Systemic lupus erythematosus (SLE): Everything about symptoms, treatments and history
When systemic lupus erythematosus - SLE or short - is a rare autoimmune disease: that is, the immune system produces antibodies against the body itself. As a result, everywhere in the body can occur inflammation and damage organs. Although SLE is not curable, it can be due to various active ingredients but usually get a good grip.
Depending on which organs are affected by systemic lupus erythematosus, show different symptoms - from general symptoms such as fatigue and fever to severe kidney damage. Most typically for systemic lupus erythematosus, among other things, the so-called butterfly rash - doing this symmetrical, butterfly-shaped skin redness long does not occur on the face in all patients!
The more difficult it often is to find a diagnosis and the cause - just like a hundred-piece puzzle, in which only a few pieces are available.
The professional organization of American rheumatologists (American College of Rheumatology) has therefore published a list of criteria that will facilitate the diagnosis. Among the criteria that speak for systemic lupus erythematosus, include, for example,
The disease is chronic and often advances in phases - a cure systemic lupus erythematosus can not be. With appropriate therapies and a close supervision by a doctor is the Life expectancy of those affected today hardly shortened.
Typical of systemic lupus erythematosus is a reddish, butterfly-shaped rash on the face - the so-called butterfly rash.
SLE is especially in women of childbearing age before: 9 out of 10 sufferers are women. Overall, systemic lupus erythematosus is seldom - in Germany currently suffer around 30,000 people from the disease.
Previously it was thought attacking wolves (lat. Lupus = wolf) would be responsible for the scars on the face of those affected. We now know that an autoimmune disease is the cause - was the myth only the name "lupus" left. The word "erythematosus" means blushing - eponymous reddish rashes are in the face.
The exact cause of the systemic lupus erythematosus unknown. However, doctors believe that external factors that stimulate the immune system or encumber the development of SLE promote or enhance relapses.
Among the possible triggers include approximately:
Therefore, the disease breaks sometimes after a longer stay in the sun, for example, after a beach holiday.
genetic changes appear to play a role: While this is not a hereditary disease, but the SLE occurs in some families heaped upon - twins have about a 25% risk of becoming ill themselves SLE if the sibling is affected.
Especially women childbearing age, particularly when they hormonally prevent (e.g., with the pill), suffering from systemic lupus erythematosus - both suggests that hormones promote the SLE-emergence. The hormonal changes during a pregnancy trigger a lupus erythematosus in rare cases.
In systemic lupus erythematosus there is a malfunction of the body's own defenses - the immune system reacts to components of one's body and makes antibodies against them. It is a so-called autoimmune disease in which the affected organs become inflamed chronically developed. The disease is usually in exacerbations - in phases, the symptoms increase, phased slacken.
In systemic lupus erythematosus mainly autoantibodies against components of the nucleus form - there is the DNA, so the genetic makeup of humans. Antibody and cell components combine to form so-called immune complexes that circulate in the bloodstream - they are deposited over time in the vessels of many organs and cause inflammation.
Lupus erythemotodes is a rare, chronic autoimmune disease in which the immune system attacks healthy cells and tissues. Find out in the video about the different forms of lupus and what symptoms they are accompanied!
The symptoms in systemic lupus erythematosus are very different, as the disease can affect almost the entire body. Therefore, there is no guiding symptoms. Especially at the beginning, the disease very often by joint pain and general symptoms.
To the common symptoms in systemic lupus erythematosus counting:
Especially typical of SLE is the so-called butterfly rash - a reddish rash on the face that spreads butterfly shape over the nose and cheeks.
The disease in SLE is very diverse - so it is for the doctor often difficult to determine the lupus disease. Systemic lupus erythematosus can more of the following, for example, symptoms cause:
Systemic lupus erythematosus begins insidiously and is often diagnosed late. To make the diagnosis sure are different laboratory tests necessary.
Typically erythematosus (SLE) formed in systemic lupus antibodies against the body's own structures - these can be detected in the blood. For the diagnosis of systemic lupus erythematosus therefore help different, sometimes very specific laboratory tests, with which one these so-called Autoantibodies can prove.
In addition, the doctor examines the organs involved: in addition to X-rays of the joints and ultrasound examinations of the organs additional tissue tests may be necessary. For this, the doctor takes small tissue samples from the skin (so-called. Biopsy) and possibly the kidney and examined them.
In the skin biopsy the doctor removes a small piece of skin from an affected region and examined it fine tissue (histology). Frequently found the so-called lupus band: This occurs in systemic lupus erythematosus, especially in skin areas that are exposed to light. It corresponds deposited in the skin immune complexes.
How much the kidneys on systemic lupus erythematosus (so-called. lupus nephritis) Are involved, show the following findings:
Course and treatment of lupus disease will largely depend on how much the kidneys are damaged.
To make the diagnosis of systemic lupus erythematosus, have at least four of the eleven so-called ACR criteria available. These criteria are provided by the American College of Rheumatology - the scientific association of US rheumatologists.
Systemic lupus erythematosus (SLE) can be not heal - is paramount to alleviate the discomfort. But that also means that if there are no complaints, no drugs are needed. In patients with mild SLE nonsteroidal anti-inflammatory drugs (NSAIDs) may already help to alleviate typical symptoms such as joint pain.
