Ever heard of Systemic Lupus Erythematosus and how it could affect your wellbeing? From ailing the skin and joints to being anemic and facing more health complications, this certainly could be a very cumbersome condition to endure. “Systemic Lupus Erythematosus or in short SLE is an inflammatory connective tissue disease and is also known as ‘Lupus’ says Dr. Himantha Atukorale, Consultant in Rheumatology & Rehabilitation and Fellow of American College of Rheumatology.
Inflammation is a process where our body’s immune system attempts to heal a certain area. Explaining further he said that in SLE, the immune mechanism malfunctions and triggers off an exaggerated response and targets connective tissues.
Although most SLE patients have a very mild condition, rarely one may experience severe organ involvement. In mild cases, SLE affects the skin or joints resulting in skin rashes and joint pain/swelling. If the patient has mild SLE involving the nerves they might have simple migraine.
“When severe, the disease causes changes in the blood cells with low red cells, white cells or platelets. Sometimes the kidneys are affected with red cells or protein seen in a urine test.
The covering layers of the lungs (pleura) or the heart (pericardium) can also be affected in some patients. Neurological involvement in SLE can manifest as psychosis where mood and behavioral changes are seen in patients” he said.
When asked if the condition is fatal, Dr. Atukorale said that very severe SLE will lead to central nervous system changes, meaning the brain is affected. These patients present with epilepsy and various other manifestations including a condition called aseptic meningitis also known as “Cerebral Lupus” in the overall.
“The kidneys can be damaged in severe Lupus. When not identified at the initial phase, it can slowly change the structure within the kidneys causing permanent damage. Kidney involvement is also known as “Lupus nephritis”.
These complications are rare and require interventions from neurologists and Nephrologists” he added.
Symptoms and Diagnosis
Mild SLE is sometimes ignored by patients. Skin rashes as the butterfly rash, sun light sensitive rash and mouth/nose ulcers and joint pain with swelling are often the symptoms.
“The pleura and pericardium involvement leads to chest pain in inhaling and also pain which varies with posture. Lack of red cells can cause low haemoglobin /anaemia with breathlessness and tiredness. Fatigue or undue tiredness is observed in SLE. Kidney involvement with loss of body protein can cause swollen legs and swelling around the eyes”
Patients are diagnosed by blood tests and certain scans.
Apart from blood counts and urine tests, special tests such as ANA and double stranded DNA are also conducted.
When queried on the treatment procedure, he said that it is individualized and depends on the severity of the condition. Disease modifying drugs and steroids can control SLE very well and proper treatment makes the patient asymptomatic.
Take home message
Stating that there is no preventive method for SLE since what triggers the disease is still not known, he added that women between the ages of 14-45, especially having a family member affected with Lupus are vulnerable to the disease.
“SLE is a disease that presents with an unusual combination of symptoms. This is the reason why it is ignored. If you have a combination of such symptoms it’s better to visit your doctor to get yourself tested. Depending on the test results, various specialists will further look in to your disease condition. If found early, SLE can be well controlled with medication” Dr. Atukorale added conclusively.