c


Y is one of many disorders of the immune system known as autoimmune diseases

Y  

  


  

Y {an affe{t many parts of the body, in{ uding the joints, skin, kidneys,heart, ungs, b ood vesse s,
and brain.
Y different symptoms,some of the most {ommon ones in{ ude extreme fatigue, painfu or swo en
joints (arthritis), unexp ained fever, skin rashes, and kidney prob ems.




 c

xisturbed immune regu ation that {auses an exaggerated produ{tion of autoantibodies.
=> is the form of the disease that most peop e are referring to when they say ³ upus.´
=> The word ³systemi{´means the disease {an affe{t many parts of the body.
=> The symptoms of SLE may be mi d or serious.
=> A though SLE usua y first affe{ts peop e between the ages of 15 and 45 years, it {an o{{ur
in {hi dhood or ater in ife as we .
Y s a {omp ex disease, and its {ause is unknown. t is ike y that
a {ombination of geneti{, environmenta (sun ight,therma burns) , hormona fa{tors and drug rea{tions
su{hn as hydra azine,isoniazid et{.

Y SLE is a {hroni{ inf ammatory disease be ieved to be a type  hypersensitivity response with potentia
type  invo vement.[13]

Œ
 

Œredisposing fa{tors su{h as hormona , geneti{s,environmenta and drugs. This stimu ates abnorma suppressor t-{e
fun{tion eading to tissue damage and inf ammation o{{urs stimu ating antigens whi{h in turns stimu ates additiona
antibodies and the {y{ e repeats.

Œathogeni{ autoantibodies are the primary {ause of tissue damage in patients with upus. The produ{tion of these
antibodies arises by means of {omp ex me{hanisms invo ving every key fa{et of the immune system.The abnorma
{e u ar and humora response to the formation of these autoantibodies is modu ated by geneti{, environmenta , and


 

n SLE, the body's immune system produ{es antibodies against itse f, parti{u ar y against proteins in the {e
nu{ eus. SLE is triggered by environmenta fa{tors that are unknown.

The immune system must have a ba an{e (homeostasis) between being sensitive enough to prote{t against infe{tion,
and being too sensitive and atta{king the body's own proteins (autoimmunity). From an evo utionary perspe{tive,
a{{ording to Crow, the popu ation must have enough geneti{ diversity to prote{t itse f against a wide range of
possib e infe{tion; some geneti{ {ombination's resu t in autoimmunity. The ike y environmenta triggers in{ ude
u travio et ight, drugs, and viruses. These stimu i {ause the destru{tion of {e s and expose their x A, histones, and
other proteins, parti{u ar y parts of the {e nu{ eus. Be{ause of geneti{ variations in different {omponents of the
immune system, in some peop e the immune system atta{ks these nu{ ear-re ated proteins and produ{es antibodies
against them. n the end, these antibody {omp exes damage b ood vesse s in {riti{a areas of the body, su{h as the
g omeru i of the kidney; these antibody atta{ks are the {ause of SLE. Resear{hers are now identifying the individua
genes, the proteins they produ{e, and their ro e in the immune system. Ea{h protein is a ink on the autoimmune
{hain, and resear{hers are trying to find drugs to break ea{h of those inks
è


  

   
 



 


 
   

 
   
 Π 
 Π  
  

è  
  

    
Y Arthritis-presenting feature, Joint swe ing
·  
Y Butterf y shaped rash a{roos the bridge of nose and {heeks- most fami iar skin manifestation.
Y Exa{erbations are worsen by esions, ora u {ers in bu{{a mu{osa and hard pa ate.
3. !
Î p euritis, {hest pain,
" è 
#
Y n some patients, upus affe{ts the brain or {entra nervous system heada{hes, dizziness, memory disturban{es, vision
prob ems, seizures, stroke, or{hanges in behavior.
 #
Y B ood vesse s may be{ome inf amed (vas{u itis), affe{ting the way b ood {ir{u ates.
6. # anemia, eukopenia (a de{reased number of white b ood {e s), or thrombo{ytopenia
7. è  $ Myo{arditis, endo{arditis, peri{arditis)- most {ommon, risk of atheros{ erosis

x  

Antinu{ ear antibody (A A) testing and anti-extra{tab e nu{ ear antigen (anti-E A) form the mainstay of sero ogi{
testing for SLE.Severa te{hniques are used to dete{t A As.C ini{a y the most wide y used method is indire{t
immunof uores{en{e.The pattern of f uores{en{e suggests the type of antibody present in the patient's serum. A A
s{reening yie ds positive resu ts in many {onne{tive tissue disorders and other autoimmune diseases, and may o{{ur
in norma individua s. Subtypes of antinu{ ear antibodies in{ ude anti-Smith and anti-doub e stranded x A
(dsx A) antibodies (whi{h are inked to SLE) and anti-histone antibodies (whi{h are inked to drug-indu{ed upus).
Anti-dsx A antibodies are high y spe{ifi{ for SLE; they are present in 70% of {ases, whereas they appear in on y
0.5% of peop e without SLE.[10] The anti-dsx A antibody titers a so tend to ref e{t disease a{tivity, a though not in
a {ases.[10] Other A A that may o{{ur in SLE sufferers are anti-U1 R Π(whi{h a so appears in systemi{
s{ erosis), SS-A (or anti-Ro) and SS-B (or anti-La; both of whi{h are more {ommon in Sjögren's syndrome). SS-A
and SS-B {onfer a spe{ifi{ risk for heart {ondu{tion b o{k in neonata upus.[22]

