What to eat for lupus erythematosus. Variants of the course of systemic lupus erythematosus. Photos of what the symptoms of lupus erythematosus look like

Healthy nutrition is an important component of treatment for patients suffering from lupus. Balanced diet is extremely important for maintaining the functioning of the body. There is no strictly planned diet for patients suffering from lupus, however, certain general rules will be useful for them. A person with lupus should consult a doctor before starting a specific diet. The doctor will provide more detailed information about the features of proper nutrition, and may also recommend a highly qualified nutritionist.

Weight loss, poor appetite: People with lupus often lose weight. Loss of appetite and weight can be caused by both the disease and lupus medications, which can cause stomach upset and mouth ulcers.

If you have a problem with weight loss, you should consult a doctor who will conduct an examination, evaluate other symptoms and advise necessary changes in diet.

Weight gain: Common in patients taking corticosteroids. Drugs in this group increase appetite, which leads to weight gain.

To solve the problem of weight gain, you should consult a doctor who will advise you on a diet and other ways to reduce body weight. These can include both physical and psychological exercises. Particularly effective can be long-term cooperation between the patient and a nutritionist, who will develop an individual diet for the patient.

Side effects of drugs: Some drugs cause gastrointestinal disorders - heartburn, indigestion, nausea and vomiting, mouth ulcers.

If the patient experiences such disorders, he should immediately consult a doctor. Sometimes changing the dose and method of taking the drug is enough to save the patient from unpleasant side effects. The doctor may also prescribe a different drug. Many medications are designed to be taken with food, which reduces side effects. For example, if you have mouth ulcers, your doctor may prescribe the same drug in liquid form. The anesthetic will ease the pain and make painful breathing easier.

Osteoporosis: This is a disease in which the patient's bones become more brittle and their density decreases. This disease is more common in older women and can develop in people who take corticosteroids for a long time.

The doctor may prescribe a diet fortified with calcium (1,000-1,500 mg/day) and vitamin D (100-500 mg/day), and also recommend certain exercises.

Steroid-induced diabetes: In diabetes, the human body does not produce enough insulin to maintain the required level of glucose (sugar) in the blood. Long-term use of corticosteroids can cause diabetes, which is treated like regular diabetes.

Kidney disease: With lupus, kidney damage is often observed, so the doctor will order several tests to determine the condition of the kidneys. If the doctor detects kidney damage, his task is to prevent the progression of this process. The doctor may advise the patient to follow a diet low in salt, potassium, and protein.

Diseases of the cardiovascular system: Among these diseases that often accompany lupus are atherosclerosis and high blood pressure. For atherosclerosis fat deposits accumulate in the arteries, blocking blood flow. High blood pressure increases the risk of heart attack and stroke. High blood pressure in lupus is caused by kidney disease, which helps the body control blood pressure levels.

If a doctor determines that a patient is at risk for developing atherosclerosis, he or she may advise the patient to eat a low-fat diet as well as exercise. This will help lower cholesterol levels in the blood and control body weight. If a patient has high blood pressure, they may be given a low-sodium diet, medications, or both to help restore blood pressure. normal level blood pressure.

Systemic lupus erythematosus is a complex autoimmune disease that requires lifelong treatment. It doesn’t matter where the treatment is carried out, in a domestic or foreign clinic, using the method of traditional Chinese or Slavic medicine, lupus has every prospect of staying with a person forever. Therefore, the main goal in the healing process is long-term remission. Preferably for many years.

Who's at risk

It is extremely rare that lupus is diagnosed in children. But pregnant women with this disease will have to regularly visit the doctor, take tests, and take medications prescribed by the doctor. Moreover, not only throughout pregnancy, but also after the birth of the child.

Is lupus contagious?

Systemic lupus erythematosus, similar to allergies or atopic dermatitis, non-contagious. So far it has not been possible to find microbes that would cause this disease. There is no one magic cure or cure-all diet for treating lupus.

Medicinal herbs are very useful in the process of curing lupus, but they should only be used in combination with prescribed hormones or cytostatics. Otherwise, an extremely life-threatening condition may develop. Carefully study the effect of herbs on the body; do not take medicinal herbs without consulting your doctor. Herbal teas that seem harmless at first glance may be contraindicated for you.

Principles of proper nutrition for lupus

To improve your health with lupus, you should follow dietary nutrition and herbal medicine. The disease has a bad effect on the kidneys, and the liver is also subject to severe hepatotoxic effects. This is due to the large number of side effects of prescribed medications that are used for a long time for lupus. Therefore, the diet should be light, without saturated heavy fatty acids. Linoleic acid is very useful for lupus; it is recommended to eat it regularly.

You will have to limit your intake of table salt, eat more foods that contain calcium and potassium salts, which are washed out of the body during treatment.

Salads made from dandelions, fresh nettles, and lungwort will be very beneficial for patients. They can enrich the body with micro and macroelements, vitamins, calcium and iron. The calcium content in the diet should be at least one thousand milligrams per day.

From medicinal herbs, which can support the kidneys, the most effective are lingonberries and horsetail. Lingonberries are rightfully considered a multivitamin and a good diuretic.

This is a chronic disease of an autoimmune nature, during which the defenses (immune system) attack their own tissues, while they do not fight pests (viruses and bacteria), thereby developing constant inflammatory processes in the body.

According to statistics, the majority of lupus patients are female.

