Lupus erythematosus: history, Types, causes, diagnosis, treatment

Last Updated on March 14, 2023 by Dr. Saqib Mueed

Systemic Lupus erythematosus (SLE) is an autoimmune disease, and it occurs when the immune system attacks the body because it mistakenly took it as something foreign. There are many types of autoimmune diseases and one of them is lupus erythematosus.

Its symptoms are different in among people. It is unusual onset of at15-45 years of age. Different studies on SLE show that it is a syndrome not a single disease.

Early History of SLE

Rogueries Frugardi at first named this term LUPUS in the 1200s. The term Lupus is a Latin word, this word for wolf. As compared to this word is consider as condition of facial rashes look like a wolf bite. In 1800 Austrian doctor Ferdinand was a first Physician which study on LUPUS and its symptoms is extended beyond the skin. After then a French doctor name them into LUPUS erythematosus from erythema which is a Greek word means blush

Frequency

According to the Lupus Foundation of America, there are at least 1.5 million Americans suffering from diagnosed lupus. The exact commonness faces complexity in determination because many of the symptoms of SLE show resemblance to other disorders. It is possible that the condition remains undiagnosed in some affected people. Females have 9 times more chances to become susceptible to disease as compared to males.

Over the past 50 years SLE has become more prevalence in industrialized western countries. The research show that factors like, tobacco used in industrial countries may contribute to difference in disease frequency.

The SLE is not exactly a known its causes, but several factors are relevant to this disease

Genetics

Genetics is linked to be considered as the certain gene is responsible for SLE. Genome-wide associated studies GWAS using hundreds or thousands of single Nucleotide polymorphism SNP. The GWAS is associated with SLE

Environment

Environmental factors also cause SLE. These factors are;

• Physical and emotional pressure
• Viruses
• Drugs
• Ultraviolet rays

About hundred drugs are reported as inducing the lupus syndrome

Sex and hormones

SLE affects the women more as compared to men. Women can face serious symptoms during pregnancy and menstrual cycles. These observations show that female hormone Estrogen probably has a role in causing SLE, however research is needed to prove it.

Types of Lupus

There are 5 different types :

• Complete Lupus erythematosus
• Discoid Lupus erythematosus
• Sub-acute cutaneous Lupus erythematosus
• Drug induced Lupus erythematosus
• Neonatal Lupus erythematosus

Systemic lupus erythematosus

It is a disease that involves the entire body and is the most serious type.

Discoid Lupus

It is the disease in which only rash occur mostly a mark in circular shape occurs without any other symptoms.

Sub-acute cutaneous lupus

It includes the most widespread rash that is often aggravate by exposing to sun. It is relevant to limited form of SLE.

Drug-induced lupus

It is comparatively rare and is induced by drugs such as some anti-seizure drugs and hydrazine. 

It usually causes pain in chest, heart and lungs soreness, undue blood test and rashes.

Neonatal lupus

It mostly present in child when their mothers have abnormalities in blood. But it is not present in those children whose mother have SLE but not have these abnormalities. In this type symptoms vanish after a few months.

Inheritance patterns of lupus        

SLE and other diseases related to it are transferred in next generations, but the transferring mechanisms are not known. When the disease is transferred there are chances that the person will be susceptible to disease but it’s not compulsory that the person will develop the disease. It is observed that there are mutations present in the genes of persons transferring the SLE, but they do not show signs of the disease.

Organs affected by lupus erythematosus

Joints

Joint pain is most common in Lupus erythematosus. Inflexibility and severe pain in joints occur especially at dawn. There is no time limit for it, this joint pain may exist for days, weeks or for years.

 Skin

Troubles to skin occur commonly during this disease. Redness occurs at face and the marks may develop due to this disease.

When exposed to sun the rashes can be increased. And chances increased that disease will become panic. The scars are generally circular in shape that formed during this disease. The disease may result in the formation of vesicles on the body.

Kidney

When the lupus occurs it also led to kidney problems. Kidney pain occurs and swelling occurs in kidneys which may lead to kidney problems.

Blood

When lupus occurs in a person then person also faces blood complications. The number of erythrocytes, white cells and blood platelets decreases.

Person having lupus tends to develop clots of blood. These clots of blood are formed in lower limbs, brain and lungs. When blood clots are formed in the body then it leads to the formation specialized antibodies that heighten the rate of blood to clot. Blood tests are performed for these antibodies.

