Lupus erythematosus

Lupus erythematosus (also known as systemic lupus erythematosus or SLE) is an autoimmune disorder in which antibodies are created against the patient's own DNA. It is named for the Latin lupus, meaning "wolf," due to the butterfly-shaped rash that the disease classically creates on the cheek which medieval people believed to resemble a wolf bite.

Signs and symptoms

Common initial and chronic complaints are fever, malaise, myalgias and fatigue , Because they are so often seen with other diseases, these signs and symptoms are not part of the diagnostic criteria for SLE, but when occurring in conjunction with other signs and symptoms, they are considered suggestive.

Related Topics:
Fever - Malaise - Myalgia - Fatigue

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Dermatological manifestations

As many as 30% of patients present with some dermatological symptoms (and 65% suffer such symptoms at some point), but only 30% to 50% suffer the classic malar (or butterfly) rash associated with the disease. Patients may present with discoid lupus, thick, red scaly patches on the skin. Alopecia, mouth and vaginal ulcers and lesions on the skin are also possible manifestations.

Related Topics:
Alopecia - Ulcers

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Musculoskeletal manifestations

Patients most often seek medical attention for joint pain, with small joints of the hand and wrist usually affected, although any joint is at risk. Unlike rheumatoid arthritis, SLE arthropathy is not usually destructive of bone, however, deformities caused by the disease may become irreversible in as many as 20% of patients.

Related Topics:
Joint - Rheumatoid arthritis - Bone

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Hematological manifestations

Anemia and iron deficiency may develop in as many as half of patients. Low platelet and white blood cell counts may be due to the disease or a side effect of pharmacological treatment.

Related Topics:
Anemia - Platelet - White blood cell

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Cardiac manifestations

Patients may present with inflammation of various parts of the heart: pericarditis, myocarditis and endocarditis. The endocarditis of SLE is characteristically non-infective (Libman-Sacks endocarditis), and involves either the mitral valve or the tricuspid valve. Atherosclerosis also tends to occur more often and advance more rapidly in SLE patients than in the general population. (Asanuma, et al., 2003) (Bevra, 2003) (Roman, et al., 2003)

Related Topics:
Heart - Pericarditis - Myocarditis - Endocarditis - Mitral valve - Tricuspid valve - Atherosclerosis

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Renal involvement

Painless hematuria or proteinuria may often be the only presenting renal symptom. Because of early recognition and management of SLE, end stage renal failure occurs in less than 5% of patients.

Related Topics:
Hematuria - Proteinuria - Renal failure

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Neurological manifestations

About 10% of patients may present with seizures or psychosis. A third may test positive for abnormalities in the cerebrospinal fluid.

Related Topics:
Seizure - Psychosis - Cerebrospinal fluid

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

T cell abnormalities

Abnormalities in T cell signaling are associated with SLE, including deficiency in CD45 phosphatase,

Related Topics:
T cell - CD45 - Phosphatase

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

increased expression of CD40 ligand.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Also associated with SLE is increased expression of FcεRIγ, which replaces the TCR ζ chain, which is deficient in some SLE patients.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Other abnormalities include:

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

• increased and sustained calcium levels in T cells
• moderate increase of inositol triphosphate
• reduction in PKC phosphorylation
• reduction in Ras-MAP kinase signalling

And deficiencies in:

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

• protein kinase A I activity