Causes of lupus

Until today, scientists have not identified the exact reasons that triggered the onset of the disease. The family factor remained in the assumptions (this applies to all autoimmune diseases). It is worth noting that lupus is a disease caused by genetics and is not hereditary.

Lupus can be caused by a combination of a familial pattern with 3 major dangers. These should include ultraviolet irradiation, disturbances in a woman’s hormonal system(fluctuations in estrogen levels, taking hormonal contraceptives) and the third important factor for the occurrence of lupus is infections located inside the body.

Types and signs of lupus

Depending on what is damaged and what is the trigger, 4 types of lupus are distinguished: systemic lupus erythematosus, discoid lupus erythematosus, drug-induced lupus erythematosus, neonatal lupus.

Systemic lupus erythematosus is the most common type of disease that is meant when people say “lupus.” This disease can affect any system of the body, which is why it is called “systemic”. The disease can be detected at any age in the range from 15 to 45 years. Symptoms depend on which system is damaged.

Discoid form of lupus erythematosus only affects skin. A red, oozing rash appears on the skin, which is covered with scales in the most pronounced places. Most often, the rash appears on the face. It may disappear and appear again, or may not go away for many years. This form of lupus erythematosus does not transform into systemic lupus erythematosus.

The following 2 types of lupus are classified as special forms:

Drug-induced lupus(or drug-induced lupus erythematosus) can develop while taking isoniazid, guinidine, methyldopa, procainamide. It can also be caused by certain anti-seizure drugs. It occurs in a mild form, affecting joints and skin. All symptoms go away after stopping the medications that triggered the lupus.

Neonatal lupus– develops in infants born to women with lupus or whose immune system is severely compromised. Such babies experience severe disruptions in the functioning of the cardiovascular system, skin rashes, low levels of blood cells, and problems in the functioning of the liver. Cases of neonatal lupus are very rare; most mothers with lupus have babies born completely healthy, and the rash goes away on its own over time without any intervention from medical professionals.

Common signs of lupus

There are a number of signs that can help distinguish a lupus rash from a common allergy. The patient's rash is located mainly on the face and has the shape of a butterfly. When exposed to sunlight, the rash becomes more pronounced and reddens. At the same time, the body temperature rises, all joints and muscles ache, the mucous membranes of the throat and nose become inflamed, there may be rapid breathing, increased perception of light, a sudden change in weight, severe hair loss, lack of air, pinched heart, swelling of the feet. If the course is too severe, it may develop vibration disease, anemia, psychosis, paralysis and even seizures.

Healthy Foods for Lupus

It’s worth noting right away that there are no foods or dishes that can cause lupus and cure it.

In this case, your diet should be compiled depending on the type of lupus and the symptoms that torment the patient. It is also worth considering which body systems are affected by the disease.

In order to help the body fight lupus, you need to eat a varied diet and, with the help of nutrition, fight the main problems with this disease. Namely: you need to take care of relieving inflammation; about bone strength, muscle elasticity; about the elimination of all side effects that arose due to taking medications during drug therapy for lupus; It is worth taking care to maintain the correct body weight and ensure the normal functioning of the cardiovascular system. Let's consider each direction separately.

Relieving inflammation in the body directly depends on foods containing omega-3 and antioxidants.

Vegetables and fruits that have antioxidant properties are foods containing vitamins E, C and beta-carotene: mangoes, apricots, broccoli, peaches, grapefruit, nectarines, beets, turnips, all citrus fruits, papaya, bell peppers, tomatoes, zucchini, green peas, carrots, nuts, melon, kiwi, spinach and all greens, sunflower seeds, beans, eggplant, dried fruits, grapes (especially red).

The same vitamin D and folic acid(found in all leafy vegetables and herbs, currant and viburnum leaves, cucumbers, mushrooms, orange and yellow fruits, vegetables and berries, chicken meat, barley porridge, eggs, whole grain bread).

Medicines prescribed by doctors for lupus contain large amounts of corticosteroids, which destroy bone and muscle tissue.

Maintaining proper body weight

Every lupus patient has serious problems with weight. For some, body weight decreases to critical values, while for others, on the contrary, it increases at tremendous speed.

In this matter, it is important to consult a nutritionist who will select the directly required diet for each person.

All people suffering from this disease should adhere to the following principles:

• do not overeat;
• eat fractionally, in small portions and 6 times a day;
• prepare all dishes either steamed or boiled;
• drink at least 2 liters of fluid per day;
• there is only healthy food;
• to live an active lifestyle;
• if there is no allergy, then replace sugar with honey;
• do not drink fatty broths - only broth boiled with meat for the second time is allowed (this means that the first, rich broth is drained, then the meat is poured a second time with water, boiled, and only then is the patient allowed to drink).

If these rules are followed, normal metabolism, which is responsible for maintaining a healthy weight, will not be disrupted.

Prevention of cardiovascular diseases

Often, with lupus, the patient's heart suffers. Therefore, to avoid problems and complications of the situation, you need to eat foods rich in omega-3 and completely eliminate cholesterol foods, and do not overdo it during physical activity.

If you have any specific heart problems, your diet needs to be adjusted for each heart disease individually.

Traditional medicine for lupus

Methods traditional medicine, are mainly aimed at taking infusions and preparing ointments for treating rashes.

