatens to develop into a more acute form. To prevent the development of symptoms, lupus sufferers need to carefully monitor them and undergo medical treatment at all times. With appropriate treatment, people with this condition can freely lead active, healthy lives.

It is also known that women are 10 times more likely than men to develop lupus.

Types of lupus

The disease has several varieties depending on how it manifests itself and what areas it affects.

There are usually three types of this disease:

1. Discoid lupus erythematosus appears on the skin and affects the skin tissue. It appears as a red rash that can appear on the scalp and other parts of the body, and the affected areas develop a thick, scaly crust. Such a rash can last not only for several days, but for several months or even years, disappearing and appearing again after some time.
2. Drug-induced lupus erythematosus occurs as a result of the use of drugs. Symptoms such as rash, arthritis, chest pain, etc. appear when taking medications and disappear as soon as it stops.
3. Neonatal lupus is extremely rare. As a rule, it manifests itself in newborns and, even if the mother has systemic lupus erythematosus, the likelihood that the disease will be transmitted to the child is small. In addition, doctors now have the opportunity to diagnose the risk of the disease from a very early age, so it begins in a timely manner. With this type of lupus, the baby develops a skin rash, abnormality and cytopenia (lack of blood cells), as well as severe lesions, which is the most dangerous.

Causes

Despite the close attention of scientists to this disease, the exact causes of its occurrence have not yet been established. Genetics plays an important role here, and very often the disease is inherited.

There are many other factors that influence the onset of lupus. Most likely, it does not appear under the influence of anything specific, but due to a whole set of certain factors, starting with the environment and ending with the general condition of the human body.

These include the following:

• Stress
• Viral infection
• Colds
• Hormonal imbalances (eg, during puberty, postpartum, menopause)
• Excessive sun exposure
• Allergies to medications or any foods

The cause of the disease can be a variety of factors, but still, with a genetic predisposition, the risk of developing lupus increases significantly.

Signs

Systemic lupus erythematosus is polysyndromic. This indicates the variety of different symptoms that appear during illness. The main symptoms are general weakness and fatigue, fever and loss of appetite, skin rashes and joint pain.

Symptoms are classified from mild and almost unnoticeable to particularly serious, including severe damage to internal organs, including vital ones. Symptoms may go away and appear again.

The following symptoms may also be a sign of the disease:

• Swelling of the joints
• Muscle pain
• Causeless fever
• Chest pain when taking a deep breath
• Excessive hair loss
• Enlarged lymph nodes
• Increased sensitivity to the sun
• Swelling of the legs and area around the eyes
• Convulsions
• Headaches and dizziness
• Mouth ulcers
• White, blue, or excessive redness of fingers during stress

Lupus is often accompanied by disorders of the nervous system and mental disorders. The patient is more susceptible to depression, headaches, and constant causeless anxiety. Appetite is also lost and rapid weight loss occurs.

All patients experience the disease differently and exhibit different symptoms.

For some, the disease affects only one system of the body and manifests itself only, for example, on the skin or in the joints. In another patient, several systems will be affected, including internal organs, and the severity of the disease will be much greater.

Since the causes of the disease are not yet precisely known, and the symptoms are very diverse, diagnosing lupus is very difficult. Sometimes it can drag on not only for several months, but also for several years. Some symptoms “ripe” in the patient gradually and do not appear immediately.

It is impossible to immediately make an accurate diagnosis based on one or even several symptoms.

It requires high professionalism of the doctor, complete information about the patient’s entire medical history, and many tests and laboratory tests.You may even have to seek help from several doctors in different fields.

Diagnosis begins with a detailed questioning of the patient about all symptoms, previous diseases, as well as relatives and their diseases, followed by a complete examination of the patient from head to toe.

Laboratory tests include the following:

• and counting all cells: platelets, and
• Skin and kidney biopsy

Unfortunately, a diagnosis cannot be made based on the results of any one test. This requires long and painstaking work, which can take a long time.

