Lupus causes the disease. Systemic lupus erythematosus symptoms and how it is treated

Date: 01.07.2020

One of the most serious diseases is systemic lupus erythematosus (SLE). It is characterized by autoimmune inflammation with many other symptoms. This disease is dangerous for its complications. With it, organs of many body systems suffer, but most of all problems occur with the musculoskeletal system and kidneys.

Description of the disease

Lupus develops due to a malfunctioning immune system, in which antibodies are formed that negatively affect healthy cells and tissues. This leads to negative changes in blood vessels and connective tissue.

The term lupus was once used to refer to red patches that appear on the face. They resembled the bites of wolves or she-wolves, which often attacked people and sought to get to unprotected parts of the body, like the nose or cheeks. Even one of the symptoms of the disease is called "lupus butterfly". Today the name is associated with the cute word "wolf cub".

Autoimmune disease develops against a background of hormonal disorders. An important role is played by the increased amount of estrogens, therefore, lupus is most often observed in the fair sex. The disease is usually diagnosed in adolescent girls and young women under 26 years of age.

In men, SLE is more severe, and remissions are rare, but their disease occurs 10 times less often, since androgens have a protective effect. Symptoms may be more pronounced in different genders. For example, in women, joints are more affected, and in men, the central nervous system and kidneys.

Lupus can be congenital. SLE symptoms appear in children during the first years of life.

The disease develops in waves, with periods of exacerbations and remissions alternating. SLE is characterized by an acute onset, rapid progression and early spread of the disease process. In children, the symptoms of systemic lupus erythematosus are the same as in adults.

Causes of occurrence

More than one cause affects the onset and development of lupus. It is due to the simultaneous or sequential influence of several factors at once. Scientists were able to find the main causes of the disease:

Scientists do not include the last factor in the general causes of SLE, but they believe that the patient's relatives are at risk.

Stage classification

SLE has a wide range of symptoms. During the illness, exacerbations and remissions occur.

Lupus is classified according to the forms of its course:

The stages of the disease are also distinguished. The minimum is characterized by mild headaches and joint pains, high fever, ailments and the first manifestations of lupus on the skin.

In the moderate phase, the face and body are severely affected, and then the vessels, joints and internal organs. At a pronounced stage, the work of various body systems is disrupted.

Symptoms of the disease

At the onset of SLE, skin lesions concern only 20% of patients. In 60% of patients, symptoms appear later. For some people, they don't appear at all. Signs of the disease can be seen on the face, neck and shoulders. On the back of the nose and cheeks, a rash appears in the form of reddish, scaly plaques, reminiscent of wolf bites in the past. It is called the "lupus butterfly" because it looks like this insect. The patient's skin sensitivity to ultraviolet light increases.

Some people with lupus lose hair in the temporal areas and break their nails. Mucous membranes are affected in 25% of cases. Lupus cheilitis appears, characterized by dense edema of the lips in the form of grayish scales. Small ulcers of red or pink color may appear along the border. In addition, the oral mucosa is affected.

Lupus affects various body systems:

Common symptoms of lupus in women and men are CNS lesions. The disease is characterized by rapid fatigue, weakness, decreased memory and performance, deterioration in intellectual abilities. A person suffering from an autoimmune disease has irritability, depression, headaches, etc.

The patient may have a decrease in sensitivity. Seizures, psychosis, and seizures also develop with lupus.

Diagnostic methods

Differential diagnosis can be used to confirm the diagnosis of lupus. It is done because each manifestation speaks of the pathology of a particular organ. For this, a system developed by the American Rheumatological Association of Specialists is used.

The diagnosis of SLE is confirmed with four or more of these symptoms:

After making a preliminary diagnosis, the patient is referred to a specialist with a narrow focus, for example, a nephrologist, pulmonologist or cardiologist.

A detailed examination includes a thorough history taking. The doctor needs to know about all the patient's previous illnesses and the methods of their treatment.

Treatment methods

Medical therapy for a patient with SLE is selected individually. Treatment methods depend on the stage and form of the disease, the symptoms manifested and the characteristics of the patient's body.

It will be necessary to hospitalize a person suffering from lupus only in certain cases: a constant temperature above 38 degrees, a decrease, and also if a stroke, heart attack or severe central nervous system damage is suspected. If the clinical signs of the disease progress, then the patient will also be referred to hospitalization.

Lupus erythematosus treatment includes:

Hormonal creams and ointments eliminate peeling and burning sensations that have arisen in certain areas of the skin.

Particular attention is paid to the patient's immune system. During remission, the patient is treated with immunostimulants in combination with vitamin complexes and physiotherapy procedures.

Comorbidities and complications are also taken into account. Since the first place in cases of mortality is occupied by kidney problems, they must be constantly monitored for SLE. It is necessary to treat lupus arthritis and heart disease in a timely manner.

Dandelion P acts as a natural chondroprotector that prevents joints from collapsing and restores cartilage tissue. It lowers blood cholesterol and detoxifies the body. Dihydroquercetin Plus is used to strengthen the walls of blood vessels. It also eliminates bad cholesterol and improves blood microcirculation.

People with lupus are prescribed foods to help ease the symptoms of the disease. The patient should be given preference to food that can protect the brain, heart and kidneys.

A person who has been diagnosed with lupus must be consumed in sufficient quantities:

Protein will help fight the disease. Doctors recommend eating veal, turkey and other dietary meats and poultry. The diet should include cod, pollock, pink salmon, tuna, squid, low-fat herring. Fish contains omega-3 unsaturated fatty acids that are vital for the normal functioning of the brain and heart.

You need to drink at least 8 glasses of clean water per day. It improves the functioning of the gastrointestinal tract, controls hunger and improves overall health.

Some foods will need to be abandoned or limited in your diet:

Fatty meals. Foods that contain a lot of butter or vegetable oil increase the risk of exacerbations from the cardiovascular system. Due to fatty foods, cholesterol is deposited in the vessels. Because of it, acute myocardial infarction can develop.
Caffeine. This component is present in large quantities in coffee, tea and some other drinks. Because of caffeine, the stomach lining is irritated, the heart beats more often and the nervous system is overloaded. If you stop drinking cups of drinks with this substance, you will be able to avoid the occurrence of erosion and the duodenum.
Salt. Food should be limited as it overloads the kidneys and raises blood pressure.

People with lupus erythematosus should give up alcoholic beverages and cigarettes. They are already harmful in themselves, and in combination with drugs can lead to disastrous consequences.

