Lupus

25 July 2017

Lupus or when the immune system goes awry

Lupus, what is it?

Inflammatory disease, Lupus, also called systemic lupus erythematosus (SLE) or lupus erythematosus (SLE), is part of the family of chronic autoimmune diseases that have the distinction of seeing the immune system attacking and defending against the patient’s own body; the human body facing overactive lymphocytes. The body’s cells are targeted and destroyed; lupus can affect every organ in the body, whether it is the heart, the kidneys, the skin but also the brain … Please note that if lupus affects both adults and children, it is mostly women (aged between 15 to 40) who suffer most, the cause being hormonal (estrogen in women, which is why pregnant women are particularly affected), but also due to the X chromosome, the cells of women are carriers of two X chromosomes (one X chromosome carrying the immune system genes, immune system that goes awry in case of lupus).

Normally, the antibodies (proteins) that are designed to protect the body from all external attacks are fixed on the latter; these antibodies are called antigens that help blocking these attacks. Or in case of lupus, there are mistakenly attacks by the body of all the cells and tissues that have not yet been labeled by these specific antigens, the latter normally helping the body to identify all the elements that do not belong to the body.
In case of Lupus, the antibodies called autoantibodies produce inflammation of healthy cells and tissues thus leading to the symptoms of lupus.

Known causes of the Lupus onset

The causes of lupus onset are still unclear for the medical world, although hereditary factors and environmental factors seem to be implicated: tobacco, UV rays, pesticides, certain viruses such as infectious mononucleosis (Epstein-Barr virus) but also certain medications (it is called induced Lupus) … More precisely, there is a combination of factors that trigger the onset of lupus in an individual.

Symptoms of Lupus

We can distinguish several types of lupus that are accompanied by specific clinical signs, the main type that affects approximately 70% of patients is a very specific skin condition that tends to worsen in the sun.
We talk about :

  • discoid Lupus: it is characterized by lesions in the skin, a rash that is characterized by a disk-shaped lesion of the face, the scalp, the torso or the extremities. The internal organs of the body are not affected but the scars that remain after these lesions are very common.
  • Systemic Lupus Erythematosus (SLE): if it is not treated, it can affect every organ in the body, complications can be severe with life-threatening condition for the patient, by example the organ damage can lead to coughing, difficulty in breathing (impairment of lungs) or arrhythmia (impairment of the heart).

As every individual is unique (which does not facilitate the doctor’s diagnosis), it is reflected in:

  • Inflammatory episodes in the tendons, joints and muscles
  • Fever
  • Unexplained fatigue
  • Increase in the size of lymph nodes (lymphadenopathy)
  • Inexplicable hair loss
  • Unexplained weight loss
  • Nausea, vomiting
  • Headaches
  • Photosensitivity
  • Butterfly-shaped rash on the cheeks and on the nose (also called “vespertilio” erythema)

All these symptoms can disappear and be in remission for many years; Lupus is then overshadowed until a new symptom onset (Lupus is a chronic disease).

The blood test will then help the doctor to confirm the diagnosis of lupus following the occurrence of these symptoms.

Lupus Screening by blood tests

The laboratory blood test can detect the possibility of Lupus (and can be helpful not to confuse it with another disease) but also monitor and evaluate its progress, all this in different ways:

  • By the detection of abnormalities such as anemia through the decrease in the amount of red cells in the blood, decrease in the amount of white blood cells in the blood (lymphopenia) or low platelets count (thrombocytopenia)
  • By the detection of high levels of immunoglobulin
  • By the detection of a higher settling velocity than normal
  • By the detection of the presence of specific antibodies, anti-nuclear auto-antibodies, but also additionally by the presence of anti-DNA autoantibodies, anti-SSA / SSB, anti-Sm, antiphospholipid, these antibodies attacking the nucleus of healthy cells. The mere presence of these antibodies being the signal for the occurrence of an immune reaction that acts against the patient’s own cells.
  • By the detection of kidney disease by the determination of urea and creatinine

In addition, further investigations will allow the monitoring or ability to confirm the disease:

  • Skin and / or renal biopsy
  • Urinalysis to check the kidney function
  • A chest X-ray to monitor the heart and lungs together with an electrocardiogram
  • MRI (neurological damage)

This list is obviously not exhaustive.

Screening is essential to develop a drug treatment that reduces and even suppresses the symptoms of Lupus while avoiding irreversible damage to vital organs. The overall goal is a reduction in the immune system hyperactivity as quickly as possible. The patient’s living comfort is improved significantly but the disease is not cured, as it is a chronic disease.

The treatments are based on the prescription of anti-inflammatory drugs, corticosteroids, immunosuppressants, on the treatment of skin lesions (based on creams) but also on a preventive aspect (smoking cessation, protection against the sun, a healthy and active lifestyle).

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