What disease is lupus? Dangers and complications of the disease

This is an automatically translated article.

The article was advised by Specialist Doctor I Le Thi Thu Hang - Dermatologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital
Systemic lupus erythematosus is an autoimmune disease. The disease manifests and causes complications throughout the organ systems in the body. Without aggressive treatment and intervention, lupus can be life-threatening. Understanding this disease is essential for early detection, timely treatment, and avoiding complications of the disease.

1. What is lupus erythematosus?

Lupus erythematosus is divided into two main types: discoid lupus erythematosus and systemic lupus erythematosus. Systemic lupus erythematosus is a common autoimmune disease. The cause of lupus in particular and autoimmune diseases in general is that the body has a mismatch in the immune response, leading to the immune system fighting against the body's own organs. Currently, there is no cure for lupus, but it can be controlled with the right treatment in the first place.
According to statistics, of the patients with lupus erythematosus, 90% are female. The common age group is from 15 to 50 years old and the disease accounts for 50/100,000 population.
Mechanism of causing lupus erythematosus
The role of the immune system is to create a defensive barrier, helping the body to resist the invasion of foreign agents (bacteria, viruses,...). However, in the body of patients with systemic lupus erythematosus as well as other autoimmune diseases, the immune system completely loses the ability to distinguish "foreign - familiar", mistaking the body's own tissues for the disease. The body is also a foreign body, so the reaction produces antibodies against the cells of most organs.
So far, the cause of the disease has not been clearly proven. However, there are some tentative hypotheses that systemic lupus erythematosus is the result of the interplay of many factors.
In which, there are some factors that play a much more prominent role such as:
Genetics: People with a family history of siblings with systemic lupus erythematosus have a 20 times higher risk of developing the disease. compared with normal people Environment: Due to infectious agents, exposure to chemicals, sunlight Endocrine: The disease occurs mainly in women of reproductive age,... In addition, one Some drugs such as hydralazine, procainamide, isoniazid, sulfonamide, phenytoin, penicillamine can cause lupus-like disease, so it is easy to misdiagnose with real lupus. At the same time, oral contraceptives have also been shown to play a role in initiating or aggravating the disease.

2. Manifestations of lupus erythematosus like?

Because it is a systemic disease, lupus involves most organs. At the same time, symptoms of systemic lupus erythematosus can appear suddenly or gradually over months or years.
Skin : This is the most often noticeable symptom. Up to three-quarters of patients find themselves with an abnormal red rash on the skin. In particular, a butterfly-shaped erythema on the face is a very characteristic sign of lupus. In addition, lesions on the skin are also seen in other open areas such as the neck, hands, ... These lesions are generally very sensitive to sunlight. If it progresses for a long time, the lesion can atrophy in the midsection, hence the term "Erythema discoid". Some lesions may be hyperplastic. In addition, skin lesions caused by lupus also take the form of bullae, maculopapular hemorrhages. The mucous membranes in the mouth and oropharynx are easy to sore but not painful. Blond hair, easily broken and shed a lot. Cardiac: Patients may present with chest pain, dyspnea like myocarditis, pericarditis. Sometimes the disease has progressed severely, causing heart failure. Lungs: Symptoms of pneumonia, pleurisy are also common and may cause respiratory failure. Joints: Arthritis is a very common manifestation, making it difficult for patients to move and walk. Blood: Most of the patients have anemia from mild to severe with blue skin, pale mucous membranes, pale lips, limited exercise capacity. Blood tests show a decrease in all three blood cell lines: red blood cells, white blood cells, and platelets. Kidneys: Lupus nephritis is a common diagnosis in the group of autoimmune nephritis. Patients coming to the doctor may have cloudy urine, hematuria, generalized edema, and increased blood pressure. Urinalysis is abnormal and can sometimes be confirmed with a kidney biopsy. Neuropsychiatric: Some patients have disorientation, decreased consciousness, memory loss. Sometimes there is a severe headache or generalized convulsions. Neuropsychiatric symptoms may be aggravated in the case of long-term and high-dose corticosteroids. In addition, in clinical practice, the majority of patients come to the clinic because of non-specific manifestations such as weight loss, fatigue, anorexia, low-grade fever, hair loss, prolonged mouth ulcers, pain in joints. small. Even many cases just because of muscle pain, menstrual disorders.
Symptoms of lupus often develop in acute episodes, alternating between periods of remission. In the early stages of the disease, the symptoms are often vaguely similar to many other diseases, so the time from the first symptoms until the diagnosis of the disease can be several years late.

3. What are the complications of lupus erythematosus?

Lupus erythematosus disease has a complicated course, progresses in stages, the next phase is more severe than the previous one and causes damage to almost all organs in the body such as kidneys, blood-forming system, cardiovascular, nervous system, digestive system. chemical, respiratory,... In severe cases, the disease can be life-threatening.
If the disease is left untreated, lupus erythematosus can cause severe damage to most internal organs according to organ systems, commensurate with the symptoms presented.
In the heart: Systemic lupus erythematosus can cause myocarditis, pericardial effusion. Prolonged conditions can cause chronic heart failure. In contrast, some cases progressed to fulminant, acute myocarditis, causing acute heart failure, the patient suddenly died due to cardiovascular collapse.
In the lungs: The patient may have difficulty breathing, acute respiratory failure due to pleural effusion, pneumonia.
In the kidney: Lupus damage causes glomerular destruction by glomerulonephritis reactions, progressing to renal failure.
In the nervous system: The patient may have convulsions, mental disorders.
In the hematopoietic system: Systemic lupus erythematosus can cause anemia and bleeding. Prolonged anemia also affects the functioning of organ systems. At the same time, the bleeding situation aggravates the problem of anemia and is life-threatening if it causes cerebral hemorrhage, compressing the brain.
In addition, patients may also experience complications from immunosuppressive drug therapy. The immune system no longer ensures its inherent function, the body is susceptible to infectious agents that cannot fight off. The infection progressed rapidly, leading to sepsis, the patient easily fell into shock and died.

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Reference source: Ministry of Health