Patient predictions

The prognosis will be favorable if the disease is detected at an early stage of its development. At the very beginning of the course of lupus, tissues and organs are not severely deformed. A mild rash or arthritis can be easily controlled by a specialist.

With advanced forms of SLE, aggressive treatment with large doses of various medications will be required. In this case, it is not always possible to determine what brings more harm to the body: large dosages of drugs or the pathological process itself.

Lupus erythematosus cannot be completely cured, but this does not mean that you cannot live happily with it. If you seek medical help in time, you can avoid serious problems. When following medical recommendations and the correct lifestyle, the patient does not have to limit himself in many ways.

Complication and progression of the disease is possible if a person has chronic infectious diseases. Frequent vaccinations and colds also have an impact. Therefore, such a patient needs to take care of his health and avoid factors that negatively affect his body.

Preventive actions

Prevention of SLE will help prevent recurrence of the disease and stop further progression of pathological processes. Secondary measures promote timely and adequate treatment of lupus.

Patients should regularly undergo dispensary examinations and consult a rheumatologist. The drugs must be taken in the prescribed dosage for a certain period of time.

It will be possible to maintain the state of stable remission with hardening, therapeutic exercises and regular walks in the fresh air. The patient must observe the regime of work and rest, avoiding unnecessary psychological and physical stress. Adequate sleep and proper nutrition are important not only for improving the condition in case of illness, but also for the normal functioning of the whole organism.

If a person has isolated areas of affected skin, it is necessary to find out if any of his relatives have been diagnosed with the disease. A person with lupus should avoid ultraviolet light and stay out of direct sunlight. In the warm season, you need to use special ointments that can protect the skin from the negative effects of the sun. A person with SLE needs to give up bad habits that only exacerbate his condition.

Does not always bring the expected result. First of all, because it is rarely possible to recognize the causes of this autoimmune disease that affects blood vessels and connective tissues. Specialists from various medical fields are studying this problem. It is almost impossible to establish a diagnosis without high-quality diagnostics, since doctors are usually confused by secondary diseases that develop against the background of systemic lupus erythematosus. This article is devoted to the symptoms and treatment of this ailment.

Causes of the disease

Judging by most of the photos, women are more likely to need treatment for lupus erythematosus. This fact is also indicated by medical statistics: men suffer from this disease much less often, the disease is rarely diagnosed among young guys.

Some researchers argue that hereditary predisposition is the main cause of lupus erythematosus. Treatment of a disease provoked by mutated genes, in their opinion, will not bring a stable result. Violations that have arisen at the genetic level negatively affect the immune system, forcing it to act not in defense, but against the body.

Other experts believe that the main factor in this pathology is infection with a viral infection. The arguments for this version are numerous laboratory experiments and tests carried out by scientists in recent years. It is believed that a virus that has entered the body stimulates the production of "wrong" antibodies: instead of destroying the pathogenic microbiota, they begin to actively fight their own tissues. The need for treatment of lupus erythematosus is difficult to overestimate. Without appropriate therapy, the disease can lead to the appearance of dangerous diseases of the nervous, respiratory, cardiovascular systems, and hematopoietic organs.

There is another form of lupus erythematosus - discoid. The treatment of this pathology differs from the therapy that is used when systemic lupus is diagnosed. The discoid form is currently recognized as an infectious-allergic autoimmune disease, despite the fact that the pathogenesis of the disease is not fully understood. In the blood of patients with this disease, an excessive amount of gamma globulins is determined. At the same time, in the conclusions of specialists on laboratory studies of the bone marrow, it is often mentioned about the presence of specific pathological cells. Such patients need urgent treatment - discoid lupus erythematosus inhibits the functions of the adrenal cortex, causes disturbances in the reproductive, endocrine systems, metabolic processes.

How does it manifest externally

Diseases develop according to the same scenario for all patients, regardless of its true cause. The symptoms of systemic lupus erythematosus and the treatment of this disease largely depend on the individual characteristics of the patient's body, his age, the presence of additional chronic diseases and other factors.

The severity of signs of pathology affects not only the well-being, but also the patient's lifestyle. The patient's condition deteriorates rapidly without proper treatment. Symptoms of systemic lupus erythematosus that occur early in the development of the disease:

Inflammation of small joints. Outwardly, the disease resembles arthritis, which is characterized by swelling, severe pain in the arms and legs, while the hands are deformed, swollen and reddened. Large joints (hip, knee) are much less likely to be involved in the pathological process.
Severe osteoporosis. Calcium entering the body is practically not absorbed. Experts learn about the deficiency of its content in the bone tissue from an X-ray.
A rash on the epidermis is another symptom of lupus erythematosus in adults. Treatment of the rash is usually not required. Changes in the skin become visually noticeable after the patient's exposure to the sun. As the disease progresses, small foci grow, merging into a single large spot, covered with scales of peeling skin. The epidermis becomes thinner, small scars form on it, which are later quite difficult to eliminate.

In addition to damage to joints, cartilage and bones, patients often complain of low-grade fever, fatigue that does not go away even after rest, general weakness, and rapid weight loss. With lupus erythematosus on the cheeks, nose, scalp, erythema may appear.

In addition to external symptoms, which give the patient more psychological discomfort than physical, it is worth noting other clinical signs of this autoimmune disease. These include manifestations of myocarditis, pericarditis, pleurisy - inflammatory processes occurring in the heart and lungs. Against the background of these disorders, arrhythmia occurs, chronic heart failure develops. Often, pathologies are accompanied by disorders of the central nervous system and the gastrointestinal tract.

Diagnostic methods

The treatment of systemic lupus erythematosus must be preceded by a comprehensive examination. The "standard" triad of manifestations in a patient will be quite enough for the doctor to suspect an illness. This is about:

rashes on the skin;
inflammatory processes in the heart, lungs;
osteoporosis and joint damage.

Without laboratory and instrumental studies, it is impossible to confirm the diagnosis and begin treatment. Early diagnosis of lupus erythematosus includes:

Clinical blood test. The acute stage of the disease is characterized by an increase in the erythrocyte sedimentation rate (ESR), a decrease in leukocyte and lymphocyte counts. A patient with lupus erythematosus is sometimes found hemolytic or hypochromic anemia, which is caused by chronic inflammation, intoxication, internal bleeding.
General urine analysis. In patients with lupus, protein, blood, leukocytes in varying degrees of severity are detected in the urine, indicating a change in the functioning of the kidneys.
Blood chemistry. Such a study is carried out, as a rule, to objectively assess the degree of functionality of internal organs and systems.

