Lupus erythematosus, systemic (disseminated):

Lupus erythematosus, systemic (disseminated)  

The immune system normally fights off dangerous infections and bacteria to keep the body healthy. An autoimmune disease occurs when the immune system attacks the body because it confuses it for something foreign. There are many autoimmune diseases, including systemic lupus erythematosus (SLE).

The term lupus has been used to identify a number of immune diseases that have similar clinical presentations and laboratory features, but SLE is the most common type of lupus. People are often referring to SLE when they say lupus.

SLE is a chronic disease that can have phases of worsening symptoms that alternate with periods of mild symptoms. Most people with SLE are able to live a normal life with treatment.

According to the Lupus Foundation of America, at least 1.5 million Americans are living with diagnosed lupus. The foundation believes that the number of people who actually have the condition is much higher and that many cases go undiagnosed.

Types 

There are several different types of lupus. Systemic lupus erythematosus is the most common. Other types of lupus include:

Cutaneous lupus erythematosus: This type of lupus affects the skin, cutaneous is a term meaning skin. Individuals with cutaneous lupus erythematosus may experience skin issues like a sensitivity to the sun and rashes. Hair loss can also be a symptom of this condition.

Drug-induced lupus: These cases of lupus are caused by certain medications. People with drug-induced lupus may have many of the same symptoms of systemic lupus erythematosus, but it’s usually temporary. Often, this type of lupus goes away once you stop the medication that’s causing it.

Neonatal lupus: A rare type of lupus, neonatal lupus is a condition found in infants at birth. Children born with neonatal lupus have antibodies that were passed to them from their mother — who either had lupus at the time of the pregnancy or may have the condition later in life. Not every baby born to a mother with lupus will have the disease.

Causes

The cause of SLE is not clearly known. It may be linked to the following factors:

  • Genetic
  • Environmental
  • Hormonal
  • Certain medicines

SLE is more common in women than men by nearly 10 to 1. It may occur at any age. However, it appears most often in young women between the ages of 15 and 44.

Symptoms 

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes called flares, when signs and symptoms get worse for a while, then improve or even disappear completely for a time.

The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include:

  • Fatigue
  • Fever
  • Joint pain, stiffness and swelling
  • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
  • Skin lesions that appear or worsen with sun exposure
  • Fingers and toes that turn white or blue when exposed to cold or during stressful periods
  • Shortness of breath
  • Chest pain
  • Dry eyes
  • Headaches, confusion and memory loss

Diagnosis 

To be diagnosed with lupus, you must have 4 out of 11 common signs of the disease. Nearly all people with lupus have a positive test for antinuclear antibody (ANA). However, having a positive ANA alone does not mean you have lupus.

The health care provider will do a complete physical exam. You may have a rash, arthritis, or edema in the ankles. There may be an abnormal sound called a heart friction rub or pleural friction rub. Your provider will also do a nervous system exam.

Tests used to diagnose SLE may include:

  • Antinuclear antibody (ANA)
  • Complete blood count (CBC) with differential
  • Chest x-ray
  • Serum creatinine
  • Urinalysis

You may also have other tests to learn more about your condition. Some of these are:

  • Antinuclear antibody (ANA) panel
  • Complement components (C3 and C4)
  • Antibodies to double-stranded DNA
  • Coombs test - direct
  • Cryoglobulins
  • Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
  • Kidney function blood tests
  • Liver function blood tests
  • Rheumatoid factor
  • Antiphospholipid antibodies and lupus anticoagulant test
  • Kidney biopsy
  • Imaging tests of the heart, brain, lungs, joints, muscles or intestines

Note: Evaluate this condition either by combining the evaluations for residuals under the appropriate system, or by evaluating DC 6350, whichever method results in a higher evaluation.

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