To treat lupus, you need to drink decoctions and infusions made from mistletoe, licorice and peony root, hemlock leaves, celandine, calendula, tartar, burdock, sweet clover, yarrow, oregano, nettle, St. John's wort, and hop cones. You can drink either individually or in combination.

Do not take alfalfa under any circumstances (either in tablets or in the form of decoctions). Alfalfa contains amino acids that activate the work immune system. Such work will increase the “devouring” of your own cells and increase the inflammatory process. Because of this, when using it for lupus, the patient feels increased fatigue, severe pain in muscles and joints.

Dangerous and harmful foods for lupus

• everything fried, fatty, salted, smoked, canned;
• confectionery with cream, condensed milk, with artificial fillers (factory-made jams, jams);
• large amounts of sugar;
• foods containing cholesterol (buns, bread, red meat, high-fat dairy products, sauces, dressings and soups based on cream);
• products to which there are allergic reactions;
• fast food and products with unnatural fillers, dyes, leavening agents, taste and odor enhancers;
• products that have a long shelf life (we mean those products that quickly deteriorate, but thanks to various chemical additives in their composition, they can be stored for a very long time - this, for example, includes dairy products with a one-year shelf life);
• sweet sodas, energy drinks and alcoholic drinks;
• if you have kidney problems, foods containing potassium are contraindicated;
• canned food, sausages and factory-cooked sausages;
• store-bought mayonnaise, ketchup, sauces, dressings.

Eating these foods can speed up the progression of the disease, which can lead to fatal outcome. These are the maximum consequences. And, at a minimum, the dormant stage of lupus will become active, which will cause all the symptoms to worsen and your health to worsen significantly.

Systemic lupus erythematosus (SLE)– a chronic autoimmune disease caused by disruption of the immune mechanisms with the formation of damaging antibodies to own cells and fabrics. SLE is characterized by damage to joints, skin, blood vessels and various organs(kidneys, heart, etc.).

Cause and mechanisms of disease development

The mechanisms of the disease are based on dysfunction of immune cells (T and B lymphocytes), which is accompanied by excessive formation of antibodies to the body’s own cells. As a result of excessive and uncontrolled production of antibodies, specific complexes are formed that circulate throughout the body. Circulating immune complexes (CIC) settle in the skin, kidneys, and serous membranes internal organs(heart, lungs, etc.) causing inflammatory reactions.

Symptoms of the disease

• Fatigue
• Weight loss
• Temperature
• Decreased performance
• Fast fatiguability

Damage to the musculoskeletal system

• Arthritis – inflammation of the joints
  • Occurs in 90% of cases, non-erosive, non-deforming, the joints of the fingers, wrists, and knee joints are most often affected.
• Osteoporosis – decreased bone density
  • As a result of inflammation or treatment with hormonal drugs (corticosteroids).

• Muscle pain (15-64% of cases), muscle inflammation (5-11%), muscle weakness (5-10%)

Damage to mucous membranes and skin

• Skin lesions at the onset of the disease appear in only 20-25% of patients, in 60-70% of patients they appear later, in 10-15% skin manifestations of the disease do not occur at all. Skin changes appear on areas of the body exposed to the sun: face, neck, shoulders. The lesions have the appearance of erythema (reddish plaques with peeling), dilated capillaries at the edges, areas with excess or lack of pigment. On the face, such changes resemble the appearance of a butterfly, as the back of the nose and cheeks are affected.
• Hair loss (alopecia) occurs rarely, usually affecting the temporal areas. Hair falls out in a limited area.
• Increased sensitivity of the skin to sunlight (photosensitization) occurs in 30-60% of patients.
• Damage to the mucous membranes occurs in 25% of cases.
  • Redness, decreased pigmentation, impaired nutrition of lip tissue (cheilitis)
  • Finely pinpoint hemorrhages, ulcerative lesions oral mucosa

Respiratory system damage

Damage to the cardiovascular system

• Pericarditis is an inflammation of the serous membranes covering the heart muscle.

• Myocarditis is inflammation of the heart muscle.

• Damage to the heart valves, most often the mitral and aortic valves.
• Damage to the coronary vessels can lead to myocardial infarction, which can also develop in young patients with SLE.
• Damage to the inner lining of blood vessels (endothelium) increases the risk of developing atherosclerosis. Peripheral vascular damage manifests itself:
  • Livedo reticularis (blue spots on the skin creating a grid pattern)
  • Lupus panniculitis (subcutaneous nodules, often painful, may ulcerate)
  • Thrombosis of blood vessels of the extremities and internal organs

Kidney damage

Damage to the central nervous system

• Headache and migraine, the most common symptoms in SLE
• Irritability, depression – rare
• Psychoses: paranoia or hallucinations
• Brain stroke
• Chorea, parkinsonism – rare
• Myelopathies, neuropathies and other disorders of nerve sheath (myelin) formation
• Mononeuritis, polyneuritis, aseptic meningitis

Damage to the digestive tract

• Damage to the esophagus, impaired swallowing, dilatation of the esophagus occurs in 5% of cases
• Ulcers of the stomach and 12th intestine are caused both by the disease itself and by the side effects of treatment
• Abdominal pain like manifestation of SLE, and can also be caused by pancreatitis, inflammation of the intestinal vessels, intestinal infarction
• Nausea, abdominal discomfort, indigestion

• Hypochromic normocytic anemia occurs in 50% of patients, the severity depends on the activity of SLE. Hemolytic anemia is rare in SLE.
• Leukopenia is a decrease in leukocytes in the blood. Caused by a decrease in lymphocytes and granulocytes (neutrophils, eosinophils, basophils).
• Thrombocytopenia is a decrease in platelets in the blood. Occurs in 25% of cases, caused by the formation of antibodies against platelets, as well as antibodies to phospholipids (fats that make up cell membranes).