In addition to laboratory methods, instrumental diagnostic methods are no less important:

chest x-ray and CT;
EchoCG to detect pulmonary hypertension;
electrocardiogram, Holter ECG monitoring;
Ultrasound of the abdominal organs, esophagogastroduodenoscopy;
electroencephalography, CT, MRI of the brain.

Basic principles of therapy

Just a few decades ago, the prognosis for people with lupus was not reassuring. But in recent years, doctors have made a huge breakthrough. Provided that early diagnosis, prescription and administration of effective medications are carried out, patients acquire good chances to lead a fulfilling life.

The treatment regimen for lupus erythematosus with medicines is compiled purely individually for each patient, depending on the course of the disease, the staging of the disease, the severity of the symptoms. Therapy is carried out on an outpatient basis, but the patient may need hospitalization if:

for a long time, there is a persistent fever, which is not knocked down by antipyretic drugs;
he has a pre-infarction or pre-stroke condition, suspected pneumonia, dangerous disorders of the central nervous system;
the patient's consciousness is depressed;
the level of leukocytes in the blood is rapidly falling;
other symptoms progress.

Treatment often involves the participation of highly specialized specialists (cardiologist, nephrologist, pulmonologist, rheumatologist). The main goal of therapy for this disease is not only to eliminate symptoms, but also to maintain the full vitality of the body. At the moment, the life expectancy of patients with this autoimmune disease is much longer than what could have been achieved, for example, 20 or 30 years ago. Success depends to a large extent on the adequacy of therapy and the patient's responsible approach to the implementation of all medical prescriptions.

Hormone therapy

Since the pathology is based on a pathological autoimmune reaction of the body, it is possible to achieve more or less stable results and improve the patient's condition only by suppressing it. Treatment of lupus erythematosus in adults involves the use of drugs from several groups. One of them is hormone-containing drugs.

It is believed that glucocorticosteroids have helped make a huge leap forward in the treatment of lupus erythematosus. Hormonal drugs are excellent at fighting inflammation and suppressing the immune system. According to statistics, long before the introduction of corticoids into the therapeutic regimen, patients did not even overcome the five-year survival threshold after diagnosis.

Hormones can help with sudden exacerbations of the disease that negatively affect the functionality of the kidneys. However, corticosteroids have a host of side effects, including bad mood, weight loss, and endocrine disruption. In addition, hormone-containing drugs with prolonged use are addictive, they also increase the risk of bone damage and the development of osteoporosis, arterial hypertension, diabetes mellitus. Steroids used to treat lupus erythematosus are taken by mouth.

The main indicator of the effectiveness of hormone therapy is the duration of remission when maintained with small doses of drugs, a decrease in the activity of the pathological process, and a stable satisfactory state of health. The most common corticosteroid drug prescribed for systemic and discoid lupus erythematosus is Prednisolone. At the stage of exacerbation, it is prescribed in a daily dosage of no more than 50 mg per kilogram of body weight of an adult patient. During the period of remission, the dose is reduced to 15 mg.

For some reason, hormone treatment is ineffective. In particular, the effect of drugs is neutralized if the tablets are taken irregularly. Steroids will not be beneficial even if the dose was incorrectly selected or the treatment was started too late.

Side effects from hormones

Since lupus is predominantly female, many of them worry about the likely side effects of these steroid medications. More often, patients are worried about the risk of possible weight gain. It is important to understand here that without hormone treatment, the prognosis will not inspire optimism. In addition, very often fears and speculations about taking hormones are exaggerated. Many people have to take steroids for decades in a row, and not everyone develops side effects.

In addition to weight gain, the more likely complications after taking steroids can be considered:

peptic ulcer of the gastrointestinal tract;
increased risk of infection;
the development of arterial hypertension;
increased blood sugar levels.

Cytostatics

According to reviews, the treatment of lupus erythematosus is not complete without the use of drugs of this pharmacological group, but they are prescribed in combination with hormones in the event that the use of corticosteroids alone is not enough for a positive dynamics of recovery. Cytostatics, like corticoids, have immunosuppressive properties. The doctor makes a decision on the use of these funds in case of lupus with a progressive course, as well as in the case of diagnosing nephritic or nephrotic syndromes, indicating the involvement of the kidneys in the pathological process.

Cytostatics can serve as an alternative method of treatment when the effectiveness of isolated hormone therapy is low or the need to reduce the dose of steroids caused by their poor tolerance or the sudden development of side effects. Often, patients with lupus are prescribed "Azathioprine", "Cyclophosphamide", "Imuran".

Non-steroidal anti-inflammatory drugs

Such drugs are prescribed to patients with severe inflammation, swelling, and joint pain. Diclofenac, Indomethacin, Aspirin, Paracetamol, Ibuprofen helps to minimize the severity of these symptoms. Taking drugs from the NSAID group can take longer than hormones. In addition, they have fewer contraindications and side effects. The course of treatment with these agents continues until the articular syndrome disappears and the body temperature stabilizes.

The choice of a drug or a combination of drugs depends on each individual case. For some patients, non-steroidal anti-inflammatory drugs alone are sufficient to control the course of the disease and suppress symptoms.

Traditional therapy

With the help of unconventional methods of treating lupus erythematosus, you can achieve good results. Quite often, in addition to drug therapy, experts advise herbal teas and homemade recipes. Alternative treatment of lupus erythematosus is a good alternative to conservative in the presence of contraindications, but, despite this, it is impossible to self-medicate and mindlessly take all the means in a row. Before resorting to non-traditional methods of therapy, it is necessary to consult with your doctor.

Some medicinal herbs have immunomodulatory and anti-inflammatory properties, other plants have a diuretic and wound healing effect, stimulate the production of hormones in the body, and reduce high blood pressure. With a competent combination of components, it is possible to reduce the severity of symptoms and enrich the body with vitamins and essential trace elements. Several recipes for effective folk remedies for the treatment of lupus erythematosus are especially popular.

Herbal infusion

To prepare this tool you will need:

motherwort (2 tbsp. l.);
St. John's wort (2 tbsp. l.);
celandine (1 tbsp. l.);
rosehip (3 tbsp. l.);
white willow bark (1 tbsp. l.);
birch buds (2 tbsp. l.);
burdock root (1 tbsp. l.).

