Tuesday, December 25, 2007

Lupus erythematosus

WHAT IS LUPUS ERYTHEMATOSUS


Lupus usually appears in one of two forms: discoid lupus erythematosus (the skin form call discoid L.E.); or systemic lupus erythematosus (the internal form called systemic L.E. or S.L.E.). Neither form is contagious.


Discoid L.E. have a particular type of skin unthinking with raise, red, scaly areas, most commonly on the facade. Usually patients with discoid L.E. own normal internal organs, although approximately one out of twenty of them may develop internal change. Up to 50% of discoid L.E. patients have significant unified aches and fatigue.


Systemic lupus erythematosus is classified as an inflammatory rheumatic disease, in like peas in a pod family as rheumatoid arthritis. It is considered a chronic, systemic, connective tissue disease involving the body's immune system. Chronic finances that the condition lasts for a long extent of time. "Systemic" literally means adjectives through the body, even though most patients have symptoms controlled to a few areas. Inflammatory describes the body's reaction to irritation next to pain and swelling L.E. involves change in the blood vessel and the connective tissue, which supports the cells of the body within much the same mode that mortar connects and supports bricks of a house. There is sometimes a rash close to that seen within discoid L.E. but often the skin is ordinary. S.L.E. can be a mild condition, but because it can involve joints and skin, kidney and blood, heart and lungs, it may appear in different forms and beside different intensities at different times in the same soul. A large number of general public with S.L.E. enjoy few symptoms and are able to live a relatively common life. While reading nearly the symptoms of S.L.E., one should be aware that it is very unlikely that adjectives of the symptoms would occur contained by any one person.


How serious lupus is vary greatly from mild to life-threatening, and depends on what parts of the body are affected Even a mild casing can become quite serious if it is not properly treated. The treatment results are usually well brought-up with lately developed medicines. The severity of an individual defence of S.L.E. should be discussed with the doctor.


Some patients beside "epilepsy" or recurrent "pneumonia," and some next to false-positive serologic tests for syphilis (STS) may in reality have pre- or impulsive lupus.


What lupus is not: Lupus is not infectious or contagious. It is not a type of cancer or maligancy.


WHAT CAUSES LUPUS ERYTHEMATOSUS


The cause of lupus is unknown, although it is believed here may be many factor involved, such as certain medicine, excessive sun exposure, and infections. A combination of genetic, viral and environmental influences may be precipitating factors. In family of S.L.E. patients it is known that near is an increase of both S.L.E. and rheumatoid arthritis. Many of the relatives have unexpected proteins in their blood, although they may not have any symptoms of the disease.


Current theories focus on a special type of allergic antipathy underlying the disease. A patient develops antibodies against his or her own tissues, as if human being allergic to himself. These antibodies are known as autoantibodies (auto medium self), and the type of allergy is called auto-immunity, or an allergy against oneself. Still, the rudimentary question which remains unreturned is what event sets off the apparatus which causes a lenient to produce these anti-bodies against his own tissues? Solving the question may very well be an important step toward preventing and curing L.E.


In smaller number than ten percent of patients with S.L.E., the disease may hold been cause by medicine. The most adjectives is procainamide (Pronestyl) which is often used to treat heart irregularities. It is essential that your physician be told of adjectives medications you are taking including vitamins, headache remedies, birth control pills, and laxitives.


SYMPTOMS AND COURSE OF LUPUS ERYTHEMATOSUS


Symptoms of L.E. are moderately wide and various and no two patients have exactly indistinguishable ones. Any part of the body can be involved, thus symptoms may include one or more of these in any combination: Joint and muscle throbbing, fever, skin rash, chest pain, extreme fatigue, swelling of hand and feet, pelt loss. Joint involvement of S.L.E. is usually less severe than that occurring in rheumatoid arthritis. In cases when symptoms clear, it is call a "remission." Medications are usually necessary to wreak remissions, but sometimes they occur spontaneously, i.e., without treatment. Physicians use the residence "remission" or "controlled," rather than "cure," contained by speaking of the periods when patients are free of symptoms, because both doctor and patient must remain cautious for a recurrence of symptoms which may be cause by such things as unusual stress, respiratory infections, excessive physical exertion, etc. Thus, "flare-ups" can be detected and treated, often in the past unnecessary damage occur.


