S YSTEMIC L UPUS E RYTHEMATOSUS (SLE)

INTRODUCTION

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can be fatal; however, with recent medical advances, fatalities are becoming increasingly rare. The immune system attacks the bodys cells and tissue, resulting in inflammation and tissue damage.
SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. Lupus can occur at any age, and is most common in women, particularly of non-European descent.

EPIDEMIC

About 90% of SLE sufferers are women while about 10% are men and children. About 90% of women with SLE are in their childbearing years, within the range of 15 to 50 years old. Ratio of SLE sufferers : In the West, among Afro-Carribeans 1 in 250-500 people USA - 1 in 2,000 people China - 1 in 1,000 people In Malaysia, it is estimated that more than 10,000 people have been diagnosed with SLE over the past 30 years. However, this number may be only the tip of the iceberg. The Malaysian SLE Association believes that there are many more SLE sufferers in Malaysia who have not been diagnosed.

S TATISTICS BY C OUNTRY FOR L UPUS

Country/Region USA Czech Republic United Kingdom Malaysia China Extrapolated Prevalence 1,511,461 6,414 310,216 121,071 6,685,245 Population Estimated Used 293,655,4051 1,0246,1782 60,270,7082 23,522,4822 1,298,847,6242

About prevalence and incidence statistics in general for Lupus: The word 'prevalence' of Lupus usually means the estimated population of people who are managing Lupus at any given time

ETIOLOGY

The cause(s) of lupus is currently unknown, but there are environmental and genetic factors involved.
Some environmental factors which may trigger the disease include :

Infections
antibiotics (especially those in the sulfa and penicillin groups) ultraviolet light extreme stress certain drugs hormones.

SYMPTOMS
SYMPTOMS Achy joints / arthralgia PERCENTAGE (%) 95

Fever of more than 100 degrees F / 38 degrees C

Arthritis / swollen joints Prolonged or extreme fatigue Skin Rashes Anemia Kidney Involvement

90
90 81 74 71 50

Pain in the chest on deep breathing / pleurisy

Butterfly-shaped rash across the cheeks and nose Sun or light sensitivity / photosensitivity Hair loss Abnormal blood clotting problems Fingers turning white and/or blue in the cold Mouth or nose ulcers

45
42 30 27 20 17 12

S YSTEMIC L UPUS E RYTHEMATOSUS

butterfly rash

Skin rashes Finger turns blue

DIAGNOSIS
Criterion Malar Rash Discoid Rash Photosensitivity Oral Ulcers Arthritis Rash over the cheeks Red raised patches Reaction to sunlight, resulting in the development of or increase in skin rash Ulcers in the nose or mouth, usually painless Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed) Pleuritis or pericarditis (inflammation of the lining of the lung or heart) Definition

Serositis

Renal Disorder

Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)

DIAGNOSIS
Criterion Neurologic Disorder Hematologic Disorder Definition Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects Hemolytic anemia , leukopenia , lymphopenia or thrombocytopenia. The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it. Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it. Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL).

Antinuclear Antibody Immunologic Disorder

Adapted from: Tan, E.M., et. al. The 1982 Revised Criteria for the Classification of SLE. Arth Rheum 25: 1271-1277.

BLOOD TESTS IN THE DIAGNOSIS OF SLE

The anti-nuclear antibody test (ANA) to determine if autoantibodies to cell nuclei are present in the blood. The anti-DNA antibody test to determine if there are antibodies to the genetic material in the cell . The anti-Sm antibody test to determine if there are antibodies to Sm, which is a ribonucleoprotein found in the cell nucleus .

Tests to examine the total level of serum (blood) complement (a group of proteins which can be consumed in immune reactions), and specific levels of complement proteins C3 and C4.

TREATMENTS

Drug therapy

nonsteroidal anti-inflammatory drugs and antimalarials

Disease-modifying antirheumatic drugs (DMARDs) Immunomodulating Drugs

Anticoagulants

Lifestyle changes

avoiding direct sunlight, covering up with sun-protective clothing, and using strong UVA/UVB sunblock lotion can also be effective in preventing photosensitivity problems. Weight loss is also recommended in overweight and obese patients to alleviate some of the effects of the disease, especially where joint involvement is significant.

REFERENCES

http://www.lupus.org/webmodules/webarticlesn et/templates/new_aboutintroduction.aspx?articl eid=75&zoneid=9

http://en.wikipedia.org/wiki/Systemic_lupus_ery thematosus
http://www.lupusmalaysia.org/e/what-is-sle/

http://www.cureresearch.com/l/lupus/statscountry.htm