The mixture must be thoroughly grinded by passing it through a meat grinder or coffee grinder, mix and send to a dark, dry place. Before each meal, it is necessary to prepare a fresh infusion, which will require 10 g of this herbal collection. Raw materials are poured with 500 ml of boiling water and, covered with a lid, left for 5-7 hours. After the time has elapsed, you need to strain the drink and add a teaspoon of alcohol tincture of Sophora to enhance the therapeutic effect. Take 250 ml of infusion on an empty stomach and before dinner. The course of treatment is 2 weeks. You need to drink the drink regularly for six days, then take a one-day break and continue treatment.

St. John's wort oil

Treatment of lupus erythematosus with folk remedies involves not only oral intake of decoctions and infusions. For the treatment of skin rashes on the face, use It can be prepared at home. You will need a couple of tablespoons of the plant's flowers and a glass of olive or sunflower oil. To infuse the product, it is necessary to remove it in a remote cool place for 2-3 weeks, but shake the contents every day. When the oil of St. John's wort is ready, it is applied to the affected areas of the skin in the morning and before bed. Similarly, you can prepare sea buckthorn oil - it also copes well with problem areas on the epidermis.

Other folk recipes

For joint pain caused by systemic lupus erythematosus, chestnut tincture can be used. Such a remedy is sold in a pharmacy and is inexpensive. To relieve puffiness and pain, you need to rub the tincture into the joint every day, after which it is imperative to bandage or wrap it with a warm cloth. The course of treatment is 1-2 weeks.
Another option for a folk remedy that helps with joint damage. For its preparation, you will need dried cherries (100 g of fruits), parsley root (20 g), black elderberry flowers (2 tbsp. L.). All ingredients are mixed and brewed with a liter of hot boiled water, then put on low heat and brought to a boil. As soon as the broth has cooled, it must be well filtered. You need to take the remedy half an hour before a meal in a glass.
Patients with impaired kidney function can use the following herbal collection: 100 g of currant leaves, the same amount of corn stigmas and rose hips. A decoction is prepared in the same way as the previous remedy.

How to live with this diagnosis

However, in order to successfully overcome exacerbations of the disease, it is important to follow the primitive, but at the same time very important recommendations of specialists:

Avoid stressful situations, psycho-emotional stress, anxiety and anxiety.
Eat a balanced diet.
Limit exposure to the sun, refuse to visit the solarium.
Play sports, but avoid excessive physical exertion.
Do not start chronic diseases, cure colds to the end.
Do not use hormonal contraception.
Lead a healthy lifestyle in which there is no place for alcohol and smoking.
Give preference to natural cosmetics.

In general, it is impossible to predict a complete recovery from lupus erythematosus. The percentage of deaths among patients with this disease is still high. But in most cases, the cause of death is not lupus itself, but complications caused by infection or deep damage to internal organs. In the case of timely detection of the disease and drawing up a competent treatment plan, lupus can be kept under control, not allowing it to destroy health and life.

Lupus is a disease of the autoimmune type, during which the defense system that the human body has (that is, its immune system) attacks its own tissues, while ignoring foreign organisms and substances in the form of viruses and bacteria. This process is accompanied by inflammation and lupus, the symptoms of which are manifested in the form of pain, swelling and tissue damage throughout the body, being in its acute stage, provokes the appearance of other serious diseases.

general information

Lupus, as its abbreviated name, is fully defined as systemic lupus erythematosus. And although in a significant number of patients with this disease, the manifestation of symptoms occurs in their weak expression, lupus in itself is incurable, threatening in many cases with exacerbation. Patients can control the characteristic symptoms, as well as prevent the development of certain diseases related to organs, for which they should regularly undergo examinations with a specialist, devoting a significant amount of time to an active lifestyle and rest and, of course, taking the prescribed medications in a timely manner.

Lupus: symptoms of the disease

The main symptoms that appear with lupus are severe fatigue and skin rashes, in addition, there is also pain in the joints. In case of progression of the disease, such lesions become relevant, which affect the functioning and general condition of the heart, kidneys, nervous system, blood and lungs.

The symptoms manifested in lupus directly depend on which organs are affected by it, as well as on what degree of damage is characteristic for them at a particular moment of their manifestation. Let's consider the main of these symptoms.

Weakness. Nearly all patients diagnosed with lupus claim to experience varying degrees of fatigue. And even if we are talking about mild lupus, its symptoms make significant adjustments to the patient's usual lifestyle, interfering with vigorous activity and sports. If fatigue is noted quite strong in its manifestation, then here we are already talking about it as a sign indicating an imminent exacerbation of symptoms.
Pain in muscles, joints. Most patients who are diagnosed with lupus have occasional joint pain (ie). At the same time, about 70% of their total number claims that pain in the muscles was the first manifestation of the disease. As for the joints, they can be reddened, they also swell and warm a little. Some of the cases indicate a feeling of immobility in the morning. In lupus, arthritis occurs primarily in the wrists, but also in the hands, knees, ankles, and elbows.
Skin diseases. The vast majority of people with lupus also experience skin rashes. Systemic lupus erythematosus, the symptoms of which indicate a possible involvement in this disease, it is due to this manifestation that they make it possible to diagnose the disease. On the bridge of the nose and on the cheeks, in addition to the characteristic rash, red painful spots often appear in the arms, back, neck, lips and even in the mouth. The rash can also be purple, bumpy, or red and dry, still focusing on the face, scalp, neck, chest, and arms.
Hypersensitivity to light. In particular, ultraviolet light (solarium, sun) contributes to an exacerbation of the rash, while simultaneously provoking an exacerbation of other symptoms characteristic of lupus. Light-haired and white-skinned people are especially sensitive to such effects of ultraviolet radiation.
Disturbances in the work of the nervous system. Quite often, lupus is accompanied by diseases associated with the work of the nervous system. These include, in particular, headaches and depression, anxiety, etc. A relevant, albeit less common manifestation, is memory impairment.
Various heart diseases. Many of the patients with lupus also experience this type of disease. So, inflammation often occurs in the area of the pericardial sac (otherwise referred to as pericarditis). This, in turn, can provoke the appearance of acute pain in the center of the left side of the chest. Further, such pain can spread to the back and neck, as well as to the shoulders and arms.
Mental disorders. Lupus is also accompanied by mental disorders, for example, they can consist in a constant and unmotivated feeling of anxiety or expressed in the form of depression. These symptoms are caused both by the disease itself and by drugs against it, and stresses accompanying many different chronic diseases also play a role in their appearance.
Temperature change. Often, lupus manifests itself with such one of its symptoms as a low temperature, which also in some cases makes it possible to diagnose this disease.
Weight change. Lupus flare-ups are usually accompanied by rapid weight loss.
Hair loss. Hair loss with lupus is temporary. Loss occurs either in small patches or evenly along the entire head.
Inflammation of the lymph nodes. When lupus symptoms worsen, patients often experience swollen lymph nodes.
Raynaud's phenomenon (or vibration disease). In some cases, this disease is accompanied by lupus, while small vessels are affected, along which blood flows to the soft tissues and to the skin under them in the area of the toes and hands. Through this process, they acquire a white, red or bluish tint. In addition, the affected areas experience numbness and tingling sensations with a simultaneous rise in temperature.
Inflammatory processes in the blood vessels of the skin (or cutaneous vasculitis). Lupus erythematosus, the symptoms of which we have listed, can also be accompanied by inflammation of the blood vessels and their bleeding, which, in turn, provokes the formation of red or blue spots of various sizes on the skin, as well as in the nail plates.
Swelling of feet, palms. Some people with lupus have kidney disease caused by it. This becomes an obstacle to the elimination of fluid from the body. Consequently, the accumulation of excess fluid can lead to swelling of the feet and palms.
Anemia. Anemia, as you may know, is a condition characterized by a decrease in the amount of hemoglobin in the blood cells, through which oxygen is transported. Many people who have some kind of chronic disease, face with time, which is caused, respectively, by a decrease in the level of red blood cells.