Diagnosis of SLE

Criteria for the diagnosis of systemic lupus erythematosus

The diagnosis of SLE is made if at least 4 out of 11 criteria are present.

Disease activity indices bySLEDAI

• Light activity: 1-5 points
• Moderate activity: 6-10 points
• High activity: 11-20 points
• Very high activity: more than 20 points

Diagnostic tests used to detect SLE

1. ANA- screening test, specific antibodies to cell nuclei are determined, detected in 95% of patients, does not confirm the diagnosis in the absence of clinical manifestations of systemic lupus erythematosus
2. Anti DNA– antibodies to DNA, detected in 50% of patients, the level of these antibodies reflects the activity of the disease
3. Anti-Sm – specific antibodies to the Smith antigen, which is part of short RNAs, are detected in 30-40% of cases
4. Anti –SSA or Anti-SSB, antibodies to specific proteins located in the cell nucleus, are present in 55% of patients with systemic lupus erythematosus, are not specific for SLE, and are also detected in other connective tissue diseases
5. Anticardiolipin - antibodies to mitochondrial membranes (cell energy station)
6. Antihistones– antibodies against proteins necessary for packaging DNA into chromosomes, characteristic of drug-induced SLE.

• Markers of inflammation
  • ESR – increased
  • C – reactive protein, increased

• Compliment level reduced
  • C3 and C4 are reduced as a result overeducation immune complexes
  • Some people have a reduced level of compliment from birth, this is a predisposing factor to the development of SLE.

• General blood analysis
  • Possible decrease in red blood cells, white blood cells, lymphocytes, platelets

• Analysis of urine
  • Protein in urine (proteinuria)
  • Red blood cells in urine (hematuria)
  • Casts in the urine (cylindruria)
  • White blood cells in urine (pyuria)

• Blood chemistry
  • Creatinine – an increase indicates kidney damage
  • ALAT, ASAT – an increase indicates liver damage
  • Creatine kinase – increases with damage to the muscular system

• X-ray of joints

• X-ray and computed tomography of the chest

• Nuclear magnetic resonance and angiography

• Echocardiography

• A spinal tap can rule out infectious causes of neurological symptoms.
• A kidney biopsy (analysis of organ tissue) allows you to determine the type of glomerulonephritis and facilitate the choice of treatment tactics.
• A skin biopsy allows you to clarify the diagnosis and exclude similar dermatological diseases.

Treatment of systemic lupus

• Exclude physical and mental stressful conditions
• Reduce sun exposure and use sunscreen

1. Glucocorticosteroids the most effective drugs in the treatment of SLE.

• Inside:
  • Initial dose of prednisolone 0.5 – 1 mg/kg
  • Maintenance dose 5-10 mg
  • Prednisolone should be taken in the morning, the dose is reduced by 5 mg every 2-3 weeks

• Intravenous administration of methylprednisolone in large doses (pulse therapy)
  • Dose 500-1000 mg/day, for 3-5 days
  • Or 15-20 mg/kg body weight

Indications for pulse therapy: young age, fulminant lupus nephritis, high immunological activity, lesion nervous system.

• 1000 mg methylprednisolone and 1000 mg cyclophosphamide on the first day

1. Cytostatics: cyclophosphamide (cyclophosphamide), azathioprine, methotrexate, are used in complex treatment SCV.

• Acute lupus nephritis
• Vasculitis
• Forms refractory to treatment with corticosteroids
• The need to reduce corticosteroid doses
• High SLE activity
• Progressive or fulminant course of SLE

• Cyclophosphamide during pulse therapy is 1000 mg, then 200 mg every day until a total dose of 5000 mg is reached.
• Azathioprine 2-2.5 mg/kg/day
• Methotrexate 7.5-10 mg/week, orally

1. Anti-inflammatory drugs

• Naklofen, nimesil, airtal, katafast, etc.

1. Aminoquinoline drugs

• delagil, plaquenil, etc.

1. Biological drugs are a promising treatment for SLE

• Anti CD 20 – Rituximab
• Tumor necrosis factor alpha – Remicade, Gumira, Embrel

1. Other drugs

• Anticoagulants (heparin, warfarin, etc.)
• Antiplatelet agents (aspirin, clopidogrel, etc.)
• Diuretics (furosemide, hydrochlorothiazide, etc.)
• Calcium and potassium preparations

1. Extracorporeal treatment methods

• Plasmapheresis is a method of purifying blood outside the body, in which part of the blood plasma is removed, and with it the antibodies that cause the disease SLE.
• Hemosorption is a method of purifying blood outside the body using specific sorbents (ion exchange resins, activated carbon, etc.).

What are the complications and prognosis for life with systemic lupus erythematosus?

