Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE) - a disease related to diffuse diseases of the connective tissue, which were previously called collagen diseases, or collagenoses. The provoking factors are infections, insolation, vaccination, the use of certain drugs. Mostly women aged 20-30 are ill.
The initial clinical manifestations of the disease can be fever resistant to antibiotic treatment, articular syndrome, skin rashes that occur in isolation or in combination with each other. Almost all patients have articular syndrome in the form of arthralgia or polyarthritis with a primary lesion of the interphalangeal and wrist joints. Characterized by skin lesions, manifested by an erythematous rash on the nose and cheeks, which looks like a butterfly. The appearance of erythema under the influence of solar or ultraviolet radiation is typical. On the skin of the terminal phalanges of the fingers and toes, small erythematous spots with slight puncture and telangiectasia (capillary) can be observed. Pleurisy is often detected, usually bilateral, recurrent, with a small amount of fluid and a tendency to adhesions. Possible lung damage, manifested by cough, shortness of breath, sometimes hemoptysis. Damage to the heart can be manifested by signs of myocarditis, endocarditis with the formation of a mitral valve defect or pericarditis (intermittent pericardial friction noise). More than half of patients have kidney damage in the form of diffuse glomerulonephritis (lupus nephritis), a nephrotic syndrome with the gradual development of renal failure. Leukopenia , moderate anemia and thrombocytopenia, and an increase in ESR are characteristic. When the process is active, lupus cells (LE cells) are identified in the blood, which are mature neutrophils, in the cytoplasm of which there are large inclusions. Detection of LE cells has important diagnostic value.
The course of the disease is characterized by alternating periods of exacerbations and remissions. Allocate a subacute (most often) and chronic (benign) course of the disease.
The treatment is usually complex, includes active anti-inflammatory and immunosuppressive therapy, as well as rehabilitation measures. The main method of treatment is the use of corticosteroids. The initial (overwhelming anti-inflammatory) dose is 40-60 mg of prednisolone per day. After suppression of activity, they switch to maintenance doses (5-10-15 mg per day). Cytostatics (azathioprine), non-steroidal anti-inflammatory drugs, anticoagulants, antiplatelet agents are also used. In some cases, hemosorption, plasmapheresis are performed. With a decrease in the activity of the process, it is possible to carry out rehabilitation measures - physiotherapy exercises, massage, spa treatment in the conditions of local sanatoriums. Patients with SLE should be under constant clinical supervision.