Other tests routine y performed in suspe{ted SLE are {omp ement system eve s ( ow eve s suggest {onsumption by
the immune system), e e{tro ytes and rena fun{tion (disturbed if the kidney is invo ved), iver enzymes, {omp ete
b ood {ount and re{ent y By proteomi{s, we {an dire{t y dete{t proteins as gene produ{ts as we as their a terations
by post-trans ationa modifi{ation and interna abs{ission whi{h are {hara{teristi{a y observed in proteins.[23]

Œrevious y, the upus erythematosus (LE) {e test was not {ommon y used for diagnosis be{ause those LE {e s are
on y found in 50±75% of SLE {ases, and are a so found in some peop e with rheumatoid arthritis, s{ eroderma, and
drug sensitivities. Be{ause of this, the LE {e test is now performed on y rare y and is most y of histori{a
signifi{an{e. the antinu{ ear antibody (A A) test is {ommon y used to ook for autoantibodies that rea{t
against {omponents of the nu{ eus, or ³{ommand {enter,´ of the body¶s {e s. Most peop e with upus test
positive for A A; however, there are a number of other {auses of a positive A A besides upus,
in{ uding infe{tions, other autoimmune diseases, and o{{asiona y as a finding in hea thy peop
 The A A test simp y provides another { ue for the do{tor to {onsider in making a diagnosis.
b ood {ount, urina ysis, b ood {hemistries, and the erythro{yte sedimentation rate (ESR) test {an provide
va uab e information.

 


 Œ
 


 x

Y For peop e with joint or {hest pain or fever, drugs that de{rease inf ammation, {a ed nonsteroida
anti-inf ammatory drugs ( SAxs), are often used. Whi e some SAxs, su{h as ibuprofen and
naproxen, are avai ab e over the {ounter, a do{tor¶s pres{ription is ne{essary for others. SAxs may be
used a one or in {ombination with other types of drugs to {ontro pain, swe ing, and fever.
Y Common side effe{ts of SAxs {an in{ ude stoma{h upset, heartburn, diarrhea,
and f uid retention.

 
 

Y A {ommon antima aria used to treat upus is hydroxy{h oroquine (Πaqueni ) t may be used
a one or in {ombination with other drugs and genera y is used to treat fatigue, joint pain, skin
rashes, and inf ammation of the ungs.
Y ma aria s {an in{ ude stoma{h upset and, extreme y rare y, damage to the retina of the eye.

 è  #

Y The mainstay of upus treatment invo ves the use of {orti{osteroid hormones, su{h as
prednisone (xe tasone), hydro{ortisone, methy predniso one (Medro ), and dexamethasone (xe{adron,
Hexadro ). Corti{osteroids are re ated to {ortiso , whi{h is a natura antiinf ammatory
hormone. They work by rapid y suppressing inf ammation.
Y Corti{osteroids {an be given by mouth, in {reams app ied to the skin, or by inje{tion. Be{ause
they are potent drugs, the do{tor wi seek the owest dose with the greatest benefit.
Y Short-term side effe{ts of {orti{osteroids in{ ude swe ing, in{reased appetite, and weight gain.

d. 



 #

Y For some patients whose kidneys or {entra nervous systems are affe{ted by upus, a type
of drug {a ed an immunosuppressive may be used. mmunosuppressives, su{h as {y{ ophosphamide
(Cytoxan) and my{opheno ate mofeti (Ce Cept), restrain the overa{tive immune system by b o{king the
produ{tion of immune {e s. These drugs may be given by mouth or by infusion (dripping the drug into
the vein through a sma tube). Side effe{ts may in{ ude nausea,
Y vomiting, hair oss, b adder prob ems, de{reased ferti ity,
and in{reased risk of {an{er and infe{tion.

X 
# n some patients, methotrexate (Fo ex, Mexate, Rheumatrex), a disease-modifying
antirheumati{ drug, may be used to he p {ontro the disease.
  


Hea th tea{hing in avoiding exposure
Œrote{ting themse ves by the use of suns{reen and { othing
xietary {onsu tation to prevent risk of atheros{ erosis
nform the monitored in{rease systemi{ invo vement