Lupus Erythematosus disease
There is a variety of diseases and disorders that are caused by diverse pathogenic organisms. However, recently clinicians have started differentiating a separate group of afflictions that occur due to serious impairments and abnormalities in the immune response, and lupus erythematosus is one of them. It is a serious aberrant autoimmune disorder that can affect various vital systems of the body, which can significantly deteriorate health condition and jeopardize life expectancy. The stated ailment can entail severe deleterious health-related and socioeconomic consequences. Sufficient medical knowledge of lupus erythematosus, its clinical manifestations, causes, therapeutical interventions and preventive care can be beneficial for everyone, and particularly for those that are at risk group of acquiring the disease.
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Lupus erythematosus (LE) is a demonstrative example of incurable autoimmune diseases that can provoke acute or chronic inflammation of various tissues, and consequently affect proper functioning of the skin, musculoskeletal, renal, neuropsychiatric, hematologic, pulmonary, and reproductive systems of the body (Lam, Ghetu, & Bieniek, 2016). The discussed affliction is associated with an increased risk of having cardiovascular irregularities, which can become fatal for patients with such diagnosis. Lupus can equally affect people of different age, ethnicity, race, and gender. Statistics show that the disease affects approximately 300,000 people in the United States, amidst whom women of childbearing age prevail (Lam et al., 2016). It is more specific for black than white population. The described autoimmune disorder can cause severe medical conditions, and consequently various complications.
It is a well-known fact that the human immune system is designated for suppression and eradication of multiple viruses, pathogenic agents, toxic substances and bacteria. However, lupus erythematosus belongs to the group of diseases when the immune system becomes hostile to one's own tissues and starts attacking them. It damages not only alien infectious agents and substances but also healthy tissues and cells of the body. Such unpredictable and inappropriate behavior of the immune system results in inflammatory processes inside organs, their serious malformations and dysfunction. The immune system normally protects the body by producing antibodies that are capable of either suppressing or destroying alien microbes which invade the body (Shiel, 2017). If a person has lupus erythematosus, the immune system starts producing abnormal antibodies that propel into blood and attack healthy cells and tissues of a person. Furthermore, such mutated antibodies cause inflammation of various organs, which can be even more destructive and dangerous compared to infection with other pathogenic agents. These abnormal antibodies produced by the immune system transform into autoantibodies that can damage any organ, including the brain, kidneys, blood, skin and others. Therefore, serious mutations on the cellular and genetic levels allow the immune system transform into an aggressor to one's own body, which manifests in inappropriate functioning of organs.
The cause of lupus erythematosus still remains unknown. However, multiple researches reveal that it primarily results from the combined effect of variants in the multitude of genes which can be responsible for acquiring the disease under scrutiny (Tsokos, 2011). Simultaneously, researchers indicate that hormone imbalance and negative environmental factors such as excessive exposure to ultraviolet light, toxins, chemicals, and medications may also trigger the formation of lupus-related autoantibodies that aggravate the health condition. Additionally, stress and pregnancy can also be causative factors that may induce the development of lupus erythematosus symptoms. Furthermore, viral infections can activate certain cells in the immune system, whereas chronic infections may stimulate anti-DNA antibodies or even lupus-like symptoms (Bartels, 2017).