Variants of the course of systemic lupus erythematosus:

1. Acute course- characterized by a lightning-fast onset, a rapid course and the rapid simultaneous development of symptoms of damage to many internal organs (lungs, heart, central nervous system, and so on). The acute course of systemic lupus erythematosus, fortunately, is rare, since this option quickly and almost always leads to complications and can cause the death of the patient.
2. Subacute course– characterized by a gradual onset, alternating periods of exacerbations and remissions, a predominance of general symptoms (weakness, weight loss, low-grade fever (up to 38 0

C) and others), damage to internal organs and complications occur gradually, no earlier than 2-4 years after the onset of the disease.
3. Chronic course– the most favorable course of SLE, there is a gradual onset, damage mainly to the skin and joints, longer periods of remission, damage to internal organs and complications occur after decades.

Damage to organs such as the heart, kidneys, lungs, central nervous system, and blood, which are described as symptoms of the disease, in fact, are complications of systemic lupus erythematosus.

But we can highlight complications that lead to irreversible consequences and can lead to the death of the patient:

1. Systemic lupus erythematosus– affects the connective tissue of the skin, joints, kidneys, blood vessels and other structures of the body.

2. Drug-induced lupus erythematosus– unlike the systemic type of lupus erythematosus, a completely reversible process. Drug-induced lupus develops as a result of exposure to certain medications:

• Medicines for the treatment of cardiovascular diseases: phenothiazine groups (Apressin, Aminazine), Hydralazine, Inderal, Metoprolol, Bisoprolol, Propranolol and some others;
• antiarrhythmic drug - Novocainamide;
• sulfonamides: Biseptol and others;
• anti-tuberculosis drug Isoniazid;
• oral contraceptives;
• herbal preparations for the treatment of venous diseases (thrombophlebitis, varicose veins lower limbs and so on): horse chestnut, venotonic Doppelgerz, Detralex and some others.

3. Discoid (or cutaneous) lupus erythematosus may precede the development of systemic lupus erythematosus. With this type of disease, the skin of the face is affected to a greater extent. Changes on the face are similar to those with systemic lupus erythematosus, but blood test parameters (biochemical and immunological) do not have changes characteristic of SLE, and this will be the main criterion for differential diagnosis with other types of lupus erythematosus. To clarify the diagnosis, it is necessary to conduct a histological examination of the skin, which will help differentiate from diseases that are similar in appearance (eczema, psoriasis, cutaneous form of sarcoidosis, and others).

4. Neonatal lupus erythematosus occurs in newborns whose mothers suffer from systemic lupus erythematosus or other systemic autoimmune diseases. At the same time, the mother SLE symptoms There may not be any, but when they are examined, autoimmune antibodies are detected.

Symptoms of neonatal lupus erythematosus In a child, they usually appear before the age of 3 months:

• changes on the skin of the face (often have the appearance of a butterfly);
• congenital arrhythmia, which is often determined by ultrasound of the fetus in the 2nd-3rd trimesters of pregnancy;
• flaw blood cells in a general blood test (decrease in the level of red blood cells, hemoglobin, leukocytes, platelets);
• identification of autoimmune antibodies specific for SLE.

5. The term “lupus” is also used for tuberculosis of the facial skin - tuberculous lupus. Skin tuberculosis is very similar in appearance to systemic lupus erythematosus. The diagnosis can be established by histological examination of the skin and microscopic and bacteriological examination of scrapings - mycobacterium tuberculosis (acid-fast bacteria) is detected.

Photo: This is what tuberculosis of the facial skin or tuberculous lupus looks like.

Systemic lupus erythematosus and other systemic connective tissue diseases, how to differentiate?

• Systemic lupus erythematosus.
• Idiopathic dermatomyositis (polymyositis, Wagner's disease)– damage by autoimmune antibodies to smooth and skeletal muscles.
• Systemic scleroderma is a disease in which normal tissue is replaced by connective tissue (not bearing functional properties), including blood vessels.
• Diffuse fasciitis (eosinophilic)- damage to the fascia - structures that are cases for skeletal muscles, while in the blood of most patients there is increased amount eosinophils (blood cells responsible for allergies).
• Sjögren's syndrome– damage to various glands (lacrimal, salivary, sweat, etc.), for which this syndrome is also called dry.
• Other systemic diseases.

Differential diagnosis of systemic connective tissue diseases.