Systemic lupus erythematosus: symptoms that need to be addressed

Treatment of lupus should be started as soon as possible to avoid organ damage that is irreversible in its consequences. The main drugs used in the treatment of lupus include anti-inflammatory drugs and corticosteroids, as well as drugs whose action is aimed at suppressing the activity characteristic of the immune system. Meanwhile, about half of the total number of patients diagnosed with systemic lupus erythematosus cannot be treated using standard methods.

For this reason, stem cell therapy is prescribed. It consists in taking them away from the patient, after which therapy is carried out aimed at suppressing the immune system, which completely destroys it. Further, in order to restore the immune system, stem cells that were previously removed are injected into the bloodstream. As a rule, the effectiveness of this method is achieved with a refractory and severe course of the disease, and it is recommended even in the most severe, if not to say, hopeless cases.

As for the diagnosis of the disease, in the event of any of the listed symptoms, if you suspect it, you should contact a rheumatologist.

Systemic lupus erythematosus is an autoimmune disease of a chronic form, accompanied by symptoms of damage to the skin, vascular system, and internal organs. The cause of development is a genetic predisposition, external or internal stimuli. Lupus erythematosus is diagnosed more often in adults, less often in children. Women are more susceptible to infection than men.

History of the disease lupus erythematosus

The name of the pathology arose due to the similarity of a red rash with wolf bites. The first mention of systemic lupus erythematosus (SLE) dates back to 1828. Then, in addition to external manifestations, doctors noted damage to internal organs, as well as symptoms of the disease in the absence of a rash.

In 1948, LE-cells were found - fragments in the blood of patients with lupus erythematosus, which became an important diagnostic feature. Already by 1954, antibodies were found that acted against the cells of their own body. The presence of these elements allowed the development of more accurate methods for the determination of lupus erythematosus.

See photo: what does lupus erythematosus look like on the face and body in men, women and children

Causes of lupus erythematosus

It was revealed that among sick patients 90% of women. Lupus erythematosus in men is much less common due to the structural features of the hormonal system. In the stronger sex, the protective properties of the body are more pronounced due to special hormones - androgens.

The etiology of lupus erythematosus has not yet been established. Scientists suggest that factors may include:

genetic predisposition;
hormonal changes in the body;
endocrine system pathology;
bacterial infections;
environmental conditions;
excessive exposure to the sun, in a solarium;
the period of pregnancy or recovery after childbirth;
bad habits: smoking, alcohol.

Frequent colds, viruses, hormonal changes in adolescence, menopause, stress can serve as a trigger.

Many people wonder: is lupus erythematosus contagious? The disease is not transmitted by airborne droplets, household or sexually. A healthy person will not get infected from someone with an autoimmune disorder. SLE is acquired only hereditarily.

Pathogenesis or developmental mechanism

SLE develops against the background of a reduced defense system. A malfunction occurs inside the body: antibodies are produced against the "native" cells. Simply put, the immune system begins to perceive organs and tissues as foreign objects and directs forces to self-destruction.

The violation causes inflammation, suppression of healthy cells. The circulatory system and connective tissues are exposed to pathology. The development of the disease causes a violation of the integrity of the skin, external changes, deterioration of blood circulation in the affected area. If lupus progresses, internal organs throughout the body are affected.

Lupus erythematosus symptoms + photo

There are many manifestations of the disease, symptoms can appear and disappear, change over the years. The form of the pathology depends on the area of the lesion.

The first signs of lupus erythematosus are:

causeless weakness;
joint aches;
weight loss, decreased appetite;
temperature increase.

At the initial stage, the disease proceeds with mild symptoms. SLE is characterized by alternating flares of exacerbation that subside on their own, and subsequent remissions. Such a condition is considered dangerous, since the patient thinks that the disease has passed and does not seek medical help. And at this time, systemic lupus erythematosus affects the internal organs. With another decrease in the immune system or exposure to stimuli, SLE flares up with a vengeance, proceeding with complications and vascular damage.

Manifestations of lupus erythematosus syndrome, depending on the location of the lesion:

Skin covering. Red rash on the face: on the cheeks, under the eyes. The general appearance of the symmetrical spots is similar in shape to the wings of a butterfly. Redness appears on the neck, palms. When exposed to ultraviolet light, the spots begin to peel off, cracks form. Later, the lesions heal, leaving scars on the skin.
Mucous membranes. With the progression of systemic lupus erythematosus in the mouth, small ulcers appear in the nose, prone to overgrowth. The defeat of the protective membranes causes pain, difficulty breathing, eating.
Respiratory system. The lesions spread to the lungs. Pneumonia or pleurisy may develop. The state of health worsens, there is a risk to life.
The cardiovascular system. The progression of SLE causes the proliferation of connective tissue in the heart - scleroderma. Education complicates the contractile function, causes fusion of the valve and atria. Inflammatory processes are formed, arrhythmia, heart failure develop, the risk of heart attacks increases,.
Nervous system. Depending on the severity of the disease, disturbances in the functioning of the nervous system appear. Intolerable headaches, nervous condition, neuropathy become symptoms. The defeat of the central nervous system also leads to.
The musculoskeletal system. It manifests itself with signs of rheumatoid arthritis. With lupus erythematosus, pain appears in the legs, arms, and other joints. Small elements of the skeleton - phalanges of the fingers are often affected.
Urinary system and kidneys. Lupus erythematosus often causes pyelonephritis, nephritis, or kidney failure. Violations are developing rapidly and are life threatening.

