Systemic Lupus Erythematosus: An Overview and Investigation

Systemic Lupus Erythematosus (SLE) is a very serious disease. There is a lot of mystery surrounding SLE but there is some knowledge that is very beneficial. There are symptoms, early detection, treatment and solutions and the debate between the role of genes versus the environment in how SLE appears and operates within the human body. With current research, it is believed that SLE is a combination of genetic and environmental factors. There are also ways to increase the prevention of SLE and lower the risk of contracting the disease through changes in a person’s environment.

The mystery surrounding SLE makes it a very elusive and scary disease. One of the first areas to examine, however, despite limited knowledge, are the symptoms of SLE. “The initial presentation of lupus often mimics a viral syndrome. Such constitutional symptoms as weight loss, fatigue, and low-grade fever are common and may be accompanied by arthralgia or arthritis” (Kiriakidou, 2013, p. 3). The symptoms, unfortunately, are not unique to SLE and because some of them, such as arthritis, are less common, it is difficult to diagnose SLE based on symptoms alone. In fact, fibromyalgia and chronic fatigue syndrome are just two diseases that are often diagnosed by mistake instead of SLE (Kiriakidou, 2013, p. 6). Therefore, further testing, specifically on the sensitivity of the skin, is required to rule out diseases that SLE often mimics. Finally, because of the illusiveness of SLE, early detection is often very difficult.

Like detection, treatment is also lacking in terms of clarity. However, three families of drugs have been tested repeatedly and have been shown to have positive effects on the treatment of SLE. The drugs are NSAIDs, Glucocorticoids and Hydroxychloroquine. NSAIDs are simply pain-relieving drugs with minimal side effects. Glucocorticoids are also used for SLE to reduce pain but they are stronger than NSAIDs and sometimes come with somewhat severe side effects including hypertension, psychosis and osteoporosis. Finally, Hydroxycholorquine is used to repress flare-ups of SLE. Fortunately, Hydroxychloroquine does not contain severe side effects that are common. On the other side, there are eight drugs used to treat SLE that are, “…based on sparse evidence from clinical trials and clinical experience and often requires immunosuppressive therapy and a multidisciplinary approach” (Kiriakidou, 2013, p. 7). While the research surrounding certain drugs is lacking, it is very dangerous for a person with SLE or SLE like symptoms to refuse diagnosis and treatment. “Treatment-free remission…is extremely rare: only 3.4% in the Hopkins Lupus Cohort [a respected ongoing study of over 2,000 cases of lupus] are in remission…” (Petri, 2011, p. 1). Because SLE mistakenly attacks healthy body tissue and weakens the immune system, it is very important for people who may have this disease to seek medical care.

One area of study that is very crucial in narrowing down SLE is the debate between genetic and environmental causes. Both genetics and the environment contribute to the development of SLE. “Several studies have shown prevalence of SLE in African-Americans, and in Afro-Caribbean migrants to Europe, has been reported to be six to eight times higher than in people of European descent living in the same countries” (Molokhia & McKeigue, 2006, p. 827). “Same countries” is the key phrase in this statistic. This virtually eliminates the potential for the environment to be the sole factor in the development of SLE, at least in terms of race. In terms of the environment, there is the study of smoking and low levels of Vitamin D in relation to SLE. For smoking, “data suggested a possible close response effect as current smokers had in general higher risk for disease than ex-smokers” (Molokhia & McKeigue, 2006, p. 830). The current data smoking as a risk factor for SLE is not concrete however. In regards to Vitamin D, it has been found that controlling for other variables such as age, a deficiency in Vitamin D has an adverse effect on European-Americans. However, African-American populations do not have an association with SLE with Vitamin D deficiency (Molokhia & McKeigue, 2006, p. 831). Further research is required to ascertain exactly how big of a factor Vitamin D is regarding the development of SLE.

As shown, Systemic Lupus Erythematosus is a very hard disease to pin down and then to treat. However, even though symptoms may mimic other diseases, there are ways, through somewhat extensive medical practice to eliminate other diseases with similar symptoms. Treatment is contested for the majority of drugs used to treat SLE but there is a handful that are strongly recommended. It is also obvious that there are genetic as well as environmental factors contributing to the development of SLE. However, despite this knowledge, SLE continues to be a difficult disease to treat and cure.

References

Kiriakidou, M. (2013). Systemic Lupus erythematosus. Annals of Internal Medicine, 159(7), 2-16. Retrieved from http://www.acponline.org/journals/

Molokhia, M., & McKeigue, P. (2006). Systemic Lupus erythematosus: Genes versus environment in high risk populations. Lupus, 15(11), 827-832. Retrieved from http://lup.sagepub.com/

Petri, M. (2011). Clinical research in systemic Lupus erythematosus: Immediate relevance to clinical practice. International Journal of Rheumatic Diseases, 14(1), 1-5. Retrieved from http://www.wiley.com/WileyCDA/