Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which the body's immune system begins to attack its own healthy tissues and organs. The pathology is systemic in nature, affecting connective tissue and the microvasculature. As with some other severe systemic conditions requiring a comprehensive approach [5], the clinical picture of SLE is extremely diverse, which often complicates initial diagnosis.
Main Symptoms and Clinical Manifestations
Manifestations of lupus can affect almost any organs and systems. Patients often complain of general weakness, rapid fatigue, unexplained fever, and a sharp decrease in body weight. One of the most recognizable external signs is skin syndrome, in particular, an erythematous rash on the face in the shape of a "butterfly," which intensifies under the influence of sunlight (photosensitivity).
In addition to the skin, the pathological process may involve:
- Cardiovascular system (risk of developing pericarditis and endocarditis).
- Urinary system (lupus nephritis with impaired renal function).
- Nervous system (headaches, cognitive impairments, seizures).
- Blood system (cytopenias, tendency to thrombosis).
Joint Involvement in Systemic Lupus Erythematosus
Articular syndrome is one of the most frequent companions of SLE. Joint involvement is observed in more than 80% of patients with this diagnosis. Clinically, this manifests as arthralgia (migratory joint pain without deformity) or true arthritis.
Features of joint manifestations in lupus:
- Inflammation is often symmetrical and affects the small joints of the hands and wrists, as well as the knee joints.
- Unlike rheumatoid arthritis, lupus arthritis is generally non-erosive, although in rare cases it can lead to reversible deformities (the so-called Jaccoud's arthropathy).
- Pain syndrome can migrate from one joint to another within a few days.
Diagnosis of the Systemic Disease
Timely diagnosis of SLE is based on a comprehensive assessment of clinical symptoms, physical examination data, and laboratory-instrumental studies. Immunological blood testing is of key importance. The overwhelming majority of patients are found to have antinuclear antibodies (ANA), as well as specific markers—antibodies to double-stranded DNA and antibodies to the Sm antigen.
Doctors also evaluate the level of inflammatory markers (ESR, C-reactive protein), complete blood count indicators to exclude anemia or thrombocytopenia. If necessary, a biopsy of the affected tissues (e.g., skin or kidneys) is performed to confirm the autoimmune genesis of the inflammation.
Modern Approaches to Treatment
Treatment of systemic lupus erythematosus is aimed at suppressing the excessive activity of the immune system, stopping inflammatory processes, and preventing damage to vital organs. Therapy is selected strictly individually depending on the severity of the disease.
The treatment regimen usually includes:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve joint pain and reduce inflammation.
- Antimalarial drugs (e.g., hydroxychloroquine), which are basic agents in SLE, improve the prognosis and control skin-joint manifestations.
- Glucocorticosteroids (prednisolone, etc.) for the rapid suppression of severe inflammatory reactions during flares.
- Cytotoxic and immunosuppressive drugs (azathioprine, mycophenolate mofetil [5], cyclophosphamide) when the kidneys and other internal organs are involved in the process.
- Genetically engineered biological drugs that target specific links of the immune response.
Sources
- 1. Atypical Presentation of Classical Hodgkin Lymphoma as Superior Vena Cava Syndrome With Paraneoplastic Eosinophilia and Rash PubMed
- 2. Plasma cell leukemia and hyperviscosity syndrome PubMed
- 3. Hyperprolactinemia as a manifestation of multiple sclerosis attack PubMed
- 4. Sphenopalatine Ganglion Radiofrequency Ablation for Severe Facial Rosacea Manifestations PubMed
- 5. Severe scleroderma colopathy at initial diagnosis of systemic sclerosis in a young man PubMed
Disclaimer: The information presented in this article is for informational purposes only and does not replace an in-person consultation with a rheumatologist. If disease symptoms appear, consult a specialist.