The patient next to S.L.E. may have period of severe illness next to extreme symptoms, intermingled with period of little illness and freedom from symptoms -- remission. The weakness comes and goes so unpredictably that no two cases are alike. Even previously the discovery of cortisone, some forty percent of patients achieved remission by aspirin and rest alone. The motive of S.L.E. flare-up is usually unknown. However, some preventable causes of flare-ups are excessive sun exposure, injuries, overwork, insufficient rest, stopping the medication with which the doctor have been controlling the disorder, irregular living hablits, and violent crises. It cannot be emphasized too strongly that swiftly stopping medication, particularly significant doses of cortisone (prednisone or medrol) derivatives can lead to a severe flare of the disease or life-threatening outcome.


DIAGNOSIS OF LUPUS ERYTHEMATOSUS


The skin rash of discoid L.E. may be so typical that an experienced physician can create the diagnosis by the history and appearance of the rash. If here is any question, a skin biopsy usually help. It is essential that each merciful with discoid L.E. have a thorough physical examination, including laboratory test, to check the possibility of systemic L.E. being present.


The diagnosis of S.L.E. is more difficult. Reaching a positive answer may take months of close watch, many laboratory test, and sometimes a trial of drugs. Because of the many different symptoms, oodles patients are thought to have another disease up to that time a correct diagnosis is made. Frequently S.L.E. starts like the more adjectives rheumatic disease, rheumatoid arthritis, with swelling of a few or copious joints of hand, feet, ankles, or wrists. If typical ski n lesion are present, they are helpful within making the diagnosis. Other findings such as fatigue, fever, pleurisy or kidney disease, also facilitate to confirm the diagnosis of S.L.E. In addition to a complete history and physical nouns, routine tests are done contained by order to determine the extent of internal involvement -- for example, a blood count taken to see if at hand are too few red cells, white cell, or platelets (cells that have to do near blood clotting). A routine analysis of the urine is always done and repeatedly a kidney f unction test using adjectives urine passed in a 24-hour period. A chest x-ray and electrocardiogram are influential to determine whether there is any lung or heart involvement.


In demand to confirm the diagnosis, the specific tests for S.L.E. are perform which measure blood antibodies. These include examinations for L.E., anti-nuclear antibody (ANA), and serum complement (a protein explicitly decreased during helpful phases of autoimmune illness). Numerous other investigative analyses may be performed as in good health. In perhaps ten percent of patients, adjectives these tests may be middle-of-the-road despite other quite conclusive evidence of S.L.E.


The routine test are repeated at regular intervals to determine whether improvement is occurring or a relapse is until. If findings suggest a flare, early treatment can prevent a severe exacerbation.


Not adjectives patients with stirring systemic L.E. have positive L.E. cell test at first. However, if the test is repeated over a spell of several years, it will become positive in most patients. Ten percent of patients beside rheumatoid arthritis have positive L.E. cell test but no other signs of S.L.E.


Nine out often S.L.E. patients enjoy positive ANA tests during busy phases of the disease. It should be remembered, however, that no one oral exam alone is diagnostic whether positive or negative; consequently, the obtain of such a result does not make a diagnosis of S.L.E. All test must be evaluated by the doctor in wispy of the patient's entire disease guide.


Systemic L.E often imitate other diseases -- One of the problems in diagnosis is that at hand is no single set of symptoms or pattern for the disease. Also, S.L.E. can mimic symptoms of plentiful other diseases and strike many different parts of the body, habitually confusing even the most capable doctors. One out of six patients have a "false positive" blood test for syphilis as one of the first symptoms of L.E. This is frequently found during a routine premarital nouns, but does not mean the lenient has venereal disease.


INCIDENCE OF LUPUS ERYTHEMATOSUS


The number of current cases of S.L.E. is definitely increasing for several reason. After the L.E. cell test be devised, physicians were competent to correctly diagnose the illness within patients who were believed to own other rheumatic diseases, or who were thought to hold "neurotic" complaints. Newer tests involving anti-nuclear antibodies", which usually are positive in systemic L.E., own helped doctors discover even more patients near milder cases. It has also be learned that faultless medications such as procainamide (Pronestyl) may wreak systemic L.E. Much of the increase in the number of cases of S.L.E. is due to better recognition of lupus by doctors. Increasing toxic change in our environment next to greater use of drugs, chemicals, and possible other triggering agents may be an additional factor increasing the incidence of lupus.


Seven out of ten patients near discoid L.E. are women, usually in their belatedly twenties or beyond. Nine of ten patients with S.L.E. are women, partially of them developing their first symptoms between ages 15 and 30. L.E. is rare contained by children under the age of 5.


Lupus is found throughout the world and affects adjectives races and ethnic groups. The exact number of patients beside lupus is unknown. However, current estimates state that approximately 500,000 Americans have lupus.

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