2023-10-04 02:00 Zou Shangqian The symptoms of lupus erythematosus are very diverse and vary in severity. This is a schematic diagram. (Getty Images)
A woman in her 70s had constant fevers and abnormalities in many organs but could not find the cause. It was not until she had an examination and ruled out related diseases one by one that it was discovered that the cause was lupus erythematosus.
Lupus erythematosus is an autoimmune disease. The patient’s immune system attacks itself, targeting healthy tissues and organs. It is a systemic disease. Many patients will never develop the disease in their lifetime, but even if they do, as long as they are properly controlled, they can live as long as the average person.
20% of patients are presumed to have genetic causes
The so-called “erythema” in lupus erythematosus refers to the common skin symptom “erythematous rash”, which affects multiple systems and organs, including the skin, joints, heart, lungs, kidneys, and even the whole body. Your nervous system may be attacked by your own immune system.
Du Yunzhen, an attending physician at the Department of Rheumatology and Immunology at Taipei’s Taipei Adventist Hospital, said that common triggers of lupus erythematosus are chemicals, stress, viral infections, etc. Although 20% of patients are thought to be hereditary, most immune diseases are acquired diseases. Even if the body carries the factors, if it is not exposed to the triggering source, it may not develop in a lifetime.
Du Yunzhen said that the main patients with lupus erythematosus are women, with a male-to-female ratio of about 1:10. The onset of the disease is affected by hormones. The most common period for women is from their teenage years to before menopause, with a prevalence rate of 30 to 60 per 100,000 people. Race also has an impact, with blacks having a higher incidence rate than whites. In the case of twins, one If one parent has lupus, the other has a 30 to 50% chance of developing it; genetically, if either parent has lupus, their children have a 10% chance of developing it.
Multiple symptoms and complex diagnosis criteria
Du Yunzhen shared that he had encountered a rare clinical case in which the disease only developed after menopause. The case is a woman in her 70s. She has stopped menstruating for a long time, but her fever persists. No reason can be found. Many organs have been affected. There is a large amount of fluid in the abdomen and chest. Doctors thought it was a viral infection and suspected “tuberculosis” infection. , but after examination and diagnosis, no supporting evidence could be found. After ruling out related diseases one by one, the diagnosis of “lupus erythematosus” was made.
The diagnosis of lupus erythematosus is quite complicated. Du Yunzhen said that according to the 11 lupus erythematosus standards established by the American Medical Association earlier, the diagnosis was confirmed if four of the criteria were met. However, due to the discovery of more diverse symptoms of lupus erythematosus in recent years, in order to allow patients to be diagnosed and treated early, simple skin symptoms are separated, including discoid erythema, broken mouth, hair loss and other skin symptoms. 2 points; blood test, proteinuria, etc. are scored 4 points; if there are lesions in the kidney section, the score is 8 to 10 points, and a diagnosis of 10 points is considered.
Patients with lupus erythematosus should avoid eating too many “photosensitive plants”, such as alfalfa sprouts, celery, coriander, coriander, etc. Pictured is celery. (Photo from this newspaper’s file)
The injured organ is most afraid of worsening to the point of kidney dialysis
“Systemic immune system disorders are partly related to genes.” However, Du Yunzhen pointed out that whether patients with lupus erythematosus will develop the disease is mainly affected by the “external environment.” For example, excessive exposure to sunlight can lead to excessive ultraviolet rays; eating too many “photosensitive plants” such as alfalfa sprouts, celery, coriander, basil, etc. can make the body more sensitive to sunlight; the types of viruses can be quite diverse, and there are also clinical cases Being infected with COVID-19 and even getting vaccinated may induce lupus antibodies.
Du Yunzhen said that the most obvious symptom of lupus erythematosus is the skin symptoms like wolf scratches. Because it is a systemic immune system disease, joints and organs will be affected, and the inflammatory reaction will cause pericarditis, spinal cord inflammation, etc. At the same time, the “nervous system” will also be affected, which can manifest in the form of epilepsy.
“Lupus erythematosus is most afraid of getting worse and requiring kidney dialysis.” Du Yunzhen pointed out that since the immune response mainly manifests itself in the form of inflammation, the most typical damage to internal organs is “kidney inflammation.” When proteinuria cannot pass through the kidneys, Recycling causes water to accumulate in the body, affecting multiple organs. Water accumulates around the heart, causing pericarditis, or in other parts of the body to become pleural effusion, abdominal effusion, etc. Du Yunzhen said that patients’ kidney problems and proteinuria are the most difficult parts to deal with. If not properly controlled, they may lead to kidney dialysis, which is the most common complication.
Polytherapy medication is complex and individualized
The treatment of lupus erythematosus is quite diverse and complex, involving a high degree of personalized medicine. Du Yunzhen pointed out that the treatment of lupus erythematosus is not like traditional rheumatoid diseases. There is no single-use effective drug. Sometimes there is an acute attack, and back-line drugs must be put in early and take a period of time to take effect. The effect also varies from person to person. The only thing that is certain is that patients need long-term use of “steroids” to help control erythema, and other drugs are used to correct the immune system.
However, after the government recently liberalized biologics, more and more new drugs have been released, giving patients more drug options besides steroids to avoid kidney dialysis.
Patients with lupus erythematosus should avoid eating too many “photosensitive plants”, such as alfalfa sprouts, celery, coriander, coriander, etc. Pictured are alfalfa sprouts. (Photo of this newspaper’s data) Patients with lupus erythematosus should avoid eating too many “photosensitive plants”, such as alfalfa sprouts, celery, coriander, parsley, etc. The picture shows the nine-story tower. (Photo from this newspaper) Joint Medicine Complications
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2023-10-04 06:00:00
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