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Lupus erythematosus has diverse, extremely variable clinical manifestations depending on the affected organ. Therefore, clinicians distinguish constitutional, musculoskeletal, renal, cardiac, dermatologic, gastrointestinal, pulmonary, hematologic and neuropsychiatric symptoms and signs specific for the disease. Lupus-associated symptoms can develop either gradually or spontaneously and unexpectedly. They can be present temporally or permanently depending on the severity of the disease progression. Additionally, the symptoms can be mild and disappear periodically. However, complicated forms of lupus erythematosus result in a variety of implications. One of the most evident signs specific for the reviewed affliction is a butterfly-shaped erythematous rash localized on the cheeks and over the bridge of the nose which is painless and does not cause pruritus. It can be detected by skin lesions that appear in malar rash, acute and sub-acute cutaneous rash and can aggravate at intensive exposure to ultraviolet radiation and without appropriate and sufficient therapy (Lam et al., 2016). Furthermore, the disease can significantly damage mucus and trigger the development of mouth and nasal ulcers that can multiply with lupus erythematosus progression. People with the indicated disease can suffer from low-grade fever, headache, fatigue, dyspnea, alopecia, photosensitivity, poor appetite, and weight changes. This medical condition mimics arthritis due to frequent patients complaints about pain in the joints. Arthralgia, arthropathy, non-erosive inflammatory arthritis as well as myalgia and fibromyalgia can indicate the development of lupus erythematosus (Lam et al., 2016). The affliction can cause stiffness and swelling in the extremities. In case of stress or exposure to cold temperatures, fingers and toes can become violet or white. People having lupus can even experience deformation of small joints (Shiel, 2017). LE hinders proper functioning of kidneys, which can ultimately lead to their inflammation and even kidney failure. Renal impairments related to lupus primarily manifest in proteinuria and hematuria. Renal insufficiency is characteristic for lupus nephritis, which is commonly acquired by most LE patients and can be extremely destructive (Cleveland Clinic, 2016). Furthermore, the stated disease may induce inflammation inside brain tissues, which can contribute to psychiatric abnormalities. People suffering from LE may experience memory problems, headaches, mental confusion, depressive disorders and seizures. Lupus-associated symptoms interfere with normal functioning of the respiratory organs and heart as well. Thus, LE patients may experience chest pain due to the inflammation of pleura or pericardium, which reflects the extent of pathogenic pathway (Shiel, 2017). Furthermore, it can affect normal blood circulation and cause leukopenia, lymphopenia, hemolytic anemia, and thrombocytopenia (Lam et al., 2016). Such hematologic impairments largely increase the risk of having contamination or bleeding. Therefore, lupus erythematosus manifests in various symptoms and signs that deteriorate appropriate functioning of the vital body systems. The aforementioned description asserts the fact that lupus erythematosus refers to multifactorial and multisystem autoimmune diseases. The described medical condition ignites the development of other concomitant disorders.
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Lupus erythematosus belongs to incurable medical conditions that can be fatal without proper and duly medical management. Presently, the primary goal of LE treatment is to reduce disease flares, relieve its symptoms and minimize discomfort. Additionally, comprehensive therapeutic interventions can assist in avoiding complications and obtaining a long-term remission. The choice of treatment modalities mostly depends on the affected organ, medication compatibility, adverse effects, present comorbidities, previous disease management, and patients preferences (Muangchan et al., 2015). Low-dose glucocorticoids assist in managing most of LE symptoms. However, non-steroidal and steroidal anti-inflammatory medications can be helpful for decreasing pain in the joints, whereas a combination of glucocorticoid drugs with immunosuppressants can be effective in preserving renal function. Immunosuppressants can also effectively decrease inflammatory processes caused by lupus erythematosus. Antimalarial medication can efficiently alleviate mucocutaneous symptoms and control some of the constitutional manifestations. These drugs showed their efficacy by providing a long-lasting remission. Immunosuppressant drugs can restrain overactivity of the immune system. Simultaneously, they can be effective in managing renal insufficiency and severe abnormalities in the central nervous system. The administration of corticosteroids along with immunosuppressants can provide better therapeutic effects due to their high efficiency. Researchers continue searching and developing new medications that can be more effective and safe in treating LE. Recently, practitioners have started prescribing a medication called Belimumab that can minimize the number of mutated B cells which can be a LE causative agent (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016). The achievements of pharmacotherapy designed for lupus erythematosus treatment can be effective in preventing erratic response evoked by the immune system. Such innovative drug as Bindarit is developed for precluding the immune system from deviant response. Furthermore, researchers analyze efficacy of biologic therapies and small-molecule drugs that are capable to rectify the aberrant immune-cell function (Tsokos, 2011). Multiple clinical trials and surveys confirm the effectiveness of newly-designed medications as they do not cause severe side effects and demonstrate better outcomes. Additionally, researchers check the efficiency of other alternative therapies such as phototherapy, monoclonal antibodies, plasmapheresis, transfusion, dehydroepiandrosterone (DHEA), intravenous immunoglobulin, and autologous stem cell transplant. All approved medications can significantly improve the health condition of people afflicted with lupus and their quality of life. Besides, they can disrupt and suppress unfavorable inflammatory immune factors.
Lupus erythematosus is a serious autoimmune disease that occurs due to genetic and cellular mutations. It is specified by a variety of symptoms and signs that depend on the affected organs. The reviewed disorder refers to incurable medical conditions. Approved medication can provide preventive and supportive care with a long-term effect. Hormone therapy along with anti-inflammatory and immunosuppressive drugs can be highly helpful in reducing symptoms associated with lupus. Considering the fact that the discussed disease still remains incurable, further research, laboratory investigations and trials are highly required.