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Lupus erythematosus

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Lupus erythematosus

Specialty Rheumatology
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Lupus erythematosus is a collection of autoimmune diseases in which the human immune
system becomes hyperactive and attacks healthy tissues.[1] Symptoms of these diseases can affect
many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. The
most common and severe form is systemic lupus erythematosus.

Contents
 1 Signs and symptoms
o 1.1 Photosensitivity
 2 Genetics
o 2.1 Causes
o 2.2 Age difference
o 2.3 Differences in ethnicity
 3 Diagnosis
o 3.1 Classification
 4 Treatment

wrists. and may come and go. Other common symptoms include:  chest pain during respiration  joint pain  oral ulcer  fatigue  fever with no other cause  general discomfort. Some develop arthritis. and knees.  tumor necrosis factor alpha also seems to play a role in the development of photosensitivity. 30 of which have now been linked with the disorder.3 United States  6 See also  7 References  8 External links Signs and symptoms Symptoms vary from person to person. Some of these . or ill feeling (malaise)  hair loss  sensitivity to sunlight  skin rash – a "butterfly" rash in about half people with SLE  swollen lymph nodes[2] Photosensitivity Photosensitivity is a known symptom of lupus. uneasiness. but its relationship to and influence on other aspects of the disease remain to be defined.  5 Epidemiology o 5. Almost everyone with lupus has joint pain and swelling. Lupus is usually influenced by gene polymorphisms. Frequently affected joints are the fingers.1 Worldwide o 5. hands.2 United Kingdom o 5. Genetics Causes It is typically believed that Lupus is influenced by multiple genes.[3] Causes of photosensitivity may include:  change in autoantibody location  cytotoxicity  inducing apoptosis with autoantigens in apoptotic blebs  upregulation of adhesion molecules and cytokines  inducing nitric oxide synthase expression  ultraviolet-generated antigenic DNA.

[6][7] Atherosclerotic cardiovascular disease is more prevalent in African American Lupus patients compared to Caucasians with Lupus. the respiratory system and problems with malignancies. who had survival rates nearer to 98%. Caucasians seem to generally have a more mild manifestation of the disease. However. Nearly 50% of those with late onset Lupus die of their affliction. but this is rare. while patients of African. it is usually attributed to the genes C1. Women who are of childbearing age are also particularly at risk.[8] Diagnosis For the diagnosis of lupus 4 out of 11 signs must be present.polymorphisms have been linked very tentatively however. There have been several cases where a single gene influence appears to be present. as the role that they play or the degree to which they influence the disease is unknown. and some Asian ethnicities had survival rates closer to 79%-92%. which are largely related to healthy functioning of the immune system. skin rash. The influence of sex chromosomes and environmental factors are also noteworthy. Women are more likely to get it than men. are vulnerable to mucocutaneous manifestations of the disease (alopecia. Asian. Usually. and have a better or worse prognosis. The only documented ethnicity that had a higher survival rate than Caucasians were Koreans. Typically. Other genes that are commonly thought to be associated with Lupus are those in the Human leukocyte antigen (HLA) family. the manifestation of the disease tends to be more acute in those affected who are of younger age. When a single gene deficiency does cause Lupus. the most common causes of death were complications involving the cardiovascular system.[5] Differences in ethnicity Substantial data have been found to indicate that certain ethnic populations could be more at risk for Lupus Erythematosus. Among Caucasians. and Native Americans are more likely to get Lupus than Caucasians. and ulceration of the mucus membranes) more so than any other age group. Their survival rates after five years were typically around 94%-96%. these factors contribute to Lupus by compromising the immune system. patients with late onset Lupus have a much higher mortality rate. C2. Patients with juvenile onset Lupus in particular.[4] Age difference Lupus can develop in any age but most commonly in ages 15 to 44 with varying results. or C4. African.[9] Testing may include:  Antinuclear antibody (ANA)  CBC with differential  Chest x-ray  Serum creatinine  Urinalysis[9] Classification .

[13] In addition to medicative therapy.Lupus erythematosus may manifest as systemic disease or in a purely cutaneous form also known as incomplete lupus erythematosus. anxiety. hydroxychloroquine and corticosteroids). and depression in lupus sufferers. A more thorough categorization of lupus includes the following types:[10][11]  acute cutaneous lupus erythematosus  subacute cutaneous lupus erythematosus  discoid lupus erythematosus (chronic cutaneous) o  childhood discoid lupus erythematosus  generalized discoid lupus erythematosus  localized discoid lupus erythematosus o chilblain lupus erythematosus (Hutchinson) o lupus erythematosus-lichen planus overlap syndrome o lupus erythematosus panniculitis (lupus erythematosus profundus) o tumid lupus erythematosus o verrucous lupus erythematosus (hypertrophic lupus erythematosus) o cutaneous lupus mucinosis  complement deficiency syndromes  drug-induced lupus erythematosus  neonatal lupus erythematosus  systemic lupus erythematosus Treatment Main article: Systemic lupus erythematosus § Treatment Treatment consists primarily of immunosuppressive drugs (e.[14] Epidemiology .g.[12] In 2011.. systemic lupus erythematosus (also known as SLE) is the most common and serious form. Food and Drug Administration (FDA) approved the first new drug for lupus in more than 50 years to be used in the US. Cognitive Behavioural Therapy (CBT) has also been demonstrated to be effective in reducing stress. the U.S. An interesting second line drug is methotrexate in its low-dose schedule. due to the psychological and social impacts that Lupus may have on an individual. Lupus has four main types:  systemic  discoid  drug-induced  neonatal Of these. belimumab.

females 6 to 10 times more often than males.[13] .6 cases per 100.[15]  70% of lupus cases diagnosed are systemic lupus erythematosus.000 persons per year in parts of the continental United States.[13]  yields limited prevalence data. or 0.[13]  affects U. and the number of UK males with lupus is 3000—a total of 24. In other words.[15] United Kingdom  SLE affects UK females far more than males at a ratio of 7:1.700.041% of the population.[15]  about 5% of the children born to individuals with lupus will develop the illness.[16]  SLE is more common amongst certain ethnic groups than others.700. Estimates vary and range from 1.[16] United States  occurs from infancy to old age.S. females are seven times more likely to have the disease.[15]  20% of people with lupus will have a parent or sibling who already has lupus or may develop lupus. especially those of African origin.[16]  The estimated number of UK females with SLE is 21. with peak occurrence between ages 15 and 40.8 to 7.Worldwide  an estimated 5 million people worldwide have some form of lupus disease.