Diagnostic criteria	Systemic lupus erythematosus	Systemic scleroderma	Idiopathic dermatomyositis
Onset of the disease	weakness, fatigue; increased body temperature; weight loss; impaired skin sensitivity; periodic joint pain.	weakness, fatigue; increased body temperature; impaired skin sensitivity, burning sensation of the skin and mucous membranes; numbness of the limbs; weight loss; joint pain; Raynaud's syndrome is a severe disruption of blood circulation in the extremities, especially in the hands and feet. Photo: Raynaud's syndrome	severe weakness; increased body temperature; muscle pain; there may be pain in the joints; stiffness of movements in the limbs; compaction of skeletal muscles, their increase in volume due to edema; swelling, blueness of the eyelids; Raynaud's syndrome.
Temperature	Prolonged fever, body temperature above 38-39 0 C.	Prolonged low-grade fever (up to 38 0 C).	Moderate prolonged fever (up to 39 0 C).
Patient's appearance (at the onset of the disease and in some of its forms appearance the patient may not be affected by all these diseases)	Damage to the skin, mostly the face, “butterfly” (redness, scales, scars). The rash can be all over the body and on the mucous membranes. Dry skin, loss of hair and nails. Nails are deformed, striated nail plates. There may also be hemorrhagic rashes (bruises and petechiae) throughout the body.	The face may acquire a “mask-like” expression without facial expressions, tense, the skin is shiny, deep folds appear around the mouth, the skin is motionless, tightly fused to deep-lying tissues. Often there is a disruption of the glands (dry mucous membranes, as in Sjögren's syndrome). Hair and nails fall out. On the skin of the limbs and neck there are dark spots against the background of “bronze skin”.	A specific symptom is swelling of the eyelids, their color can be red or purple; on the face and décolleté there is a variety of rashes with redness of the skin, scales, hemorrhages, and scars. As the disease progresses, the face acquires a “mask-like appearance”, without facial expressions, tense, may be skewed, and drooping of the upper eyelid (ptosis) is often detected.
Main symptoms during the period of disease activity	skin lesions; photosensitivity - skin sensitivity when exposed to sunlight (like burns); joint pain, stiffness of movement, impaired flexion and extension of fingers; changes in bones; nephritis (swelling, protein in the urine, increased blood pressure, urinary retention and other symptoms); arrhythmias, angina pectoris, heart attack and other cardiac and vascular symptoms; shortness of breath, bloody sputum (pulmonary edema); impaired intestinal motility and other symptoms; damage to the central nervous system.	changes on the skin; Raynaud's syndrome; pain and stiffness in joints; difficulty extending and bending fingers; dystrophic changes in bones, visible on x-rays (especially the phalanges of the fingers, jaw); muscle weakness (muscle atrophy); severe disturbances of the intestinal tract (motility and absorption); heart rhythm disturbances (growth of scar tissue in the heart muscle); shortness of breath (overgrowth of connective tissue in the lungs and pleura) and other symptoms; damage to the peripheral nervous system.	changes on the skin; severe muscle pain, weakness (sometimes the patient is unable to lift a small cup); Raynaud's syndrome; impaired movement, over time the patient becomes completely immobilized; if the respiratory muscles are damaged - shortness of breath, up to complete muscle paralysis and respiratory arrest; if the masticatory and pharyngeal muscles are affected, there is a violation of the act of swallowing; if the heart is damaged - rhythm disturbance, up to cardiac arrest; if the smooth muscles of the intestine are damaged - its paresis; violation of the act of defecation, urination and many other manifestations.
Forecast	Chronic course, over time it is affected more and more more organs. Without treatment, complications develop that threaten the patient's life. With adequate and regular treatment, it is possible to achieve long-term, stable remission.
Laboratory indicators	increased gammaglobulins; acceleration of ESR; positive C-reactive protein; decreased level of immune cells of the complementary system (C3, C4); low blood counts; the level of LE cells is significantly increased; positive ANA test; anti-DNA and detection of other autoimmune antibodies.		increase in gammaglobulins, as well as myoglobin, fibrinogen, ALT, AST, creatinine - due to the breakdown muscle tissue; positive test for LE cells; rarely anti-DNA.
Principles of treatment	Long-term hormonal therapy (Prednisolone) + cytostatics + symptomatic therapy and other drugs (see article section "Treatment systemic lupus» ).

Systemic lupus erythematosus in children, what are the symptoms and treatment?

Considering the nature of the immune system, hormonal background, growth rate, systemic lupus erythematosus in children occurs with its own characteristics.

Features of the course of systemic lupus erythematosus in childhood:

• more severe course of the disease , high activity of the autoimmune process;
• chronic course the disease occurs in children only in a third of cases;
• more common acute or subacute course diseases with rapid damage to internal organs;
• also isolated only in children acute or lightning-fast course SLE is almost simultaneous damage to all organs, including the central nervous system, which can lead to death little patient in the first six months from the onset of the disease;
• frequent development complications and high mortality;
• most common complication – bleeding disorder in the form of internal bleeding, hemorrhagic rashes (bruises, hemorrhages on the skin), as a result - the development of a shock state of DIC syndrome - disseminated intravascular coagulation;
• Systemic lupus erythematosus in children often occurs in the form of vasculitis – inflammation of blood vessels, which determines the severity of the process;
• children with SLE are usually malnourished , have a pronounced deficiency of body weight, up to cachexia (extreme degree of dystrophy).

1. Onset of the disease acute, with an increase in body temperature to high numbers (over 38-39 0 C), with pain in the joints and severe weakness, sudden loss of body weight.
2. Skin changes in the form of a “butterfly” are relatively rare in children. But, given the development of a lack of blood platelets, hemorrhagic rashes throughout the body (bruises for no reason, petechiae or pinpoint hemorrhages) are more common. Also, one of the characteristic signs of systemic diseases is hair loss, eyelashes, eyebrows, up to complete baldness. The skin becomes marbled and very sensitive to sunlight. There may be various rashes on the skin, characteristic of allergic dermatitis. In some cases, Raynaud's syndrome develops - a violation of blood circulation in the hands. In the oral cavity there may be ulcers that do not heal for a long time - stomatitis.
3. Joint pain– typical syndrome of active systemic lupus erythematosus, pain is periodic. Arthritis is accompanied by the accumulation of fluid in the joint cavity. Over time, joint pain is combined with muscle pain and stiffness of movement, starting with the small joints of the fingers.
4. For children formation of exudative pleurisy is characteristic(fluid in the pleural cavity), pericarditis (fluid in the pericardium, the lining of the heart), ascites and other exudative reactions (dropsy).
5. Heart damage in children it usually manifests itself as myocarditis (inflammation of the heart muscle).
6. Kidney damage or nephritis It develops much more often in childhood than in adulthood. Such nephritis relatively quickly leads to the development of acute renal failure (requiring intensive care and hemodialysis).
7. Lung damage It is rare in children.
8. In the early period of the disease in adolescents, in most cases there is damage to the gastrointestinal tract(hepatitis, peritonitis and so on).
9. Damage to the central nervous system in children it is characterized by capriciousness, irritability, and in severe cases, seizures may develop.

