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Autoimmune diseases are caused by a loss of tolerance from our immune system that causes it to fire against the patient's own organs. Systemic Lupus Erythematosus is a very common autoimmune disease, with no cure and very severe consequences.

SLE is not an easy illness to describe. Since the autoantibodies that the immune system produce can attack basically any organ, symptoms and signs are quite varied, and most of the times it is very difficult for doctors to diagnose a patient with this disease.

 

Symptomatology

Since autoantibodies target several organs, the symptomatology of the disease is not specific, so doctors have tried to classify it in various types, depending on the symptoms and the organs that are affected.

There are some common symptoms, though, including fever, weight loss, fatigue and muscular and articular pain. Some patients also experience dermatologic problems, such as rashes, skin lesions and ulcers.

Specific symptoms are caused by autoantibodies affecting mainly the musculoskeletal, cardiac, pulmonary, renal, gastrointestinal and neurological systems. A patient with musculoskeletal SLE, for example, would experience arthralgia and arthritis, as well as muscular stiffness. 

Renal SLE is one of the most common manifestations of the disease with more than 50% of SLE patients suffering from renal damage.

What causes SLE?

It is not quite clear why the immune system fails and attacks the patient's own antigens. This disease has been related to genetic factors, but it is also possible that hormones and environmental factors, such as UV radiation and specific viral infections, have a lot to do with the loss of immune tolerance.  

Women in their childbearing years are the ones that are most affected by this disease, with recent data indicating that 90% of new SLE patients are female. The disease is also more prevalent in people of African and Latin descendant.

SLE diagnosis relies mainly in the detection of the autoantibodies and an increase in the count of immune cells, detected in a blood test. This data, along with the evaluation of the signs and symptoms that the patient refers, help the doctor in the diagnosis of the disease.

SLE treatment is based on immunosuppressants, a type of medication that decreases or stops the exacerbated immunological response that the patient experiences. Medications like azathioprine, mycophenolate mofetil, and cyclophosphamide may be used in more severe cases to reduce immune system activity.

Steroids are the most common type of immunosuppressants and are widely used, not only to treat SLE, but also to treat other autoimmune diseases. Of course, the use of steroids represents a risk, because they put the patient into a state of immunosuppression, meaning that its system is switched off and in case of an infection, it won’t be able to respond properly.

Apart from the use of immunosuppressive agents, SLE patients also take medications to control the symptoms caused by the organ damage and to prevent further consequences. For example, they are prescribed with medications to control blood pressure, to prevent and treat osteoporosis, and other agents that help in the prevention of infections, such as antibiotics

Biologic drugs are typically reserved for individuals with moderate to severe lupus who have not responded well to other standard treatments. Belimumab is the first and only biologic drug specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of SLE. It works by targeting a protein called B-lymphocyte stimulator (BLyS) that plays a role in the overactivity of the immune system seen in lupus. Belimumab can be administered by intravenous infusion or subcutaneous injection.

See Also: Systemic lupus erythematosus (SLE)

Nowadays, thanks to an improvement in medications and diagnostic methods, patients with SLE have a better prognosis than a few years ago. Even so, their mortality rate is three times higher than that of the normal population, but hopefully, with the research that is being carried out at the moment on this illness and other similar ones, better ways to treat and improve the quality of patients will be found.

Living with lupus may require ongoing management and lifestyle adjustments, but with proper medical care and self-care, many people with lupus can lead fulfilling lives.