The Definition Of Systemic Lupus Eyrthematosus
What is Systemic Lupus Erythematosus? The best way to describe this disease is an autoimmune disease. The immune system mistakenly attacks its healthy cells and tissue, causing inflammation over the body and damaging tissues and organs. It can damage the skin, joints, brain, blood vessels, kidneys, blood cells, and many other organs in the system (Solutions, 2021). SLE flares is when the symptoms worsen and makes the person feel ill. Systemic Lupus Erythematosus is also known as lupus and there several different diseases. For example, some are cutaneous (affects the skin only), drug-induced (caused by high doses of certain medications), and neonatal lupus (a rare condition where the mother antibodies affect the fetus), but the most dangerous is Systemic Lupus Erythematosus (affects heart, lungs, kidneys and brain) (Lupus Foundation of America , 2016). SLE affects every person with different symptoms and some can have mild to severe symptoms. SLE does not have a cure and can only be treated with medication and having a healthy life style can help the patient to live a normal life. (University of Rochester Medical Center, n.d.). SLE can affect people of all ages even children. Women from the age of 15 to 44 years old are at greatest risk. Men are not as likely to have Lupus (CDC Centers for Disease Control and Prevention, 2018).
In a patient with lupus, the immune system is uncontrollable by innate immunity and adaptive immunity (SpringerLink, 2019). “The innate and adaptive immune response against self-antigen produce the production of autoantibodies and the deposition of immune complexes in tissue leads to the activation of complement, accumulation of neutrophils and monocytes, and self-reactive lymphocytes” (SpringerLink, 2019). In our immune system, we have many antibodies, such as B cells; this cell produces antibodies that are proteins and are used to protect against infectious agents. In patients with Lupus, B cells and T cells are abnormally activated, which attack their tissues and organs. Lupus can affect the humoral and cellular abnormalities by both increased and decreased regulation. Researchers are still examining the role of the immune system in the pathogenesis of Lupus. The innate and adaptive are involved, this can cause an autoimmune response. B cells produce autoantibodies and these autoantibodies damages and cause injury to the tissue. Lupus is known to cause the disease of B cells (NIH National Institute of Arthritis and Musculoskeletal and Skin Disease, 2007). “The complement involving is classic and alternative pathway are components a patient with lupus, complement doesn’t specifically diagnose lupus, but it is helpful treating the patients. CD3 and CD4 are used to monitor this disease” (Turgen, 2018).
The cause of SLE is uncleared. Some of the causes that can be from is the environment such as sunlight, stress, smoking, certain medications, and virus this can trigger some symptoms and people that are likely to get Lupus due to their genes. Female hormones such as estrogen, are most common in women during their childbearing years. Medical professionals believe this can cause SLE in women (OWH office of women's health womenshealth.gov, 2019).
The signs and symptoms that Lupus can cause to a patient health are a facial rash that crosses noise and cheeks, weight loss, hair loss, arthritis (swollen joints), fever, fatigue, shortness of breath, seizures, fingers turning white or blue, mouth and nose ulcers, swollen lymph nodes, fingers can turn white or blue (Herndon, 2020).
Some of the damages that SLE can cause in patient are, brain and nerves system some patient can have headaches, memory loss, and mood swings. Nerves that control the movement of eyes can be damage, lung inflammation of the tissue, heart problems patient with Lupus can lead to death due to high blood pressure, high cholesterol, and Lupus can lead to kidney failure, which can lead to dialysis. Skin problems such as rashes or sores over the body. Blood such as RBC, WBC, platelets can cause anemia due to low of RBC, blood clots due to the low of platelets, inflammation in the blood vessels, and WBC low levels of leukopenia and neutropenia (Nichols, 2018). About 20 % of patients who have Lupus will have fever due to an infection, sometime this can lead to death due to the cause of bacteria, fungal, parasitic pathogen (Turgen, 2018).