If at least four of these signs are found, we can talk about the diagnosis of SLE.

Forms and types of the disease

Depending on the severity of the symptoms, the autoimmune disorder is classified:

Acute lupus. A stage characterized by a sharp progression of the disease. Manifestations are: constant fatigue, high temperature, fever.
Subacute form. The time interval from the moment of illness to the appearance of the first signs can be a year or more. This stage is characterized by frequent alternation of remissions and exacerbations.
Chronic lupus. The disease in this form is mild. Internal systems are working properly, organs are not damaged. Measures are directed at the prevention of exacerbations.

Chronic lupus erythematosus

In addition to systemic lupus erythematosus, skin diseases caused by autoimmune disorders, but not systemic, are distinguished.

There are the following clinical types:

Disseminated- Expressed in a rising red rash on the face or body. It can be chronic or recurrent. A small percentage of patients later acquire systemic lupus erythematosus.
Discoid lupus erythematosus- manifested by rashes on the face: more often it is the cheeks and nose. The well-defined rounded spots resemble the shape of the wings of a butterfly. The inflamed areas begin to flake off and cause scar atrophy.
Medicinal- caused by drugs such as Hydralazine, Procainamide, Carbamazepine, and disappears with the termination of their intake. It manifests itself as inflammation of the joints, rashes, fever, chest pain.
Neonatal lupus- typical for newborns. Transmitted from a mother with systemic lupus erythematosus or other severe autoimmune disorders. A feature is the defeat of the heart.

The overwhelming majority of patients with SLE are young women, mostly of childbearing age. Complications during pregnancy put the child at risk of developing lupus erythematosus. Therefore, it is important to pay special attention to family planning.

Diagnosis of systemic lupus erythematosus

Since SLE is a complex disease affecting many organs, with varying phases from acute to latent, each patient needs an individual approach. It is important to collect all the signs in the order of their occurrence. You will need to visit doctors such as: nephrologist, pulmonologist, cardiologist.

It is necessary to pass a number of tests for lupus erythematosus:

antibody test;
general blood analysis;
blood chemistry,
biopsy of the kidneys, skin;
Wasserman reaction: result for syphilis.

After collecting anamnesis, studying laboratory tests, the doctor draws up a general clinical picture and prescribes treatment. The diagnosis of systemic lupus erythematosus is indicated by the ICD-10 code: M32.

How to treat lupus erythematosus: medications

Therapy for lupus erythematosus is individual. Clinical guidelines and medications depend on the symptoms, provoking factors and the form of pathology.

Now it is almost impossible to get rid of SLE completely. Basically, drugs are prescribed for the prevention of complications:

Hormonal drugs.
Anti-inflammatory medicines.
Antipyretic drugs.
Ointments to relieve pain and itching.
Immunostimulants.

To maintain protective functions, physiotherapy procedures are prescribed. Strengthening measures are carried out only during the period of remission.

Lupus erythematosus is often treated at home. Hospitalization is required when the patient has complications: a febrile condition, disruption of the central nervous system, suspected stroke.

Forecast for life

Systemic lupus erythematosus is not a sentence. It is recorded that with timely treatment and competent treatment, people live after diagnosis for more than 20 years. The exact development of lupus erythematosus and life expectancy is difficult to predict, everything proceeds individually.

Famous singer Toni Braxton and contemporary singer Selena Gomez live with autoimmune disease. Lupus erythematosus does not choose a victim for social status or skin color, it affects a weakened body.

Often, the appearance of side effects and negative consequences from taking drugs complicates therapy. Patients may develop metabolic disorders, blood pressure rises. Osteoporosis is possible, leading to disability.

But recent advances in molecular biology offer hope for a breakthrough in the treatment of systemic lupus erythematosus. We are talking about the creation of a new drug by the method of genetic engineering, which acts on damaged cells in a targeted manner, without affecting healthy ones. The drug has already passed clinical trials.

Prophylaxis

In conclusion, a few words about prevention: in the case of autoimmune diseases, it is important to prevent their occurrence. To do this, it is enough to exclude provoking factors. Excessive insolation, that is, adherence to tanning and solarium, baths, saunas, allergenic medicines and food, cosmetics, household chemicals - these are the main provocateurs. An attentive attitude to one's own health, a reasonable attitude to nutrition, moderate physical activity are simple recommendations to avoid such serious diseases as systemic lupus erythematosus.

Systemic lupus erythematosus is a chronic, symptomatic disease that is based on persistent autoimmune inflammation. More often young girls and women from 15 to 45 years old are ill. Prevalence of lupus: 50 per 100,000 population. Despite the fact that the disease is quite rare, it is extremely important to know its symptoms. In this article, we will also talk about the treatment of lupus, which is usually prescribed by doctors.

The causes of systemic lupus erythematosus

Excessive exposure to ultraviolet radiation on the body contributes to the development of the pathological process.

Excessive exposure to ultraviolet radiation (especially "chocolate" tanning and tanning before sunburn).
Stressful situations.
Episodes of hypothermia.
Physical and mental overload.
Acute and chronic viral infection (, herpes simplex virus, Epstein-Barr virus, cytomegalovirus).
Genetic predisposition. If a family member has or is sick with lupus, then for everyone else, the risk of getting sick increases significantly.
Deficiency of C2 component of complement. Complement is one of the "participants" in the body's immune response.
The presence of antigens HLA All, DR2, DR3, B35, B7 in the blood.

A number of studies show that lupus does not have one specific cause. Therefore, the disease is considered multifactorial, that is, its occurrence is due to the simultaneous or sequential effects of a number of reasons.

Classification of systemic lupus erythematosus

According to the development of the disease:

Sharp start. Against the background of complete health, lupus symptoms appear sharply.
Subclinical start. Symptoms appear gradually and may simulate another rheumatic disease.