Treatment

Treatment begins immediately after diagnosing the disease. Any delay can cause an exacerbation, which can threaten not only the general health of a person, but also his life.

Treatment is purely individual and depends on how the disease progresses, which body systems it affects and how severe its impact is for the patient, what symptoms appear and what the patient’s condition is at the time of diagnosis.

Medicines are prescribed exclusively by a doctor and depending on what symptoms bother the patient. The doctor chooses exactly those medications that are aimed at combating certain manifestations of the disease.

If the disease has gone too far and already directly threatens a person’s life, then doctors go to extreme measures. The patient's stem cells are taken, and then his immune system is completely destroyed in order to subsequently restore it again. The patient is injected with previously obtained stem cells, and thus the immune system is restored, which can completely rid him of the dangerous disease. But there is still a lot of controversy about this method, it is not well developed and requires a lot of money.

It is important to remember that it is better not to try to fight the disease on your own.

Seeing a doctor is mandatory, because only medical intervention and professional treatment can help prevent the development of the disease. But you can choose traditional medicines that will work together with medications. However, they can only be used with the consent of a doctor.

Interesting information from the video about what systemic lupus erythematosus is.

An infusion of Eleutherococcus is used to treat lupus. This remedy has a positive effect on the functioning of the adrenal glands and reduces joint pain:

• You will need 100 grams of Eleutherococcus root (crushed) and half a liter of vodka.
• Pour the root into a bottle of vodka and place in a dark place at room temperature. Before use, the tincture should be kept for 7 days.
• You need to take the tincture 2-3 times a day, half a teaspoon.

The affected areas of the skin can be smeared with homemade ointment. You can make it from crushed birch buds:

• A glass of kidneys should be mixed with 0.5 liters of interior fat.
• This mixture must be kept in the oven at low temperature for three hours a day for 7 days.
• The resulting ointment can also be dissolved in warm milk and taken orally before meals.

A fatal outcome with systemic lupus erythematosus is possible, but only with severe liver damage or, which begins if it is seriously neglected. Medicine has all the necessary drugs that can prevent the disease from damaging internal organs if treatment is started in a timely manner.

Lupus is accompanied by unpleasant symptoms and treatment may cause side effects, but most patients can lead a normal, active lifestyle. But this does not mean that the disease is always easy.

Complications are also possible, which manifest themselves in damage to internal organs. At this point, the disease moves to a more serious and dangerous stage, requiring timely and thorough treatment.

Lupus can negatively affect kidney function. For example, every 4th patient suffering from this disease experiences kidney dysfunction. Blood or blood cylinders appear, the legs swell - this is the main symptom. If the kidneys are too heavily affected by the disease, they may fail.

Lupus can also cause serious heart, lung, and blood problems.

However, even if any serious complications begin, a competent specialist can prescribe effective treatment and prevent the spread of the disease.

Lupus is serious and unpredictable. The disease is incurable, but it may not bother the patient for years, and then strike with renewed vigor. They can change all the time and move from milder to more serious. It is extremely important to understand that you cannot do this without regular medical care and the help of specialists. Only professional treatment can give truly positive results and prevent the development of the disease forever.

If you hear the word lupus, you probably have a lot of questions. Lupus is not a simple disease with an easy explanation; it is tuberculosis of the skin. You can't just take a pill and get rid of lupus. It may be difficult for the people you live and work with to notice that you have an illness. Lupus has no clear set of symptoms that people can see. You may know that something is not as it should be, but it will still take you time to reach a diagnosis.

Lupus comes in many shades. It can affect people of different races, ethnicities, and ages, and both men and women. It can be similar to various other diseases. Lupus is different for each person.

The good news is that you can get help. The first step is to learn about the disease. Ask questions, talk to your doctor, family and friends. People who are looking for answers are more likely to find them.

What exactly is skin tuberculosis or lupus?

Lupus is an autoimmune disease. Your body's immune system is like an army with hundreds of soldiers. The immune system's job is to fight external substances in the body, such as germs and viruses. But in autoimmune diseases, the immune system is uncontrolled. It attacks healthy tissue, not microbes.