Basically, the treatment of SLE is aimed So then, what organs are affected and how active the disease. Here, a doctor should the therapy supervise closely - both related to the disease and mentally.
The treatment can be divided into three categories:
For light curves with skin and joint involvement usually already the antimalarial drug hydroxychloroquine or chloroquine against the complaints help. Experts recommend starting from the date of diagnosis to treatment with antimalarial drugs, if no organ involvement such as kidney or lung exists. With prolonged use over several years, however, the risk of retinal damage increases. It is therefore important in the treatment of perceiving the follow-up appointments with the ophthalmologist annually.
Later in drugs usually come from the group of active glucocorticoids ("cortisone") for use. Systemic lupus erythematosus almost always responds to higher doses of these agents. In acute cases, corticosteroids are administered in dosages of 20 to 100 milligrams of prednisone equivalent per day the drug of choice. In severe cases, an infusion shock therapy with 500 to 1,000 milligrams per day may come three days are used.
Important: Treatment with glucocorticoids should indeed be basically as long as necessary, but as short as possible. And Idle of lupus erythematosus no corticosteroids are often erfordlich.
In severe cases of systemic lupus erythematosus stronger drugs are often necessary to suppress the immune system. These include:
Doctors rely mainly on one:
A newer method of therapy is the administration of belimumab, a so-called Biologikum. This antibody inhibits artificially produced part of the immune cells and relieves the symptoms of systemic lupus erythematosus.
If these drugs are not successful, the drug rituximab is as reserve funds. The drug is not officially approved for the treatment of systemic lupus erythematosus - the so-called experts speak "off-label use"When a drug to treat a disease is used, for which it has not approved.
In addition, a special form of dialysis is in some cases after treatment with cyclophosphamide used: the so-called plasmapheresis. It removes autoantibodies from the blood. Although a very serious systemic lupus erythematosus, this therapy can help.
In addition, support further measures the treatment of systemic lupus erythematosus:
If you have SLE, it is important that you consistently other from sunlight and protect UV radiation, because UV light can increase systemic lupus erythematosus: You should therefore use sunscreens with high SPF (SPF 60), avoid tanning beds and keep yourself in the shade.
Thanks to new treatment options and care closer to the prognosis of systemic lupus erythematosus has improved considerably: Today, the vast majority of persons affected almost normal life age to reach. However, the prognosis worsens when added organ damage.
Systemic lupus erythematosus, in the course at different complications lead - especially who it affects organs such as the brain or kidneys. It can sometimes lead to a chronic renal failure; a dialysis must replace the function of the kidney.
Since the SLE therapy mainly aims to suppress the immune system, it is possible in individual cases that the patient suffering from a serious viral infection.
Several different progressive forms Lupus erythematosus known - such as
Among the special forms of lupus erythematosus is one of the antiphospholipid syndrome, with so-called Antiphospholipid antibodies form: These are autoantibodies that are directed against components of the cell membrane (e.g., anti-cardiolipin antibody).
Activate the blood coagulation system and cause
Women with antiphospholipid syndrome often have miscarriages. These are caused by thrombosis of the placenta (placenta), usually after the third month of pregnancy. Treatment with can often allow a successful pregnancy in these women.
Many sufferers have life-long anticoagulant drugs taking.
Also in systemic lupus erythematosus can develop antiphospholipid antibodies in the course - this is called secondary antiphospholipid syndrome.
Another special form of lupus erythematosus, by drugs arise - Doctors call this "drug-induced", Different drugs come of it as the cause in question. For example, the means procainamide irregular heart beat or blood pressure medicines hydralazine cause lupus erythematosus.
The drug-induced lupus erythematosus runs as compared to the SLE mildFrequently it affects only joints, pleura, and occasionally the pericardium (pericarditis) and disappears after discontinuation of the causative drug normally again. The drug-induced lupus erythematosus is not usually affects the kidneys and nervous system.
In the laboratory, namely antinuclear antibodies (ANA) are used as evidence of lupus disease, but otherwise no other signs of systemic lupus erythematosus. can be the drug-induced lupus erythematosus Instead, so-called Antihiston antibody prove.
For treating these special form are drugs that suppress the immune system strong, usually not necessary.
In addition to the systemic lupus there is also the pure skin lupus (Cutaneous lupus erythematosus), which only affects the skin and there round, sharply demarcated scaly patches forms.
Often not even the typical autoantibodies in the blood can be detected. treating the cutaneous lupus erythematosus in most cases corticosteroids or so-called retinoids. a strong sun protection (SPF 60) protects against UV rays. The prognosis is Cheap.
A lupus erythematosus may also have Newborn concern when autoantibodies of the mother through the placenta into the blood of the child go. As a result, there is skin lesions - but these disappear spontaneously. In two out of 100 cases, however, developed a cardiac defect. For therapy, especially glucocorticoids are eligible - a pacemaker therapy in Newborns may be necessary.
Website of Rheumaliga Hessen e.V. with information on systemic lupus erythematosus
Website of the German Lupus Erythematosus Self-Help Community