The course of the disease:

Sharp. Usually, patients can tell with an accuracy of several hours when their first symptoms appeared: the temperature rose, a typical reddening of the facial skin appeared ("butterfly"), joints ached. Without proper treatment, the nervous system and kidneys are affected within 6 months.
Subacute. The most common form of lupus. The disease begins nonspecifically, begins, the general condition worsens, and skin rashes may appear. The disease proceeds cyclically, with each relapse involving new organs in the process.
Chronic. Lupus for a long time is manifested by relapses of only those symptoms and syndromes with which it began (polyarthritis, skin syndrome,), without involving other organs and systems in the process. The chronic course of the disease has the most favorable prognosis.

Systemic lupus erythematosus symptoms

Joint damage

It is observed in 90% of patients. It is manifested by migrating pain in the joints and alternating inflammation of the joints. It is very rare when the same joint constantly hurts and becomes inflamed. The interphalangeal, metacarpophalangeal and wrist joints are mainly affected, less often the ankle joints. Large joints (for example, knee and elbow) are much less affected. Arthritis is usually associated with severe muscle pain and inflammation.

Skin syndrome

The most common lupus butterfly is a reddening of the skin around the cheekbones and nasal bridge.

There are several options for skin lesions:

Vasculitic (vascular) butterfly. It is characterized by unstable diffuse redness of the skin of the face, with blue in the center, increased manifestations under the influence of cold, wind, excitement, ultraviolet radiation. Redness foci are both flat and raised above the surface of the skin. After healing, no scars remain.
Multiple skin rashes due to photosensitivity. They occur in open areas of the body (neck, face, décolleté, arms, legs) under the influence of sunlight. The rash goes away without a trace.
Subacute lupus erythematosus. Redness areas (erythema) appear after sun exposure. Erythema is raised above the surface of the skin, can be in the form of a ring, a crescent, almost always scaly. A patch of depigmented skin may remain in place of the spot.
Discoid lupus erythematosus. First, patients develop small red plaques, which gradually merge into one large lesion. The skin in such places is thin, in the center of the focus there is excessive keratinization. Such plaques appear on the face, extensor surfaces of the limbs. After healing, scars remain at the site of the lesions.

Hair loss (up to complete), nail changes, ulcerative stomatitis can join skin manifestations.

Damage to the serous membranes

Such a lesion belongs to the diagnostic criteria, since it occurs in 90% of patients. This includes:

Pleurisy.
Peritonitis (inflammation of the peritoneum).

Damage to the cardiovascular system

Lupus.
Pericarditis.
Endocarditis Liebman-Sachs.
Coronary artery disease and development.
Vasculitis.

Raynaud's syndrome

Raynaud's syndrome is manifested by a spasm of small vessels, which in patients with lupus can lead to necrosis of the fingertips of the hands, severe arterial hypertension, and retinal damage.

Lung damage

Pleurisy.
Acute lupus pneumonitis.
Damage to the connective tissue of the lungs with the formation of multiple foci of necrosis.
Pulmonary hypertension.
Pulmonary embolism.
Bronchitis and.

Kidney damage

Urinary Syndrome.
Nephrotic syndrome.
Nephritic Syndrome.

Damage to the central nervous system

Astheno-vegetative syndrome, which manifests itself as weakness, fatigue, depression, irritability, sleep disturbances.
During the period of relapse, patients complain of decreased sensitivity, paresthesia ("goose bumps"). On examination, a decrease in tendon reflexes is noted.
In severely ill patients, meningoencephalitis may develop.
Emotional lability (weakness).
Decreased memory, deterioration in intellectual abilities.
Psychoses, seizures.

Diagnosis of systemic lupus erythematosus

In order to diagnose systemic lupus erythematosus, it is necessary to confirm the presence of at least four criteria from the list in the patient.

Rash on the face. Flat or raised erythema localized to the cheeks and cheekbones.
Discoid eruptions. Erythematous spots, with scaling and hyperkeratosis in the center, leaving behind scars.
Photosensitization. Skin rashes appear as an excessive reaction to the action of ultraviolet radiation.
Oral ulcers.
Arthritis. The defeat of two or more peripheral small joints, pain and inflammation in them.
Serositis. Pleurisy, pericarditis, peritonitis, or a combination thereof.
Kidney damage. Changes in (appearance of traces of protein, blood), increased blood pressure.
Neurological disorders. Convulsions, psychosis, seizures, emotional disturbances.
Hematological changes. At least 2 clinical blood tests in a row must have one of the indicators: leukopenia (decrease in the number of leukocytes), lymphopenia (decrease in the number of lymphocytes), thrombocytopenia (decrease in the number of platelets).
Immunological disorders. A positive LE test (high amount of antibodies to DNA), a false positive reaction to a moderate or high level of rheumatoid factor.
The presence of antinuclear antibodies (ANA). Revealed by enzyme immunoassay.

With what you need to carry out a differential diagnosis

Because of the wide variety of symptoms, systemic lupus erythematosus has many manifestations in common with other rheumatologic diseases. Before a diagnosis of lupus is made, the following should be excluded:

Other diffuse connective tissue diseases (scleroderma, dermatomyositis).
Polyarthritis.
Rheumatism (acute rheumatic fever).
Still's syndrome.
Kidney damage is not lupus in nature.
Autoimmune cytopenias (a decrease in the number of leukocytes, lymphocytes, platelets in the blood).

Treatment of systemic lupus erythematosus

The main goal of treatment is to suppress the body's autoimmune response, which underlies all symptoms.

Patients are prescribed various types of drugs.

Glucocorticosteroids

Hormones are the drugs of choice for lupus. They are the ones that best relieve inflammation and suppress the immune system. Before glucocorticosteroids were introduced into the treatment regimen, patients lived for a maximum of 5 years after diagnosis. Now life expectancy is much longer and to a greater extent depends on the timeliness and adequacy of the prescribed treatment, as well as how carefully the patient follows all the prescriptions.

The main indicator of the effectiveness of hormone treatment is long-term remissions with maintenance treatment with small doses of drugs, a decrease in the activity of the process, and a stable stabilization of the state.

The drug of choice for patients with systemic lupus erythematosus is Prednisolone. It is prescribed on average at a dose of up to 50 mg / day, gradually decreasing to 15 mg / day.

Unfortunately, there are reasons why hormone treatment is ineffective: irregular pills, improperly selected dose, late start of treatment, a very serious condition of the patient.