You cannot get this disease from another person. It is not cancer and it is not related to AIDS.

Lupus is a disease that can affect many parts of the body. Everyone reacts differently. One person with this disease may experience swollen knees or a fever. Another person may be tired all the time or have kidney failure. Someone else may break out in a rash. Tuberculosis of the skin can affect the joints, skin, kidneys, lungs, heart and/or brain. If you have this disease, it may affect two or three parts of your body. Usually, one person does not have all possible symptoms.

There are three main types of lupus:

• - the most common form. It is also sometimes called the stationary set, or simply lupus. The word "systemic" means that the disease can involve many parts of the body, such as the heart, lungs, kidneys and brain. Signs may be mild or severe.
• Disc-shaped erythematous tuberculosis of the skin mainly affects the skin. A red rash may appear, or the color of the skin on the face, scalp, or elsewhere may change.
• Drug-induced skin tuberculosis. This type of disease is similar to the systemic type, but the symptoms are usually more mild. In many cases, the disease goes away when the medications no longer work. Many men develop tuberculosis because they take drugs that cause the disease, hydralzine and procainamide are used to treat heart disease, which is usually observed in men.

Lupus is difficult to diagnose. It is often mistaken for other diseases. That's why lupus has been called the "great imitator." The symptoms of this disease vary depending on the person. Some people only have some symptoms; others have more.

General signs of skin tuberculosis:

• Red rash or color changes on the face, often in a butterfly shape across the nose or cheeks
• Severe pain or swelling in the joints
• Groundless fever or fever
• Chest pain and rapid breathing
• Swollen tonsils
• Extreme fatigue (always feeling tired)
• Unusual hair loss (mainly on the scalp)
• Pale or purple fingers or toes from cold or stress
• Sensitivity to the sun
• Poor blood test results
• Depression, unpleasant thoughts, and/or memory problems

What is Flash?

When signs appear, they are called "flares." These signs may come and go. You may have swelling and rash for one week and then no symptoms. You might think that you experience this spike in symptoms after being out in the sun for a long time or after a hard day at work.

Even if you take medications for lupus, you may find that there are times when symptoms get worse. It may help to recognize when a flare-up of symptoms occurs, then you can take steps to manage it. Many people feel very tired or have pain, rash, fever, abdominal discomfort, headache, or dizziness just before an outbreak. Steps such as reducing sun exposure, spending more time recovering, and staying quiet can also be helpful to prevent such outbreaks.

Preventing Outbreaks:

• Learn to acknowledge that you are having an outbreak.
• Talk to your doctor.
• Try to set realistic goals and priorities.
• Limit the time you spend in the sun.
• Maintain a healthy diet.
• Develop self-control skills to limit stress.
• Try to get enough rest and silence.
• Exercise moderately whenever possible.
• Develop a support system by surrounding yourself directly with people you trust and feel comfortable with (family, friends, etc.).

The US Food and Drug Administration recently launched a new diagnostic test for lupus that promises to improve cure rates and facilitate earlier treatment for a disease that claims more and more lives every year.

“Any test that can improve the diagnosis rate is a significant major advance for patients with cutaneous tuberculosis,” says Duane Peters, vice president of advocacy and communications at the Cutaneous Tuberculosis Foundation of America (LFA) in Rockville, Md. “Timely detection will allow doctors study the disease at an early stage, prevent organ removal or even death."

Lupus - also known as Systemic erythematous tuberculosis of the skin- is a poorly understood condition in which the body's misdirected immune system attacks its own healthy body, causing tissue pain, fatigue and damage to vital organs. Approximately 90% - 1.4 million Americans - are diagnosed with the disease - young women between the ages of 15 and 45. A recent report from the Centers for Disease Control and Prevention (CDC) showed a 70 percent increase in the proportion of African American women who have died from lupus over the past 20 years. The same study found that death rates were more than five times higher for women with lupus than for men with the disease.