That is, in children, systemic lupus erythematosus is also characterized by a variety of symptoms. And many of these symptoms are masked under the guise of other pathologies; the diagnosis of systemic lupus erythematosus is not immediately assumed. Unfortunately, timely treatment is the key to success in transitioning the active process into a period of stable remission.

Diagnostic principles systemic lupus erythematosus are the same as in adults, based mainly on immunological research(detection of autoimmune antibodies).
In a general blood test, in all cases and from the very beginning of the disease, a decrease in the number of all formed blood elements (erythrocytes, leukocytes, platelets) is determined, and blood clotting is impaired.

Treatment of systemic lupus erythematosus in children, as in adults, involves long-term use of glucocorticoids, namely Prednisolone, cytostatics and anti-inflammatory drugs. Systemic lupus erythematosus is a diagnosis that requires urgent hospitalization of the child in the hospital (rheumatology department, if it develops severe complications– in the intensive care unit or intensive care unit).
In a hospital setting, a complete examination of the patient is carried out and the necessary therapy is selected. Depending on the presence of complications, symptomatic and intensive therapy. Given the presence of bleeding disorders in such patients, Heparin injections are often prescribed.
If treatment is started on time and regularly, you can achieve stable remission, while children grow and develop according to their age, including normal puberty. In girls, a normal menstrual cycle is established and pregnancy is possible in the future. In this case forecast favorable for life.

Systemic lupus erythematosus and pregnancy, what are the risks and treatment features?

Risks of pregnancy for a woman with systemic lupus erythematosus:

1. Systemic lupus erythematosus In most cases does not affect the ability to get pregnant , as well as long-term use of Prednisolone.
2. It is strictly forbidden to become pregnant while taking cytostatics (Methotrexate, Cyclophosphamide and others). , since these drugs will affect germ cells and embryonic cells; pregnancy is possible only no earlier than six months after discontinuation of these drugs.
3. Half cases of pregnancy with SLE ends in birth healthy, full-term baby . In 25% cases such babies are born premature , A in a quarter of cases observed miscarriage .
4. Possible complications pregnancy with systemic lupus erythematosus, in most cases associated with damage to the blood vessels of the placenta:

• fetal death;
• . Thus, in a third of cases, a worsening of the disease develops. The risk of such deterioration is greatest in the first weeks of the first or third trimester of pregnancy. And in other cases, there is a temporary retreat of the disease, but in most cases one should expect a severe exacerbation of systemic lupus erythematosus 1-3 months after birth. No one knows which path the autoimmune process will take.
  6. Pregnancy can be a trigger in the development of systemic lupus erythematosus. Pregnancy can also provoke the transition of discoid (cutaneous) lupus erythematosus to SLE.
  7. A mother with systemic lupus erythematosus can pass the genes on to her baby , predisposing him to develop a systemic autoimmune disease during his life.
  8. The child may develop neonatal lupus erythematosus associated with the circulation of maternal autoimmune antibodies in the baby’s blood; this condition is temporary and reversible.
  • It is necessary to plan a pregnancy under the supervision of qualified doctors , namely a rheumatologist and gynecologist.
  • It is advisable to plan a pregnancy during a period of stable remission chronic course of SLE.
  • In acute cases systemic lupus erythematosus with the development of complications, pregnancy can have a detrimental effect not only on the health, but also lead to the death of the woman.
  • And if, nevertheless, pregnancy occurs during an exacerbation period, then the question of its possible preservation is decided by doctors, together with the patient. After all, exacerbation of SLE requires long-term use of medications, some of which are absolutely contraindicated during pregnancy.
  • It is recommended to become pregnant no earlier than 6 months after discontinuation of cytotoxic drugs (Methotrexate and others).
  • For lupus damage to the kidneys and heart There is no talk of pregnancy; this can lead to the death of a woman from kidney and/or heart failure, because these organs are under enormous stress when carrying a baby.
  Management of pregnancy with systemic lupus erythematosus:

  1. Necessary throughout pregnancy be observed by a rheumatologist and obstetrician-gynecologist , the approach to each patient is individual.
  2. It is necessary to adhere to the following regime: don’t overwork, don’t be nervous, eat normally.
  3. Be attentive to any changes in your health.
  4. Delivery outside the maternity hospital is unacceptable , since there is a risk of developing severe complications during and after childbirth.
  7. Even at the very beginning of pregnancy, the rheumatologist prescribes or adjusts therapy. Prednisolone is the main drug for the treatment of SLE and is not contraindicated during pregnancy. The dose of the drug is selected individually.
  8. Also recommended for pregnant women with SLE taking vitamins, potassium preparations, aspirin (up to the 35th week of pregnancy) and other symptomatic and anti-inflammatory drugs.
  9. Mandatory treatment of late toxicosis and other pathological conditions of pregnancy in a maternity hospital.
  10. After childbirth the rheumatologist increases the dose of hormones; in some cases, it is recommended to stop breastfeeding, as well as prescribe cytostatics and other drugs for the treatment of SLE - pulse therapy, since the postpartum period is dangerous for the development of severe exacerbations of the disease.