Spinal cord and Brain

Spinal cord and brain are usually not affected by this disease. When it occurs, it may lead to coldness, sadness, seizure and trauma. When the infection occurs in spinal cord it leads to failing of body systems.

How the lupus erythematosus diagnosed                                 

To check the disease bodily exams will be performed. This includes.

• Rash formation due to sunlight
• Sore membrane of mucous especially in nose and oral cavity
• Puffiness of joints of lower limbs and elbows
• Loss of hair
• Shrinking of hair
• Asymmetrical heartbeats

Blood tests are not more helpful in determining the disease, but the diagnosis can be performed by;

• X-ray of chest area
• Urine tests
• Antibody test

You should have to go to a doctor who is specialized in treating arthritis and other diseases related to it

Treatment for lupus erythematosus

The treatments vary from person to person so treatment is made according to the situation.

• Medicines to reduce inflammation are used
• Special creams or tubes are used for scars
• To treat joint problems drugs are recommended
• Drugs for modifying the disease are used in rigorous cases
• The doctor made the changes in diet and lifestyle to treat the disease.
• Doctor also made suggestion to eat the special food to reduce the symptoms of disease.

Person suffering from the lupus have to made special care because as disease proceeds it may lead to the weakness and pores in bones. So, preventive measures are necessary.

Complications due to lupus erythematosus

• Complications always occur due to the disease and changes occur due to the proceeding disease
• Clots of blood and swelling occur in the veins
• Bulge of the heart
• Attack to heart
• Changes in behavior
• Lessen functioning of kidneys

During gestation, SLE has bad effects on the body of mother. So, to consult a doctor is necessary for the avoidance of disease.

• The medicines made from microorganisms, animals and human are used.
• The drugs having role in suppressing the immune system strength are used
• Medicines treating arthritis and inflammation are used
• Medicines reducing longing and allergic reactions are used

Life with lupus erythematosus

Although people have lupus it does not mean that they have not normal life expectancy

It is difficult to live with such type of disease but special measures are taken to live a healthy life. As different medicines are used to treat the disease these may have side effects so proper consultation with doctor is very important.

Although medication plays a great role in treating lupus but other precautionary measures are also important to ensure better quality of life.

Exercising     

Proper exercise is very important to live a healthy life. Proper exercise especially morning walk plays a great role in maintaining health. It prevents us from stress and made our body fit and healthy.

Leave Smoking

Smoking is injurious to our health. Smoking leads to many infectious diseases especially it leads to heart and lung diseases. Due to smoking risk of increasing mucous level in the pulmonary arteries increases. So, it is compulsory to quit the smoking to prevent lupus.

Taking Rest

Resting sooth pain and reduces sudden outbursts.

Staying away from sun exposure

Keeping away from the sunlight provides protection from harmful radiations from the sun. Constant exposure to sun causes dark marks on the body.

Vitamin D

Vitamin D is most important for our body. It is very essential for our bones.

Cleaning of hands at regular intervals

When hands are washed regularly it helps a lot in removing germs and ultimately prevention occurs from infectious diseases.

Supervising pain

Different ways are there through which pain is controlled. Proper bathing, proper exercising and recommended drugs are proved effective in this condition.

Maintaining mental health

Proper mental health by consulting psychiatrist and making proper diet plans.

Pregnancy and lupus erythematosus

Women suffering from lupus have probability of becoming pregnant, but it is suggested that the woman must consult doctor before such type of plans. When lupus is at lower stage then you are at advantage for these plans. But when the disease becomes, severe women are suggested to avoid baby because lupus had bad effects especially on brain, lungs and kidneys.^[1]https://www.eular.org/myuploaddata/files/sample chapter20_mod 17.pdf^[2]https://ard.bmj.com/content/annrheumdis/80/1/14.full.pdf^[3]Systemic Lupus Erythematosus – StatPearls – NCBI Bookshelf (nih.gov)^[4]2016-12-23-autoimmune-cunha.pdf (rimed.org)

Reviewed by:

Dr. Shahid Bukhari

MBBS, FCPS (Medicine)

Ex. Registrar DOW Medical College Karachi

Medical Officer Aga Khan University Hospital Karachi

Our reviewers’ details, Click Here