Because the symptoms of lupus are somewhat unpredictable and often vary from patient to patient, obtaining a timely and accurate diagnosis can create self-doubt and delay the process. In fact, half of lupus patients consult three or more doctors over four or more years before being properly diagnosed.

A newly-approved scanning technique has the potential to simplify diagnoses for patients and doctors. New test could help detect disease earlier, according to Mark Roth, Ph.D., who developed the test with colleagues at the Fred Huchinson Cancer Research Center in Seattle.

"This test will improve doctors' ability to make good decisions when diagnosing lupus, and we also know for sure that this test will help determine where in the body the disease is initially lodged," said Roth, a professor of biochemistry at the University of Washington School of Medicine.

Yet experts warn that it is far from a definitive and 100% accurate test. "This is not a superior scanner," said George Tsokos, director of rheumatology. "It will complement the tests already available, but not all lupus patients may be eligible for this type of test." However, this new method helps clarify important diagnostic information.

The strength of the new test depends on its ability to match antibodies to so-called Eser proteins. Antibodies target a specific protein when the body goes on an immune attack. Two years ago, Roth and his colleagues discovered that most lupus patients make antibodies to ES proteins, while patients with other diseases fail to make ES antibodies.

Based on these findings, Roth and his colleagues developed a new scanner. If the patient has produced antibodies for the sera proteins, the sera will react with the proteins and turn a purple liquid. This test can identify 50%-70% of patients who react positively to ES proteins.

It may take some time before results are seen in patients from this study. The Fred Hutchinson Cancer Research Center is currently seeking a commercial partner to sponsor the production of the test so it can be made available to everyone.

Is it possible to get a cure for lupus?

Remember that each person has different symptoms. Treatment depends on the symptoms. The doctor may prescribe you aspirin or something to treat swollen joints and fever. Creams may be prescribed for the rash. For more serious problems, stronger medications containing narcotics such as corticosteroids and chemical drugs are used. Your doctor will choose treatment based on your symptoms and needs.

Always tell your doctor if you have problems with your medications. Tell your doctor if you take herbal or vitamin supplements. Your medications may not be compatible with those your doctor prescribed. You and your doctor should work together to find the best way to solve all your problems.

– a group of severe autoimmune connective tissue diseases that primarily affect the skin and internal organs of a person. This disease got its name because of the characteristic rashes on the skin of the face, which in appearance resemble wolf bites. Young women are more often affected; men and children suffer from lupus erythematosus much less frequently.

In total, the number of people suffering from lupus erythematosus is 0.004-0.25% of their total number.

Among the reasons are: hereditary predisposition to this disease, other reasons for its occurrence remain still unexplored. It is believed that acute infectious diseases, severe psychological trauma, prolonged exposure to stress, or intolerance to certain pharmacological drugs can trigger the appearance of lupus erythematosus.

A characteristic feature of lupus erythematosus is a wide range of its manifestations, because this disease affects almost all organs and systems of the human body. However, there is a list of symptoms, the presence of which is mandatory for lupus erythematosus:

• constitutional symptoms (malaise, emaciation)
• skin lesions (increased sensitivity to light, baldness, characteristic erythema on the skin of the nose and cheeks in the shape of a butterfly)
• erosive lesions of the mucous membranes
• joint damage due to arthritis
• damage to the lungs and heart
• kidney damage (in 50% of patients) up to renal failure
• nervous system disorders (acute psychosis, organic brain syndrome)
• changes in general blood and urine tests
• antiphospholipid syndrome in 20-30% of patients
• antinuclear antibody titer is high

The specific type of lupus erythematosus and the degree of disease activity at one time or another are determined by a rheumatologist after a comprehensive examination. Cutaneous lupus is most often treated by a dermatologist.

