Systemic Lupus Erythematosus: Treatment, Procedure, Cost and Side Effects

Systemic Lupus Erythematosus is a chronic inflammatory autoimmune disease caused when the immune system attacks its own tissues because it confuses it for something foreign. Lupus (SLE) can affect various parts of the body like the joints, skin, kidneys, blood cells, brain, heart, and lungs. Systemic Lupus Erythematosus is characterized by the production of unusual antibodies in the blood.

Symptoms vary from person to person and these can periodically get worse that is flare up and then again improve. Some of the most common symptoms of lupus include painful or swollen joints (arthritis), unexplained periodic fever, and extreme fatigue. A characteristic red skin rash which is called the butterfly or malar rash may appear across the nose and cheeks of the patient. Rashes may also occur on the other parts of the face and ears, upper arms, shoulders, chest, and hands. Many people with lupus are sensitive to sunlight (called photosensitivity) and thus the skin rashes often first develop or worsen after exposure to the sun. People may also show signs of chest pain upon deep breathing, unusual loss of hair, swelling (oedema) in legs or around eyes, mouth ulcers etc. A phenomenon called the Raynaud's phenomenon may occur in some people where the fingers or toes become pale and purple from cold or stress.

While there's no cure for lupus, current treatments of SLE focus on improving the quality of life through controlling symptoms and minimizing flare-ups. The treatments depend on how severe the symptoms are, whether the organs are affected because of it and how much the symptoms are affecting everyday life. For mild symptoms, the treatment mainly addresses to cure the flare-ups and joint pains, lower fatigue, and prevent the occurrence of rashes on the skin. Avoiding the sun is very important as exposure to sun rays enhances rashes on the skin. Use of sunscreens, covering the exposed portions, etc can prevent direct hitting by the sunrays. Creams and drugs are also prescribed by the doctor to cure the flare-ups and provide relief to the patient. For severe symptoms of lupus, Corticosteroids are taken in a higher dosage. Also, medicines that suppress the immune system called immunosuppressants can be taken.

In order to keep the body healthy, the immune system generally battles illnesses and bacteria. When the immune system mistakes the body for something foreign, it assaults it, causing autoimmune illness.

Causes of Systemic Lupus Erythematosus include the following:

• Environmental Factors
• Genetic Factors
• Hormonal Factors

The word lupus has been applied to a variety of immunological illnesses with comparable clinical and laboratory manifestations, but SLE is the most frequent variant of lupus. SLE is a long-term illness with periods of worsening symptoms. With medication, the majority of persons with SLE can lead normal lives.

Summary: The most common causes of systemic lupus erythematosus are genes, hormones, environment, and medications.

In order to diagnose systemic lupus erythematosus and its severity, dermatologists or rheumatologists may prescribe physical examinations. Those exams include blood tests, such as antibody tests and a complete blood count, a urinalysis and a chest X-ray. These tests help to understand the extent of sensitivity to sun, extent of joint pain, fatigue, hair loss, hair thinning et cetera.

There is no cure to this disease, treatment can only help to lessen the symptoms and ease the pain. Treatment begins with lifestyle modifications, including sun protection and diet. Further disease management includes medication such as anti-inflammatories and steroids depending on the type of symptoms and the severity. Medications include Non-steroidal anti-inflammatory drugs, Antimalarial drugs, Corticosteroids and immune suppressants and biologics. Non steroidal anti-inflammatory drugs or NSAIDs include drugs like ibuprofen and naproxen that help to decrease joint swelling, joint pain, fever, and inflammation of the heart and lung linings. Every patient with lupus is given the antimalarial drug called Hydroxychloroquine (Plaquenil) that helps lessen arthritis, fatigue, rashes, and mouth sores. Patients with serious or life-threatening problems of lupus such as kidney inflammation, lung or heart involvement, and central nervous system symptoms need corticosteroids and immune suppressants. These drugs are stronger than the earlier ones that suppress the immune system and include azathioprine (Imuran), cyclophosphamide (Cytoxan), and cyclosporine (Neoral, Sandimmune) et cetera. Belimumab (Benlysta), a type of biomedic can be used for the treatment of active mild SLE in adult patients.

Apart from the medical treatment, treatment also includes maintaining a proper diet, protecting as much from sun rays and definite self care.

A person must immediately consult a doctor when symptoms of systemic lupus erythematosus show up. People with symptoms of a heart attack like chest pain, shortness of breath, nausea or vomiting along with numbness, tingling, or weakness, fever etc call for doctor’s attention. Person with symptoms of rashes, fever, joint pain are eligible for the treatment of lupus.

Symptoms of systemic lupus erythematosus occur periodically. They keep occurring and disappearing only to flare up after a while. If the symptoms have occurred just once and do not follow a periodic pattern, then the person may not need any treatment. One time occurrence may be due to some allergic reactions or infection and does not call for medical assistance of lupus.

Systemic lupus erythematosus can be diagnosed by a physical examination, X-rays, and lab tests. But the symptoms of scoliosis are not specific, therefore, it may take time for you to detect the disease. You should not fully rely on blood tests to diagnose scoliosis.

Summary: There are mainly three ways to diagnose scoliosis which include physical examination, X-rays, and CT scan.

