The Pathophysiology Process Of Systemic Lupus
Systemic lupus is a chronic inflammatory disease that affects several systems and is also an autoimmune disease due to the cellular self-harm. Systemic lupus occurs when the antigens in the body begin to attack the tissues, leading to destruction of the surrounding tissues and eventually affected the organs or/and body systems. One of the main indications is the facial rash erythematous and occurs across the nose and cheeks “butterfly rash” (VanMeter & Hubert, 2014, p. 128). The branch of medicine that deals with incidences, distribution, and possible control of this disease is a rheumatologist. A rheumatic disease consists of conditions that cause chronic, intermittent pain affecting joints and/or connective tissue (Nayana Ambardekar, 2017).
Etiology and Risk Factors
There isn’t any research that provides evidence that might reveal what causes lupus. However, there are some risk factors to consider which are: genetic, hormones (estrogen levels), and environmental/lifestyle including; ultra violet rays and gene mutation (Nayana Ambardekar, 2017). The genetic reason is unknown but is speculated to be a gene variation that is an autosomal recessive pattern which means both copies of the cell have mutations (U.S. Department of Health & Human Services, 2019). There was an additional study done The John Hopkins Lupus Center that associated MHC class II and III two family genes known to be associated with lupus. Major histocompatibility complex (MHC) genes help shape your immune response by coding for proteins that function in response to invaders (antigens) (John Hopkins Lupus Center, 2019). In addition, the genes that increases susceptibility to autoimmune disorders have been identified (VanMeter & Hubert, 2014, p. 128). This disease is known to primarily affect women and manifest between childbearing ages of 15 – 44 and they are at greatest risk of developing SLE (estimates range from 4 to 12 women for every 1 man) (CDC, 2018). There has been a higher rate in non-white women such as: African American, Asians, Hispanics, and Native Americans (CDC, 2018).
Pathophysiological Process
Systemic lupus occurs when the anti-DNA antibody are deposited in connective tissue anywhere in the body activating complement and causing inflammation and necrosis. Vasculitis or inflammation develops in many organs impairing blood supply to the tissue. The resulting ischemia (inadequate oxygen to cells) leads to further inflammation and destruction of tissue (VanMeter & Hubert, 2014, p. 128). This inflammation process occurring in the body will manifest into a visible “butterfly rash” on face and cause most commonly either heart or lung inflammation.
Clinical Manifestations and Complications
Manifestations to be aware of are the “butterfly rash”, joint inflammation, sun sensitivity, chest pain due to inflammation in lining of heart or lungs, and problems with kidneys. A major complication with this disease is the development of immunodefiency essentially a lack of immune response from the body because of weakened state. SLE can also limit a person’s physical, mental, and social functioning mostly due to severe fatigue which ultimately is affecting quality of life (CDC, 2018). If this condition is left untreated it will have fatal consequences such as; organ damage/ failure, or even death.
Diagnostics
Upon arriving in a physician office, they will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples. The blood tests for lupus include: antinuclear antibody test (ANA), anti-double stranded DNA antibody (Anti-dsDNA), and anti-smith antibody (Anti-Sm) (Nayana Ambardekar, 2017). Most people with the presence of numerous ANAs especially anti-DNA in serum are positive for SLE. Lupus erythematosus (LE) cells, mature neutrophils containing nuclear material is also a positive sign. Complement levels will typically be low, and erythrocyte sedimentation rate (ESR) is high, indicating the inflammatory response (VanMeter & Hubert, 2014, p. 128).
References
- CDC. (2018, October 17). Systemic Lupus Erythematosus (SLE). Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/lupus/facts/detailed.html
- John Hopkins Lupus Center. (2019). Causes of Lupus. Retrieved from John Hopkins Lupus Ceneter: https://www.hopkinslupus.org/lupus-info/lupus/
- Nayana Ambardekar, M. (2017, May 5). Rheumatology and Rheumatic Diseases. Retrieved from WebMd: https://www.webmd.com/rheumatoid-arthritis/an-overview-of-rheumatic-diseases#1
- U.S. Department of Health & Human Services. (2019, May 14). Systemic lupus erythematosus. Retrieved from Genetics Home Reference: https://ghr.nlm.nih.gov/condition/systemic-lupus-erythematosus#inheritance
- VanMeter, K. C., & Hubert, R. J. (2014). Gould’s Pathophysiology for Health Professions 5th Edition. Elsevier.