  Previously, all women with systemic lupus erythematosus were not recommended to become pregnant, and if they conceived, everyone was recommended to have an induced termination of pregnancy (medical abortion). Now doctors have changed their opinion on this matter; a woman cannot be deprived of motherhood, especially since there is a considerable chance of giving birth to a normal, healthy baby. But everything must be done to minimize the risk for mother and baby.

  Is lupus erythematosus contagious?

  Of course, any person who sees strange rashes on their face thinks: “Could it be contagious?” Moreover, people with these rashes walk for so long, feel unwell and constantly take some kind of medication. Moreover, doctors previously assumed that systemic lupus erythematosus was transmitted sexually, by contact, or even by airborne droplets. But having studied the mechanism of the disease in more detail, scientists have completely dispelled these myths, because this is an autoimmune process.

  The exact cause of the development of systemic lupus erythematosus has not yet been established; there are only theories and assumptions. It all boils down to one thing: the main cause is the presence of certain genes. But still, not all carriers of these genes suffer from systemic autoimmune diseases.

  The trigger for the development of systemic lupus erythematosus can be:

  • various viral infections;
  • bacterial infections (especially beta-hemolytic streptococcus);
  • stress factors;
  • hormonal changes (pregnancy, adolescence);
  • environmental factors (for example, ultraviolet irradiation).
  But infections are not causative agents of the disease, so systemic lupus erythematosus is absolutely not contagious to others.

  Only tuberculous lupus can be contagious (facial skin tuberculosis), since a large number of tuberculosis bacilli are detected on the skin, and contact path pathogen transmission.

  Lupus erythematosus, what diet is recommended and are there any methods of treatment with folk remedies?

  As with any disease, nutrition plays an important role in lupus erythematosus. Moreover, with this disease there is almost always a deficiency, or against the background of hormonal therapy - excess body weight, lack of vitamins, microelements and biological active substances.

  The main characteristic of a diet for SLE is a balanced and proper diet.

  1. foods containing unsaturated fatty acids (Omega-3):

  • sea ​​fish;
  • many nuts and seeds;
  • vegetable oil in not large quantities;
  2. fruits and vegetables contain more vitamins and microelements, many of which contain natural antioxidants; essential calcium and folic acid are found in large quantities in green vegetables and herbs;
  3. juices, fruit drinks;
  4. lean poultry meat: chicken, turkey fillet;
  5. low-fat dairy , especially fermented milk products (low-fat cheese, cottage cheese, yogurt);
  6. cereals and vegetable fiber (grain bread, buckwheat, oatmeal, wheat germ and many others).

  1. Products with saturated fatty acids have a bad effect on blood vessels, which can aggravate the course of SLE:

  • animal fats;
  • fried food;
  • fatty meats (red meat);
  • high fat dairy products and so on.
  2. Alfalfa seeds and sprouts (legume crop).
  
  Photo: alfalfa grass.
  3. Garlic – powerfully stimulates the immune system.
  4. Salty, spicy, smoked dishes that retain fluid in the body.

  If diseases of the gastrointestinal tract occur against the background of SLE or taking medications, then the patient is recommended to eat frequent meals according to the therapeutic diet - table No. 1. All anti-inflammatory drugs are best taken with or immediately after meals.

  Treatment of systemic lupus erythematosus at home is possible only after selecting an individual treatment regimen in a hospital setting and correcting conditions that threaten the patient’s life. Heavy drugs used in the treatment of SLE cannot be prescribed on their own; self-medication will not lead to anything good. Hormones, cytostatics, non-steroidal anti-inflammatory drugs and other drugs have their own characteristics and a bunch of adverse reactions, and the dose of these drugs is very individual. The therapy selected by doctors is taken at home, strictly adhering to the recommendations. Omissions and irregularity in taking medications are unacceptable.

  Concerning traditional medicine recipes, then systemic lupus erythematosus does not tolerate experiments. None of these remedies will prevent the autoimmune process; you may simply waste valuable time. Folk remedies can be effective if they are used in combination with traditional methods treatment, but only after consultation with a rheumatologist.

  Some traditional medicines for the treatment of systemic lupus erythematosus:

  
  
  Precautionary measures! All folk remedies containing poisonous herbs or substances should be kept out of the reach of children. You have to be careful with such drugs; any poison is a medicine as long as it is used in small doses.

  Photos of what the symptoms of lupus erythematosus look like?

  
  Photo: Butterfly-shaped changes on the facial skin in SLE.
  
  Photo: skin lesions on the palms with systemic lupus erythematosus. Except skin changes, this patient shows thickening of the joints of the phalanges of the fingers - signs of arthritis.
  
  Dystrophic changes nails with systemic lupus erythematosus: fragility, discoloration, longitudinal striations of the nail plate.
  
  Lupus lesions of the oral mucosa . The clinical picture is very similar to infectious stomatitis, which does not heal for a long time.
  
  And this is what they might look like first symptoms of discoid or cutaneous lupus erythematosus.
  
  And this is what it might look like neonatal lupus erythematosus, These changes, fortunately, are reversible and in the future the baby will be absolutely healthy.
  
  Skin changes in systemic lupus erythematosus, characteristic of childhood. The rash is hemorrhagic in nature, resembles measles rashes, and leaves pigment spots that do not go away for a long time.