Systemic lupus erythematosus (SLE): Information & specialists

Systemic lupus erythematosus, or SLE for short, is an autoimmune disease. In some cases, SLE is limited to affecting the skin, but more frequently it also affects internal organs. Systemic lupus erythematosus is probably triggered by a combination of different factors. It is treated with medication.

Here you will find further information as well as selected specialists and centers for systemic lupus erythematosus.

What is systemic lupus erythematosus?

Systemic lupus erythematosus (SLE) is an autoimmune disease. These are diseases in which the immune system turns against its own organism. The body's own defense system includes lymphocytes and antibodies. These antibodies directed against themselves (autoantibodies) react primarily with the nuclei of the organ cells. They are therefore also referred to as antinuclear antibodies (ANA).

The autoantibodies enter all areas of the body with the blood. They can therefore lead to inflammation and damage in practically all organs. In some cases, SLE is limited to affecting the skin. More frequently, however, it also affects internal organs (systemic or visceral LE).

What are the causes of systemic lupus erythematosus?

SLE can occur at any age. However, young women between 16 and 40 are particularly affected. At this age, the female body produces particularly high levels of sex hormones. Obviously, these hormones facilitate the development of SLE.

Ultimately, it is not known what causes SLE. Various factors probably come together.

A genetic predisposition and female hormones are considered to be precursors. Triggers are

• Physical and psychological stress,
• infectious diseases,
• sunlight,
• pregnancy and
• medication.

What are the symptoms of SLE?

The inflammation in the body leads to general symptoms such as

• Fever,
• fatigue and
• fatigue.

In addition, there are symptoms that are caused by the involvement of specific organs. These are listed below.

Skin:

• Redness and burning of the skin, often on the face over the cheeks and nose (butterfly erythema),
• Frequent sensitivity of the skin to the sun,
• frequent hair loss

Joints:

• Joint pain and
• joint inflammation(arthritis)

Muscles:

• Muscle pain,
• rarely also muscle inflammation

Kidneys:

Mild kidney pain, usually the patient does not feel the kidney inflammation! A urine test for red blood cells (erythrocytes) and protein is important

Lungs:

Pleurisy (pain when breathing)

Heart:

• Cardiac arrhythmia,
• inflammation of the pericardium,
• inflammation of the heart muscle, etc.

Central nervous system(CNS):

• Migraine,
• word-finding disorders,
• depression,
• aggressiveness up to psychoses,
• seizures

Blood vessels:

• Often a sudden pallor of the fingers(Raynaud's),
• more rarely also vascular inflammation(vasculitis), mostly on the fingers with skin bleeding

Blood: Reduction

• of white blood cells (leukocytes),
• red blood cells (erythrocytes) and
• platelets (thrombocytes).

The patient often does not notice these changes. However, they become apparent during the blood count examination through blood clotting disorders with increased thrombosis.

Sometimes there is also inflammation of the salivary and lacrimal glands (Sjögren's syndrome).

As a rule, a patient only shows some of these possible signs of the disease (e.g. skin and joints).

Systemic lupus erythematosus often shows inflammatory reactions of the skin © velimir | AdobeStock

What is the course of systemic lupus erythematosus?

SLE usually progresses in relapses, whereby a relapse can last from a few weeks to months. Some patients are completely symptom-free between relapses. Others still have minor signs of the disease, such as reduced performance and joint pain. Only in a few patients is SLE constantly active.

Some sufferers have more severe symptoms. Although skin inflammation and joint pain are very unpleasant, they are not life-threatening.

Others have hardly any symptoms, but can be at high risk. This applies to patients with kidney inflammation, for example. The kidneys are vital organs, so in rare cases SLE can also be life-threatening.

In most cases, SLE continues to exist in the same way as the individual affected has experienced it. They can expect the same organs to be affected in the event of a new flare-up.

The intensity of the disease diminishes over the years, with relapses becoming less frequent and less severe.

Treatment of systemic lupus erythematosus

A distinction is made between two forms of treatment:

• acute drug therapy during a current flare of the disease, and
• prophylaxis (prevention), which is intended to prevent a recurrence of the disease.

Drug therapy for systemic lupus erythematosus

The aim of drug therapy is to

• relieve the patient's symptoms, e.g. with an agent for joint pain, and
• to have a regulating effect on the disease so that the imbalanced immunological system is brought back into balance.

In very mild cases, treatment with an anti-rheumatic drug is sufficient. However, cortisone must often be used. The dose is higher during the flare-up, after which it can be reduced. If possible, the cortisone is discontinued completely at some point. If the patient benefits from this, they are often given a low long-term dose.

Other medications are also used:

• Antimalarials (e.g. Resochin®), which is used particularly for skin and joint inflammation, as well as
• immunosuppressants, which are intended to dampen the incorrectly programmed immune system.

The best known of these are Imurek® and Endoxan®. Whether they are used depends on the inflammatory activity of the SLE and the severity of the organ involvement. Gold and Azulfidine®, which are effective in chronic polyarthritis, must not be taken in SLE.

Measures to prevent a new SLE flare-up

The course of the disease can be favorably influenced by appropriate behavior.

1. physical and psychological stress

Patients with SLE have a very unstable immune system that cannot cope with extreme stress. This can trigger new flare-ups of the disease. A moderate lifestyle is therefore the top priority.

This applies to both physical and mental stress. Light sporting activity is permitted. Sport that leads to exhaustion is bad. Avoid unnecessary conflicts and do not allow yourself to be consumed by professional ambition. Find the right balance in all things.

2. nutrition

The "right balance" also applies to nutrition. Eat as little as possible. Being overweight is very unfavorable. Avoid all one-sided forms of nutrition, but eat as varied a diet as possible.

Too much fruit and salad can also be harmful - eat in moderation! Only eat as much protein as your body needs. However, there is no special diet that cures the disease.

3. infectious diseases

Infections caused by viruses or bacteria are the most common cause of an SLE flare-up. As far as possible, avoid all circumstances that are associated with an increased risk of infection. See a doctor quickly if you become ill so that a nascent infection can be counteracted.

Certain antibiotics can trigger an SLE flare-up, such as sulphonamides. You must therefore not take them. If you are taking cortisone, you must not reduce it during an infectious disease. It is often even advisable to increase the dose.

4. sunlight

Sunlight, more specifically ultraviolet light, can activate an SLE flare. People with sun-sensitive skin are particularly susceptible. You should therefore avoid sunlight and protect your skin with special sun protection creams. Your doctor can advise you on this.

You should also avoid tanning salons.

5 Pregnancy

SLE can worsen during pregnancy. Women with SLE are also more likely to have miscarriages and premature births than healthy women. However, the risk of malformations is not higher.

Do not plan a pregnancy until the disease has been inactive for at least 6 months. You should also only take a low dose of cortisone. In patients who have had a severe phase of organ involvement, e.g. of the kidneys, the SLE should have been dormant for 1 to 2 years.

6 Pregnancy prevention

Certain female sex hormones (oestrogens) can trigger SLE. Therefore, when using birth control pills, use progestogen-only preparations without oestrogens (so-called "mini-pills").

You can also use other contraceptive methods. However, you should bear in mind that the IUD can often cause inflammation.

7. operations

If you are due to have an operation, you must inform the surgeon about your condition and the treatment. He or she will contact an internist to discuss the medication therapy with him or her.