Patients, especially adolescents and young women, may refuse to take hormones due to their possible side effects, they are mainly concerned about possible weight gain. In the case of systemic lupus erythematosus, there is really no choice: take or not take. As mentioned above, without hormone treatment, life expectancy is very low, and the quality of this life is very poor at all. Don't be afraid of hormones. Many patients, especially those with rheumatological diseases, have been taking hormones for decades. And not all of them develop side effects.

Other possible side effects of hormone intake include:

Steroid erosion, etc.
Increased risk of infection.
Increased blood pressure.
Increased blood sugar levels.

All these complications are also quite rare. The main condition for effective treatment with hormones with a minimal risk of side effects is the correct dose, regular intake of pills (otherwise withdrawal syndrome is possible) and self-control.

Cytostatics

These drugs are prescribed in combination with when hormones alone are not effective enough or do not work at all. Cytostatics are also aimed at suppressing immunity. There are indications for the appointment of these drugs:

Highly active lupus with a rapidly progressive course.
Involvement of the kidneys in the pathological process (nephrotic and nephritic syndromes).
Low effectiveness of isolated hormone therapy.
The need to reduce the dose of Prednisolone due to its poor tolerance or the sharp development of side effects.
The need to reduce the maintenance dose of hormones (if it exceeds 15 mg / day).
Formation of dependence on hormone therapy.

Most often, people with lupus are prescribed Azathioprine (Imuran) and Cyclophosphamide.

Criteria for the effectiveness of treatment with cytostatics:

Decrease in the intensity of symptoms;
The disappearance of dependence on hormones;
Decreased disease activity;
Stable remission.

Non-steroidal anti-inflammatory drugs

Prescribed to relieve articular symptoms. Most often, patients take Diclofenac, Indomethacin tablets. NSAID treatment lasts until body temperature normalizes and joint pain disappears.

Complementary treatments

Plasmapheresis. During the procedure, metabolic products and immune complexes that provoke inflammation are removed from the patient's blood.

Prevention of systemic lupus erythematosus

The purpose of prevention is to prevent the development of relapses, to maintain the patient in a state of stable remission for a long time. Lupus prevention is based on an integrated approach:

Regular dispensary examinations and consultations with a rheumatologist.
Taking drugs strictly in the prescribed dose and at specified intervals.
Compliance with the regime of work and rest.
Adequate sleep, at least 8 hours a day.
A diet with limited salt and sufficient protein.
The use of hormone-containing ointments (for example, Advantan) for skin lesions.
The use of sunscreens (creams).

How to live with a diagnosis of systemic lupus erythematosus?

Being diagnosed with lupus doesn't mean that life is over.

Try to overcome the disease, maybe not in the literal sense. Yes, you will probably be limited in some way. But millions of people with more serious illnesses live a bright life full of impressions! So you can too.

What do I need to do?

Listen to yourself. If you are tired, then lie down and rest. You may need to realign your daily schedule. But it is better to take a few naps a day than to work out to exhaustion and increase the risk of relapse.
Examine all the signs of when the disease can turn into an exacerbation. Usually this is severe stress, prolonged exposure to the sun, and even the use of certain foods. It is worth avoiding provocative factors whenever possible, and life will immediately become a little more fun.
Give yourself some moderate physical activity. It is best to do Pilates or yoga.
Quit smoking and try to avoid secondhand smoke. Smoking generally does not add to health. And if you remember that smokers are more likely to get colds, bronchitis and pneumonia, overload their kidneys and heart ... You should not risk long years of life because of a cigarette.
Accept your diagnosis, study everything about the disease, ask your doctor everything that you do not understand and take a breath. Lupus today is not a sentence.
If necessary, do not hesitate to ask family and friends to support you.

What can you eat and what should you be from?

In fact, you need to eat in order to live, not the other way around. Plus, it's best to eat foods that help you fight lupus effectively and protect your heart, brain, and kidneys.

What needs to be limited and what needs to be discarded

Fats. Deep-fried dishes, fast food, dishes with a lot of butter, vegetable or olive oils. All of them dramatically increase the risk of developing complications from the cardiovascular system. Everyone knows that fatty substances provoke the deposition of cholesterol in the vessels. Avoid unhealthy fatty foods and protect yourself from heart attack.
Caffeine. Coffee, tea, some drinks contain a large amount of caffeine, which irritates the stomach lining, prevents you from falling asleep, overloading the central nervous system. You will feel much better if you stop drinking cups of coffee. At the same time, the risk of developing erosion will be significantly reduced.
Salt. Limit salt anyway. But this is especially necessary in order not to overload the kidneys, possibly already affected by lupus, and not to provoke rises in blood pressure.
Alcohol. harmful in itself, and in combination with drugs usually prescribed to patients with lupus, generally an explosive mixture. Cut out alcohol and you will immediately feel the difference.

What you can and should eat

Fruits and vegetables. An excellent source of vitamins, minerals and fiber. Try to eat up on seasonal vegetables and fruits, they are especially healthy and cheap enough.
Foods and supplements high in calcium and vitamin D. These can help prevent the development of glucocorticosteroids. Eat low-fat or low-fat dairy products, cheeses, and milk. By the way, if the tablets are taken not with water, but with milk, they will irritate the stomach lining less.
Whole grain cereals and baked goods. These foods are high in fiber and B vitamins.
Protein. Protein is essential for the body to fight disease effectively. It is better to eat lean, dietary meats and poultry: veal, turkey, rabbit. The same applies to fish: cod, pollock, lean herring, pink salmon, tuna, squid. In addition, seafood is high in omega-3 unsaturated fatty acids. They are vital for the normal functioning of the brain and heart.
Water. Try to drink at least 8 glasses of clear, still water a day. This will improve the general condition, improve the functioning of the gastrointestinal tract, and help control hunger.

So, systemic lupus erythematosus in our time is not a sentence. Do not despair if you have been diagnosed with this; rather, it is necessary to "pull yourself together", follow all the recommendations of the attending physician, lead a healthy lifestyle, and then the quality and life expectancy of the patient will significantly increase.

Which doctor to contact

Given the variety of clinical manifestations, sometimes it is quite difficult for a sick person to find out which doctor to contact at the onset of the disease. For any changes in well-being, it is recommended to contact a therapist. After the tests, he will be able to suggest a diagnosis and refer the patient to a rheumatologist. Additionally, you may need to consult a dermatologist, nephrologist, pulmonologist, neurologist, cardiologist, immunologist. Since systemic lupus erythematosus is often associated with chronic infections, it will be useful to be examined by an infectious disease specialist. A nutritionist will assist with treatment.