Treatment methods for lupus erythematosus

The disease cannot be completely cured, so treatment continues throughout life. How to treat lupus erythematosus is decided by the attending physician individually for each patient, depending on the specific symptoms, severity of the disease and its activity.
For mild cases of the disease or in remission, treatment is mainly symptomatic. The following drugs are prescribed:

• analgesics for severe pain syndrome
• aspirin (80-320 mg per day) with a tendency to thrombosis
• antimalarial drugs: hydroxychloroquine (orally 200 mg per day) or a combination of chloroquine (250 mg) and quinacrine (50-100 mg) - for severe damage to the skin and joints
• vitamins A, B6, B12, C

In severe cases of the disease with damage to internal organs, the following is used:

• glucocorticoids (for severe conditions, 40-60 mg of prednisolone daily, 20-40 mg for moderate disease activity) are taken for a month with a gradual reduction to a therapeutic dose (up to 10 mg per day)
• immunosuppressants (mycophenalate mofetil 500-1000 mg, azathioprine 1-2.5 mg/kg or cyclophosphamide 1-4 mg/kg once daily orally)
• heparin in combination with aspirin subcutaneously, heparin or wafarin orally for thrombosis and vascular embolism
• in severe cases with low effectiveness of glucorticoid treatment, pulse therapy with methylprednisolone and cyclophosphamide is indicated, which are administered in large doses (1 g per day) intravenously drip for 3 days in a row
• hemosorption and plasmapheresis – to remove toxic immune complexes from the body
• Stem cell transplantation is an expensive procedure that is inaccessible to most patients
• calcium supplements and vitamin D3 – to minimize the negative effects of glucocorticoid use

Patients are observed at a dispensary. Indications for their immediate hospitalization are:

• infectious complications
• chest pain
• pronounced symptoms of pathologies of the nervous system
• renal failure
• thrombosis

Traditional medicine against lupus erythematosus

Treatment of cutaneous and systemic lupus erythematosus according to traditional medicine is supportive in nature and can be used during a mild course of the disease or in remission. In this case, you cannot use drugs that stimulate the immune system - this can aggravate the course of the disease.

Popular effective recipes:

• Decoction of dried mistletoe leaves, collected from birch trees in the cold season. 2 tsp. leaves are poured with a glass of boiling water, simmered in a water bath for 1-2 minutes and left for half an hour. The resulting infusion is drunk in three doses during the day. Take 1 month.
• Licorice decoction. Pour boiling water (500 ml) over dried licorice roots (1 tablespoon), simmer over heat for 15 minutes, cool at room temperature. Drink the strained broth during the day between meals. Do this for a month.
• ointment from birch buds or tarragon for the treatment of lupus erythema. A glass of ground birch buds (tarragon) is mixed with a half-liter jar of pork fat. This mixture is simmered for 5-7 days for several hours in the oven with the door open. The resulting ointment is applied to the erythema and taken orally before meals, 1 tsp.

There are many other alternative medicine recipes that are used to treat lupus erythematosus. However, in severe cases of the disease and at the stage of its exacerbation, traditional medicine should give way to traditional drug treatment.

How to live with a diagnosis of lupus erythematosus?

In this case, it is necessary to follow basic recommendations:

• avoid stress and traumatic situations
• Avoid prolonged exposure to the sun and solarium
• monitor your health: prevent exacerbation of chronic diseases, treat colds immediately after their first symptoms
• do not take oral contraceptives and do not smoke - this significantly increases the risk of thrombosis
• use high-quality cosmetics, do not perform hardware or chemical cleansing of the face
• take vitamin complexes
• eat a balanced diet and exercise

Variants of the course of the disease and prognosis

The prognosis is unfavorable. Mortality among patients with lupus erythematosus is 3 times higher than usual. Most often, the cause of death is infectious complications and the consequences of deep damage to internal organs. But with timely detection of the disease and competent drug therapy, it is possible to keep this disease under control and not allow it to destroy life and health.

One of the most serious diseases is systemic lupus erythematosus (SLE). It is characterized by autoimmune inflammation with many other symptoms. This disease is dangerous due to its complications. It affects the organs of many body systems, but the most problems occur with the musculoskeletal system and kidneys.

