Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can affect various organs and body systems, especially:
- Central Nervous System.
It is an autoimmune disease in that it consists of a disorder of the immune system that, instead of protecting the body from bacteria and viruses, attacks its own organs and tissues.
It is a chronic disease because it can last a lifetime.
Systemic lupus erythematosus (SLE) is widespread throughout the world, and in 15% of cases one becomes ill before the age of 18.
The cause of the disease is unknown.
Systemic lupus erythematosus is not a contagious disease, but rather an autoimmune disease in which the immune system begins to produce antibodies against its own normal cells as if they were foreign cells and attacks them.
The most common initial symptoms are:
- Fever (sometimes);
- Weight loss and appetite.
These symptoms are associated with manifestations of the skin and mucous membranes:
- Butterfly rash (facial rash) also known as malar rash, at the root of the nose and cheeks, increased by sun exposure (Figure 1);
- hair loss (alopecia);
- Canker sores in the mouth.
You may also have:
- joint swelling and stiffness (arthritis);
- Muscle pain;
- reduction in the number of white blood cells and platelets.
Some children also have kidney problems with symptoms such as increased blood pressure, swelling of the feet, legs, and eyelids, and protein and blood in the urine.
The diagnosis of SLE first requires a careful collection of the child’s history and an equally careful medical examination.
It is based on a combination of symptoms (such as pain and fever) and blood and urine tests.
- ESR and CRP which, if elevated, mean that inflammation such as that caused by autoimmunity is taking place;
- Check the blood for particular antibodies (antibodies directed against DNA double helix) that are only present in people with lupus;
- Complement levels in the blood that are often low in people with lupus. Normally, the immune system needs complement proteins to destroy microbes and foreign substances;
- Urinalysis and kidney function tests to detect possible kidney failure.
Not all symptoms and abnormalities in laboratory tests occur at a specific time and this can make diagnosis difficult.
Internationally recognized criteria are used to make the diagnosis of systemic lupus erythematosus and are listed in the table below.
Since the cause is unknown, there are no specific medications to cure systemic lupus erythematosus.
However, the immunosuppressive and anti-inflammatory medications that are available to us can control the symptoms of systemic lupus erythematosus and prevent complications of this disease.
In fact, since most of the symptoms of systemic lupus erythematosus are due to inflammation of various organs and tissues, treatment is based on the use of cortisone and immunosuppressive drugs, among which are Cyclophosphamide, Azathioprine, Mycophenolate and Hydroxychloroquine. , also combined.
There are also two biotechnological drugs indicated for systemic lupus erythematosus: Rituximab (anti-B lymphocyte) and Belimumab (specific inhibitor of a molecule of the immune system called Blyss).
After the initial stages of treatment, children with systemic lupus erythematosus being treated can lead normal lives.
They should avoid excessive exposure to sunlight, especially during the hours of maximum sunshine, and always use high-filter sunscreen or, better yet, total.
In fact, sun exposure can cause a flare-up of the disease.
Infectious diseases must be treated promptly as Lupus and immunosuppressive therapies reduce immune defenses.
Children with systemic lupus erythematosus can and should go to school, except at times when they are very sick (although this is very rare)
Regular exercise is important for maintaining a healthy weight, healthy bones, and fitness, and should be encouraged during remission of the disease.
If the disease is diagnosed early and then treated promptly, it usually resolves and can go into remission (ie, symptoms go away).
However, it is a chronic disease, and children with systemic lupus erythematosus usually remain under medical care with medication for very long periods (several years), often into adulthood.