Due to the fact that the causes of lupus are unknown, there is no way to prevent the disease. You can control the condition and keep your child away from things that cause flare-ups. There are a few things you can do to help your child avoid lupus flare-ups, such as:

• Keeping out of the sun.
• Wear sunscreen and protective clothing.
• Getting adequate rest (seven to nine hours each night).
• Take the prescriptions directed by your doctor.

Summary: Although there is no way to prevent lupus flares, knowing what causes them might help a person with the disease be more prepared when they come.

Currently, there is no cure for lupus. Lupus treatment focuses on managing your symptoms and limiting the extent of the disease's harm to your body. You can control the symptoms of SLE, but it can not go away fully.

Summary: Lupus is a chronic illness that does not go away on its own. For a few people, lupus can go into remission and cause no symptoms.

Treatment of SLE and its medicines have an adverse effect on the body if used for a long time or taken in high doses. Medicines for lupus like NSAIDs can cause serious side effects like stomach bleeding or kidney damage. Side effects for antimalarial drugs can include stomach upset and, very rarely, damage to the retina of the eye. Corticosteroids, if used over a long period of time can cause side effects which include weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection. Immunosuppressants are known to cause liver damage, decreased fertility and an increased risk of cancer. Other possible side effects include nausea, diarrhea, allergy and depression.

After the treatment, it is very important for each individual to take immense self care. Medicines and routine check ups must be followed as prescribed by the doctor. It is very vital to protect oneself from the sun rays. Wearing clothes with maximum coverage, sunglasses and masks can prevent the relapse of rashes and additional symptoms of SLE. Maintaining a healthy diet and taking adequate rests and doing exercises properly are some of the vitals each patient must take care of.

Systemic lupus erythematosus is a disease that keeps recurring and is known to have no cure till yet. However, medicines are available that help to remove the flare ups and prevent them from recurring. Also, medicines which help to treat joint pain, chest pain et cetera are used over a period and SLE is brought under control. There is no definitive time period as treatment depends on the type and severity of the disease. Severe life-threatening ones require a longer time for treatment, sometimes with surgeries while mild ones can be cured by taking medicines for the required time span.

Treatment of lupus is a cost incurring procedure. It approximately ranges between Rs. 2,00,000/- to Rs. 10,00,000/- .

Systemic lupus erythematosus is a chronic autoimmune disease and is known to have no permanent cure. This disease can only be treated so lower the pain in the joints, chest and other parts and also to lessen the rashes or flare ups on the skin.

Doctors recommend a balanced and healthy diet to control the symptoms of SLE. Moderate portions of meats, poultry, and oily fish should also be included.

Following a varied, balanced diet may help if you have lupus:

• Inflammation and other symptoms are reduced.
• Keep your bones and muscles healthy.
• Medications' adverse effects should be avoided.
• healthy weight.
• Antioxidant-rich fruits can help to boost your immune system.

Summary: Lupus patients are prone to recurrent infections, so it's critical to include a variety of fresh fruits in your lupus diet, such as blueberries, strawberries, cranberries, cherries, oranges, and pineapples.

You should go for urgent care if you have the following symptoms:

• High temperature
• Headache
• Urine with blood
• Chest pain
• Breathing problems
• Swelling of legs
• Abdominal pain
• Joint ache
• Miscarriage
• Disturbances in vision

Summary: You should immediately consult your doctor if you have a new beginning of fever or a temperature that is substantially higher than normal, excessive bruising or bleeding, confusion or a shift in attitude, or a set of symptoms that includes a strong headache, neck stiffness, and a fever.

Alternative treatments also include medicines and therapies which aim at keeping the disease from progressing. These alternative treatments include stem cell transplantation and biologic treatment. Also, home remedies can help cope up with lupus. Learning stress management, getting enough rest and proper skin care can help to prevent worsening of the condition.

Although data on the impact of physical activity on cardiovascular health in SLE patients is not as robust as in the general population, the best evidence strongly suggests that MVPA improves cardiovascular well-being in SLE patients by lowering body weight, waist circumference, and time to exhaustion while improving maximum oxygen consumption, endothelial function, and insulin sensitivity.

Low physical activity has been linked to increased carotid intima-media thickness and the number of carotid plaques in SLE patients, as well as an increase in pro-inflammatory high-density lipoprotein.

Summary: Low-impact exercises like swimming, walking, yoga, or stretching provide the most and longest-lasting advantages for those with lupus.

The symptoms of systemic lupus erythematosus (SLE) determine how the disease is treated. Fever, rash, musculoskeletal symptoms, and serositis are usually treated with hydroxychloroquine, nonsteroidal anti-inflammatory medications (NSAIDs), and steroids in low to moderate dosages are needed during acute flares.

Methotrexate and azathioprine and mycophenolate have been widely used in lupus of moderate severity, and methotrexate may be effective in persistent lupus arthritis.

High-dose steroids and other immunosuppressive drugs, such as cyclophosphamide, azathioprine, or mycophenolate, are frequently used when the central nervous system or kidneys are involved.

Cyclophosphamide induction therapy has also been used to treat Class IV diffuse proliferative lupus nephritis.

Summary: Mycophenolate, azathioprine and cyclophosphamide are the most widely used medications. Because of its toxicity, cyclophosphamide is only used for 3 to 6 months at a time. In some circumstances. Rituximab (Rituxan) can also be used for the treatment of SLE.