Description of the disease

Lupus develops due to a malfunction of the immune system, in which antibodies are formed that negatively affect healthy cells and tissues. This leads to negative changes in blood vessels and connective tissue.

The term "lupus" was once used to refer to red patches that appeared on the face. They resembled the bites of wolves or she-wolves, which often attacked people and sought to get to unprotected parts of the body, like the nose or cheeks. Even one of the symptoms of the disease is called “lupus butterfly.” Today the name is associated with the cute word “wolf cub”.

Autoimmune disease develops against the background of hormonal disorders. Increased amounts of estrogens play a major role, so lupus is most often observed in the fair sex. The disease is usually diagnosed in teenage girls and young women under 26 years of age.

In men, SLE is more severe, and remissions are rare, but in them the disease is 10 times less common, since androgens have a protective effect. Some symptoms may be more severe in different genders. For example, in women the joints are more affected, and in men the central nervous system and kidneys are more affected.

Lupus can be congenital. Symptoms of SLE appear in children already in the first years of life.

The disease develops in waves, with alternating periods of exacerbations and remissions. SLE is characterized by an acute onset, rapid progression and early spread of the disease process. In children, the symptoms of systemic lupus erythematosus are the same as in adults.

Causes

The occurrence and development of lupus is influenced by more than one reason. It is caused by the simultaneous or sequential influence of several factors. Scientists were able to discover the main causes of the disease:

Scientists do not include the last factor in the common causes of SLE, but they believe that the patient’s relatives are at risk.

Classification by stages

SLE has a wide range of symptoms. During the illness, exacerbations and remissions occur.

Lupus is classified according to its forms:

The stages of the disease are also distinguished. Minimal is characterized by mild headaches and joint pains, high fever, malaise and the first manifestations of lupus on the skin.

In the moderate phase, the face and body are severely affected, and then the blood vessels, joints and internal organs. At an advanced stage, the functioning of various body systems is disrupted.

Symptoms of the disease

At the onset of SLE, skin lesions affect only 20% of patients. In 60% of patients, symptoms appear later. Some people don't experience them at all. Signs of the disease can be seen on the face, neck and shoulders. A rash appears on the back of the nose and cheeks in the form of reddish plaques with peeling, reminiscent of wolf bites in the past. It is called the "lupus butterfly" because it looks like this insect. The patient's skin sensitivity to ultraviolet radiation increases.

Some people with lupus experience hair loss from the temples and broken nails. Mucous membranes are affected in 25% of cases. Lupus cheilitis appears, characterized by dense swelling of the lips in the form of grayish scales. Small red or pink ulcers may appear along the border. In addition, the oral mucosa is affected.

Lupus affects various body systems:

Common symptoms of lupus in women and men are central nervous system lesions. The disease is characterized by rapid fatigue, weakness, decreased memory and performance, and deterioration of intellectual abilities. A person suffering from an autoimmune disease experiences irritability, depression, headaches, etc.

The patient may experience decreased sensitivity. Seizures, psychoses and convulsions also develop against the background of lupus.

Diagnostic methods

The diagnosis of lupus can be confirmed using differential diagnosis. It is done because each manifestation indicates the pathology of a specific organ. For this purpose, a system developed by the American Rheumatological Association of Specialists is used.

The diagnosis of SLE is confirmed with four or more symptoms from this list:

After a preliminary diagnosis has been made, the patient is referred to a specialist with a narrow focus, for example, a nephrologist, pulmonologist or cardiologist.

A detailed examination includes a thorough history taking. The doctor needs to find out about all the patient’s previous diseases and methods of treating them.

Treatment options

Drug therapy for patients with SLE is selected individually. Treatment methods depend on the stage and form of the disease, the symptoms that appear and the characteristics of the patient’s body.

A person suffering from lupus will need to be hospitalized only in certain cases: a constant temperature above 38 degrees, a decrease, and also if a stroke, heart attack or severe damage to the central nervous system is suspected. If the clinical signs of the disease progress, then the patient will also be sent to hospitalization.

