Jakarta (ANTARA) – A healthy immune system functions to protect the body from disease and infection. If the immune system is not functioning, instead of being a protector, it is the body that is attacked.
Cells, tissues and organs can become victims. Autoimmune diseases can affect various parts of the body, weaken body functions and threaten a person’s life.
What is Lupus?
Systemic Lupus Erythematosus or Systemic Lupus Erythematosus (SLE) is a disease Autoimmune Inflamatory Rheumatic Disease (AIIRD) which occurs when the body’s immune system attacks the body’s own tissues and organs.
This disease will result in the loss of the immune system’s ability to detect differences between foreign substances and cells or tissues belonging to the body that triggers severe inflammation (inflammation). The inflammation caused by lupus can affect many different body systems — including the joints, skin, kidneys, blood cells, brain, heart, and lungs.
Lupus can affect anyone, but mostly found in women of childbearing age between 15 to 45 years. This disease needs to be watched out for because the diagnosis is not easy and often too late.
Although 90 percent of people with lupus have a positive ANA (anti-nuclear antibody) laboratory test, there is no single laboratory test that can confirm a person has lupus. Many sufferers experience lupus symptoms for several years before they are actually diagnosed with lupus.
Also read: IDAI says 90 percent of lupus affects women of reproductive age
Also read: Diet and exercise, the key to a healthy person with Lupus
What causes Lupus?
As an autoimmune disease, lupus occurs when your immune system attacks healthy tissue in the patient’s body. It is possible that lupus is caused by a combination of genetics, hormones and the environment in which the patient lives.
There is a tendency in people with lupus, where the disease develops when they come into contact with something in their environment. In many cases, the cause of lupus is still not known with certainty.
However, some potential triggers include sun exposure, infections, medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the drug. It is rare for lupus symptoms to persist after the triggering drug is discontinued.
How is Lupus classified?
Lupus disease in general can manifest in several forms, namely:
Light SLE
Patients with mild SLE are clinically calm, there are no signs or symptoms that threaten the patient’s life. Organ functions also work normally or stable, such as: kidney, lung, heart, gastrointestinal, central nervous system, joints, hematology and skin. Examples of mild SLE include lupus with arthritis and skin manifestations.
SLE Moderate
SLE severity can be categorized as moderate when symptoms of mild to moderate nephritis (lupus nephritis class I and II) occur. Experiencing thrombocytopenia (platelets 20-50×103 per cubic mm) or a decrease in the blood platelet count below the normal limit of 150,000 to 450,000 per microliter. Serositis major or severe inflammation of the inner lining of the lungs (pleuritis) and heart (pericarditis) usually occurs with chest pain, fever, and exudative effusion.
LES Weight
SLE can be classified as severe or very serious when it is life-threatening or organ-threatening.
What are the symptoms of Lupus?
Symptoms of lupus are mostly symptoms of other diseases, that’s why the diagnosis of this disease is quite difficult. Inflammation that occurs due to lupus can attack various organs of the body.
This causes the symptoms of lupus can be very diverse and where one patient with another sufferer can be different. However, there are a number of common symptoms that usually occur, namely joint pain and stiffness, rashes on the skin especially on the cheeks and nose which are often called “butterfly rash”, severe fatigue without triggers, swelling of joints, skin more sensitive to sunlight, hair loss , anemia, blood clotting problems, weight loss, fever for no apparent reason, fingers turning pale to white or blue and tingling when cold aka Raynaud’s phenomenon and thrush.
Other symptoms may also be experienced depending on the part of the body that is affected, such as digestive tract, heart, or skin problems.
Also read: Lupus is difficult to diagnose but can be detected through SALURI
How is Lupus diagnosed?
The difficulty of diagnosing lupus, causes sufferers to undergo a number of examinations. The doctor will start by extracting information about the symptoms and medical history of the patient and family.
Next, a thorough physical examination will be carried out on the patient, including checking for the presence or absence of rashes and joint inflammation that usually appear in people with lupus.
The diagnosis of SLE is made on the basis of a combination of clinical manifestations of typical missed disease and positive serological results. Supportive examinations such as follow-up screening will also be carried out to make it easier for doctors to make the right diagnosis, including an ANA (antinuclear antibody) examination, to check for the presence of certain antibody cells in the blood that are usually possessed by lupus patients.
Complete blood test, to measure the number of each type of blood cell and find out how well the kidneys are functioning as well as the liver. Urine test, to measure the level of protein or red blood cells in the urine which can be a benchmark for kidney work. Skin or kidney biopsy, to determine the presence or absence of abnormal tissue in the skin and kidneys.
The doctor will also perform a physical examination to check for the typical signs and symptoms of lupus, such as: Sun sensitivity rashes (malar rashes/butterfly rashes), Discoid rash, which is a red rash on the skin that leaves scars Arthritis which is swelling or pain in the small joints of the hands, feet, knees, and wrists.
As well as kidney disorders characterized by the appearance of protein in the urine, nervous disorders characterized by seizures or psychosis, inflammation of the lining of the lungs (pleuritis) or the lining of the heart (pericarditis), blood disorders such as anemia, leukopenia, or thrombocytopenia.
Also immune system disorders. It is possible that the doctor will also refer the patient to a rheumatologist, a doctor who specializes in treating joint and soft tissue disorders and autoimmune diseases.
How is Lupus treated?
Treatment for people with lupus will depend on the symptoms and needs of each patient. At least the treatment is carried out using drugs that are focused on reducing swelling and pain, calming the body’s immune system so as not to attack organs and body tissues, reducing or preventing damage to joints, reducing or preventing organ damage.
Some types of drugs commonly used to treat lupus include:
1. Corticosteroids (and other immune system-suppressing drugs). Oral steroids such as prednisone and prednisolone can be very helpful treatments for sufferers. Especially in serious lupus attacks that affect organs such as the kidneys, steroids in high doses can quickly control the symptoms that occur.
2. Anti malaria. This drug is also known as an antimalarial drug used to treat malaria, where researchers found that this drug can also help treat lupus. This drug works well with mild to moderate cases of lupus, helping to relieve symptoms such as joint swelling and skin rashes. But it should be noted that hydroxychloroquine cannot be used alone for severe cases of lupus involving the kidneys or other organs.
3. Immunosuppressants. Because lupus is a disease caused by an overactive immune system, medications that suppress the immune system can help relieve symptoms, including calcineurin inhibitors (eg cyclopsorin), mycophenolates, azathioprine, cyclophosphamide, and others. These drugs are commonly used as steroid sparring agents in people with moderate to severe lupus.
Keep in mind that lupus can affect many different parts of the body, so many patients will need other medications depending on their symptoms. These can include statins, diuretics, anticoagulants, drugs to strengthen bones, blood pressure medications, antibiotics, stimulants, and so on.
In addition to treatment as already mentioned, patients are also advised to adopt a healthy lifestyle, and manage stress in a positive way.
Autoimmune Disease (AIIRD) and COVID-19
Patients with autoimmune diseases must act more vigilantly and take extra precautions to avoid exposure to viruses, because their bodies are very susceptible to viruses and there are indications of developing other diseases, which can lead to complications.
Although people with autoimmune disease (in this case, lupus) have a higher risk of complications, the study found that it was quite a relief that the survival rate of patients with lupus or arthritis who were attacked by the COVID-19 virus was relatively high.
Also read: COVID-19 challenges for people with autoimmune inflammatory rheumatism
Also read: FKUI launched the Lupusku app to improve therapy adherence
Also read: Autoimmune inflammatory rheumatism patients need to be vaccinated against COVID-19
By Nanien Yuniar
Editor: Maria Rosari Dwi Putri
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