Signs
and Symptoms of LupusSystemic lupus affects mainly women between 35 and
45. It often presents as non specific joint pains, often in the hands with tendons
being affected also. Morning stiffness can be considerable. Associated with this there may be profound fatigue,
which cannot be explained otherwise. There might be mouth ulcers, rarely also
ulcerations in the nose or vagina. Light hypersensitivity occurs frequently. This
occurs mainly in the face, the neck and upper chest area with the development
of often roundish (maculopapular) skin lesions. Here is a picture link
to a site showing the butterfly rash in the face . Here is a link
to a picture of another example of skin involvement with systemic lupus, a conditon
called discoid
lupus. Unfortunately, as the ANA titer increases, more systemic
features may develop. In 25-50% of patients with lupus systemic disease such as
kidney disease develops. Fortunately, if this is spotted by urinary tests with
dipstick measurements of protein, and treated only less than 5% will go on to
end stage kidney failure. Brain lupus (medically termed "cerebral lupus")
is extremely rare, but when present can be very confusing: such diverse clinical
conditions as psychosis, epilepsy, organic brain syndrome and severe headaches
can all be different manifestations of the same disease process. Even strokes
and personality changes do occur occasionally.
| Signs and symptoms
of lupus | | Signs
and symptoms: | Comments:
| | generalized
arthritis | pronounced morning stiffness,
but little to find | | skin
manifestations | facial butterfly rash, skin
lesions in face, neck, chest | | rapid
hair loss | important diagnostic sign, hair
regrows with remission of lupus | | ulcerations
in the mouth, nose or vagina | in
mouth most commonly, often self limiting |
| fatigue | common with
flare-up of lupus; with chronic lupus due to depression |
| major organ disease | in
a minority lupus affects kidneys, central nervous system, lungs and heart |
| pleurisy ( =fluid in chest cavity) | pleuritic
pain may mimic pneumonia or pulmonary embolism |
| pericarditis (=fluid in sac around heart) | lack
of energy with physical exertion | | CNS
involvement | severe headaches, epilepsy,
personality changes, stroke, psychosis |
| enlarged lymph glands and spleen | particularly
common in children and blacks | As indicated
in the table above other vital organs such as the heart and the lungs can also
be affected by immune complexes with high ANA titers. There can be breathing problems
when water in the lungs develops (effusion in the chest cavity). This condition
is called pleurisy. Similarly there can be a buildup of fluid in the pericardial
sac, called pericarditis. This can be life threatening, if it leads to cardiac
tamponade, a condition where the fluid is under pressure and the heart has a hard
time pumping blood. On rare occasions a vasculitis of the coronary arteries can
develop (Ref. 2, p.426), which can lead to a sudden heart attack in a young patient,
which normally (without lupus) would be very unusual event.
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Disclaimer: This
outline is only a teaching aid to patients and should stimulate you to ask the
right questions when seeing your doctor. However, the responsibility of treatment
stays in the hands of your doctor and you. References: 1.
ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books,
1999. Chapter 15. 2. The Merck Manual, 7th edition, by M. H. Beers et al.,
Whitehouse Station, N.J., 1999. Chapter 50. 3. BP Tsao et al. Curr Rheumatol
Rep 2001 Jun;3(3):183-190. 4. D Alarcon-Segovia Isr Med Assoc J 2001 Feb;3(2):127-130. 5.
CC Mok Semin Arthritis Rheum 2001 Jun;30(6):426-435. 6. Goldman: Cecil Textbook
of Medicine, 21st ed.(©2000)W.B.Saunders 7. Ferri: Ferri's Clinical Advisor:
Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc. 8.
Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier Last
Modified: March 18, 2012 | |
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