Treatment of lupus erythematosus includes:

Hormonal creams and ointments eliminate peeling and burning sensations that occur in certain areas of the skin.

Particular attention is paid to the patient's immune system. During remission, the patient is treated with immunostimulants in combination with vitamin complexes and physiotherapeutic procedures.

Concomitant diseases and complications are also taken into account. Since the first place in cases of mortality is occupied by kidney problems, they must be constantly monitored in SLE. It is necessary to promptly treat lupus arthritis and heart disease.

Dandelion P acts as a natural chondroprotector, which prevents joints from collapsing and restores cartilage tissue. It lowers blood cholesterol and cleanses the body of toxins. Dihydroquercetin Plus is used to strengthen the walls of blood vessels. It also eliminates bad cholesterol and improves blood microcirculation.

People with lupus are prescribed foods to help relieve symptoms of the disease. The patient should give preference to foods that can protect the brain, heart and kidneys.

A person diagnosed with lupus must be consumed in sufficient quantities:

Protein will help fight the disease. Doctors recommend eating veal, turkey and other dietary meats and poultry. The diet should include cod, pollock, pink salmon, tuna, squid, and low-fat herring. Fish contains omega-3 unsaturated fatty acids, which are vital for normal brain and heart function.

You need to drink at least 8 glasses of clean water per day. It improves the functioning of the gastrointestinal tract, controls hunger and improves general condition.

You will need to avoid or limit some foods in your diet:

• Fatty dishes. Foods that contain a lot of butter or vegetable oil increase the risk of exacerbations of the cardiovascular system. Due to fatty foods, cholesterol is deposited in the blood vessels. Because of it, acute myocardial infarction can develop.
• Caffeine. This component is present in large quantities in coffee, tea and some other drinks. Because of caffeine, the mucous membrane of the stomach is irritated, the heart beats faster and the nervous system is overloaded. If you stop drinking cups of drinks with this substance, you will be able to avoid the occurrence of erosions in the duodenum.
• Salt. The food should be limited as it overloads the kidneys and increases blood pressure.

People suffering from lupus erythematosus should give up alcoholic beverages and cigarettes. They are already harmful in themselves, but in combination with medications they can lead to disastrous consequences.

Prognosis for patients

The prognosis will be favorable if the disease is detected early in its development. At the very beginning of lupus, tissues and organs are not subject to severe deformation. Mild rashes or arthritis are easily controlled by specialists.

Advanced forms of SLE will require aggressive treatment with large doses of various medications. In this case, it is not always possible to determine what causes more harm to the body: large dosages of drugs or the pathological process itself.

Lupus erythematosus cannot be completely cured, but this does not mean that you cannot live happily with it. If you seek medical help in time, you can avoid serious problems. If you follow medical recommendations and lead a correct lifestyle, the patient will not have to limit himself in many ways.

Complications and progression of the disease are possible if a person has chronic infectious diseases. Frequent vaccinations and colds also have an impact. Therefore, such a patient needs to take care of his health and avoid factors that negatively affect his body.

Preventive actions

Prevention of SLE will help prevent relapses of the disease and stop further progression of pathological processes. Secondary measures promote timely and adequate treatment of lupus.

Patients should undergo regular medical examinations and consult with a rheumatologist. The drugs must be taken in the prescribed dosage for a certain period of time.

A state of stable remission can be maintained with hardening, therapeutic exercises and regular walks in the fresh air. The patient must follow a work-rest regime, avoiding unnecessary psychological and physical stress. Adequate sleep and proper nutrition are important not only for improving the condition of the disease, but also for the normal functioning of the entire body.

If isolated areas of affected skin have been identified in a person, it is necessary to find out whether any of his relatives have been diagnosed with the disease. A person with lupus should avoid ultraviolet radiation and stay away from direct sunlight. In the warm season, you need to use special ointments that can protect your skin from the negative effects of the sun. A person suffering from SLE needs to give up bad habits that only aggravate his condition.