When it comes to testing the diagnoses for a patient with SLE, it is difficult to diagnose; there is no one test that can diagnose Lupus. To diagnose Lupus, multiple blood and urine tests are required. Some of the tests that are done are as follows: CBC which tests for glucose, sodium, potassium, chloride, creatine, blood urea nitrogen (BUN), LDH which measures liver function; RBC, WBC, platelet counts (Richey, 2019). Another test is called Erythrocyte sediment rate. This test can tell how much inflammation and swelling is in the body. The erythrocyte testing measures by how fast the red blood cells sit at the bottom of the tube in an hour. As soon as the results are done, this can show clumps of the proteins that stick together, and they become heavier than a normal blood from a healthy patient. When red blood cells settle fast in the tubes, this can be very bad to the patient body causing inflammation (University of Rochester Medical Center, n.d.). Kidney and liver are done with blood to check if their functioning and are healthy becuase both organs can become damage. A urine test can be done to check the WBC, RBC, casts, bacteria, this can show if the kidney has become damaged. If there is any RBC in the urine, it can be that Lupus has damaged the kidney due to the glomerular begin damage. Some other testing can include an imagining test, chest x-ray. A biopsy test can be done on the bone marrow, skin, kidneys (Mayo Clinic, 2021). The most common test for SLE is Antinuclear antibody (ANA), is a group of autoantibodies that a person produces in the immune system. The appearance of anti-DNA, anti-Smith, and antiphospholipid antibodies is more particular for diagnosing SLE. The immune system can distinguish between “self” and “non-self”. ANA test can detect the autoantibodies in the blood. The immune system can recognize foreign (non self) such as bacteria or virus and the body’s cell (self). With lupus, it attacks the healthy cells and causes the effect of the organs, tissues, and inflammation in a patient body. Patients with SLE can have moderate anemia due to low RBC. WBC can show low levels of lymphocytopenia, and thrombocytopenia. When WBC is low this can cause infection. Patient with SLE can have low platelet and is can be harmful to the person, if bleeding do not stop due to a cut (Turgen, 2018).
There are many medications that a patient with Lupus takes. Some of the common medication is anti-inflammatory such as Aspirin or Tylenol, that can help with the pain. Another one is called Corticosteroids; it’s a steroid medication, which helps decrease swelling and pain that is due to inflammation. This medication helps to boost your immune system. For example, it helps regulate hormones and blood pressure. Antimalarials are another steroid that and help with skin rashes, ulcers, and joint pain. Antimalarials can also help by decreasing autoantibody production. This protects the skin from the damages that the sun does with a patient that has Lupus. Immunosuppressants are another medication that can help control inflammation and the immune system. Anticoagulants help to thin the blood because the patient with Lupus can have life-threatening blood clots. Monoclonal antibodies (mAbs) are a type of protein that attaches to one substance in the body. Benlysta is a monoclonal antibody in the human body. This medicine was developed to disrupt the activation of B lymphocytes by interfering with BLys, a protein required for B cell activity. Studies have shown that Benlysta can reduce autoantibody levels and help control disease activity (Medications used to treat Lupus, 2021).
The prognosis of a patient with SLE has improved from a 5-year survival rate of approximately 50% in the 1950s to about over 90% in the early 2000s. SLE is still life-threatening and can lead to death (PMC US National Library of Medicine National Institute of Health, 2020). Patients will have different symptoms and effects and complications. The life expectancy of SLE depends on how advance the disease has gotten into the immune system (Nichols, 2018).
I have a friend who has Lupus, so the human aspect of the disease is personal to me. Though the symptoms of this disease can be mild or severe, it is not an easy disease to live with. Many can live a normal life, and some must live life with medication and treatments. In honor of a very nice friend, I wanted to write about her perspective of this disease. She began having signs and symptoms in late 2010. That year was a rough year for her. Her signs began with low hemoglobin and swollen lymph nodes throughout her body. She was very fatigued and had a difficult time breathing when doing a simple task. She was diagnosed in May 2011 by a bone marrow biopsy. She does treatment with a Rheumatologist. She takes about 6 different medications and has been stable for 10 years. Her biggest change is not getting too tired and keeping her stress level low. If she does get too tired, she will have a flare- up that includes headaches and extreme fatigue. She also has a mild case of pleurisy that will never go away. She mentions that is very painful to take a deep breath. As long she takes her medication, she can remain stable. Lastly, she firmly believe attitude plays a huge part in how she feels and deals with it (anonymous, 2021)
