Clinical Manifestation of Systemic Lupus Erythematosus (SLE)

Course of the disease Systemic Lupus Erythematosus (SLE) is highly variable. The disease can arise suddenly accompanied by signs exposed to various systems in the body. Can also be chronic with symptoms in a system that gradually followed by symptoms that affected the immune system. In the chronic type there are remissions and exacerbations. Remission may last for years.

Onset of the disease can be spontaneous or preceded by precipitation factors such as sun exposure, viral infections / bacterial remedy. Each attack is usually accompanied by a clear common symptoms such as fever, poor appetite, weakness, weight loss, and irritability. The most prominent is fever, sometimes with chills.



Musculoskeletal symptoms

The most common symptom of SLE is; musculoskeletal symptoms, such as arthritis (93%). The most commonly affected are the proximal interphalangeal joints followed by knee, wrist, metacarpophalangeal, elbow and ankle. Besides swelling and pain may also include joint effusion. Arthritis is usually symmetrical, without causing deformity, contractures or ankylosis. Sometimes there are rheumatoid nodules. Vascular necrosis can occur in various places, and was found in patients receiving treatment with high-dose streroid. The most commonly affected is the femoral head.


Mucocutaneous symptoms

Abnormalities of the skin, hair or mucous membrane was found in 85% of cases of SLE. Skin lesions are most commonly found in SLE is ; skin lesions of acute, subacute, discoid, and reticular livido .
Skin rash butterfly-shaped form rather edamatus erythema on the nose and cheeks. With proper treatment, this disorder can be healed without scarring. On the part of the body exposed to the sun can skin rash that occurs due to hypersensitivity. These lesions include acute skin lesions. Skin lesions typical subacute annular shaped.

Discoid lesions progressed through three stages: erythema, hyperkeratosis and atrophy . Usually presents as erythematous patches of elevated, covered by keratin scales with the blockage of the follicle. If it lasts longer be shaped silikatriks.
Vasculitis can cause ulceration of the skin in the form of small to large. Often also seemed bleeding and periungual erythema. Reticular Livido a mild form of vasculitis, it is often found in SLE.


Kidney

Renal insufficiency was found in 68% of cases of SLE. The most frequent manifestation is proteinuria or hematuria. Hypertension, renal failure nephrotic syndrome is rare, only found in 25% of cases of SLE urine showed abnormalities.
There are 2 kinds of pathological abnormalities in the kidneys, which diffuse lupus nephritis, and membranous lupus nephritis. Lupus nephritis is the most severe disorder. Usually appear clinically as nephrotic syndrome, hypertension and impaired renal function with moderate to severe. Membranous lupus nephritis are less common. Marked with nephrotic syndrome, impaired renal function and mild course of the disease may be rapid or slow but progressive.
Other renal abnormalities that may be found in SLE is chronic pyelonephritis, renal tuberculosis. Kidney failure is one cause of death chronic SLE.


Central Nervous

Disorders of central nervous system consists of two main abnormalities organic psychosis and convulsions.
Organic brain disease is usually found in conjunction with active SLE symptoms in others systems. Patients showing symptoms of hallucinations in addition to the typical symptoms of organic brain as difficult to calculate and could not recall the pictures ever seen.
Steroid psychosis also include organic brain syndrome which is clinically indistinguishable from lupus psychosis. The difference between the two can only be known by lowering or raising the dose of steroids used. Lupus psychosis improved if the steroid dose is increased and vice versa.
Seizures arising grandmal type normally included. Other abnormalities that may be found is aphasia, hemiplegia.


Eye

Eye disorders may include conjunctivitis, sub - conjunctival hemorrhage and the body sitoid in the retina.


Heart

Inflammation of various parts of the heart can occur, such as pericarditis, endocarditis and myocarditis. Chest pain and arrhythmia may occur as a result of these circumstances.


Lungs

Can occur in lupus pleurisy (inflammation of the lining of the lungs) and pleural effusion (accumulation of fluid between the lung and the wrapper). As a result of these events often arise chest pain and shortness of breath.

Gastrointestinal tract

Abdominal pain present in 25 % of cases of SLE , may be accompanied by nausea and diarrhea. Symptoms disappear quickly if systemic disorders receive adequate treatment. Pain that may arise due to the sterile peritonitis or arteritis of small blood vessels that lead to bowel mesentery and intestinal ulceration. Arteritis can also cause pancreatitis.


Hemic - Lymphatic

Lymph nodes are commonly affected are the axillary and cervical, with the characteristics of non-tender and soft. Splenomegaly other lymphoid organs is usually accompanied by an enlarged heart. Lien in the form of myocardial damage or thrombosis associated with lupus anticoagulant. Anemia can be found in the period of disease progression LES, which is mediated by the immune and non-immune.