Dear Dr. Deena,
I have a family member who was diagnosed with Lupus and I wanted to make more sense of it. What is it really doing to the body?
Regards,
Anonymous
Thank you for your question, Anonymous. I am so sorry to hear about your family member who was recently diagnosed with Lupus. I hope that this blog can help you and your family better understand this disease.
Systemic Lupus Erythematosus (commonly known as “SLE” or “Lupus”) is an autoimmune inflammatory disease. In SLE, the patient’s immune system recognizes healthy tissues as "foreign". These tissues may include organs (like the kidney, lungs or heart), joints, ligaments, bone, etc. SLE can ultimately attack any tissue in the body which leads to inflammation that may cause pain, swelling, and/or inability for an organ to function properly.
In order to fully understand SLE, one must first understand what an autoimmune disease is and the process of inflammation.
Our immune system is developed to help protect us against anything that is foreign to the body. These “foreign” things can include bacteria, viruses, parasites, splinters, dirt, pollen, etc. Normally our immune system produces chemicals to help destroy these “foreign” substances.
In an "autoimmune" disease the body mistakenly recognizes its own healthy cells as foreign and begins to destroy them. This process of destruction of healthy cells leads to a great deal of inflammation.
The process of inflammation is very complex. I will briefly describe this to you in the following steps, so you can better understand what is happening in the body in patients with SLE.
As an example, let's imagine a patient with SLE who is experiencing symptoms in their knee joint. (Remember the process that I am describing to you, is what happens in ANY tissue that is affected by SLE. I chose to focus on the knee joint because its easier to visualize the ultimate effects of inflammation on the knee)
1. Since SLE is an autoimmune disease, the immune system mistakenly recognizes the healthy knee joint tissue as "foreign".
2. An immune cell, called the macrophage, releases chemical signals to increase blood flow towards the knee. As the blood flow increases to the knee joint it appears more red and warm.
3. The chemical signals released by the macrophage, also cause the blood vessels to become porous. These pores allow red blood cells, white blood cells, and fluid to exit freely into the space surrounding the knee tissue. This leads to swelling of the knee joint.
4. White blood cells also recognize the chemical signals sent out by the macrophage and enter into the space surrounding the knee joint.
5. The white blood cells begin to attack the healthy knee tissue cells that it mistakenly recognizes as "foreign" and consumes all destroyed cells in a process called "phagocytosis".
6. As the immune system continues to attack more and more healthy knee tissue, this inflammation continues to destroy the knee joint. This process can ultimately lead to thickening and scarring of tissue (“fibrosis”) and loss of function of that knee joint (leading to inability to move knee, bare weight, etc.).
Here is a picture of what you might have pictured the knee to look like during a SLE flare of the knee. Now you can understand why the knee appears red, warm, swollen, and tender --> the classic signs of inflammation! (left knee is abnormal and right knee is normal).
image from http://kneeswellingnopainsrgl.wordpress.com/
Now that you understand what is happening to the body with SLE, let's discuss the symptoms.
Every SLE patient is different - some might have disease that is mild and some might have disease that is life-threatening. Some patients might have symptoms every day, and some might have symptoms only a few times in their lifetime after which they go into remission ("a symptom free period").
As mentioned before SLE symptoms are caused by inflammation, which can affect the whole body or any individual part of the body.
When SLE affects the whole body symptoms might include fatigue, fevers, and changes in weight.
When SLE affects the joints this may result in pain, swelling, stiffness, and difficulty with walking. The most commonly affected joints include the fingers, wrists, and knees.
SLE can affect the kidneys causing problems in filtering waste products from the blood stream. If kidney disease is left untreated. the patient may require dialysis or kidney transplantation.
When SLE affects the digestive system, patients may experience abdominal pain, nausea, vomiting, and/or diarrhea.
SLE can affect the lungs in a variety of ways leading to shortness of breath and pain with breathing ("pleurisy").
SLE can affect any part of the heart leading to chest pain, shortness of breath, and increases the patient's risk for having a heart attack.
Some of the most common problems affecting the nervous system in patients with SLE include difficulty concentrating, memory loss, depression and anxiety, headaches, pain in the hands or feet (called peripheral neuropathy), weakness or numbness, or even stroke.
Skin changes associated with SLE include a rash, hair loss, ulcerations in the mouth, and "Raynaud's Phenomenon". Raynaud's Phenomenon occurs when blood vessels in the fingers and toes narrow in response to cold temperatures, stress, cigarette smoking, and other triggers.
As the blood vessels narrow, less blood flows to the area, causing the fingers or toes to become pale and then blue, purple, and/or red. Below is an example of how Raynaud's Phenomenon progresses as the fingers turn from pale to blue/purple:
As always please feel free to leave comments below, and continue to email your questions to DoctorDeenaMD@gmail.com.
**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**
I have a family member who was diagnosed with Lupus and I wanted to make more sense of it. What is it really doing to the body?
Regards,
Anonymous
Thank you for your question, Anonymous. I am so sorry to hear about your family member who was recently diagnosed with Lupus. I hope that this blog can help you and your family better understand this disease.
Systemic Lupus Erythematosus (commonly known as “SLE” or “Lupus”) is an autoimmune inflammatory disease. In SLE, the patient’s immune system recognizes healthy tissues as "foreign". These tissues may include organs (like the kidney, lungs or heart), joints, ligaments, bone, etc. SLE can ultimately attack any tissue in the body which leads to inflammation that may cause pain, swelling, and/or inability for an organ to function properly.
In order to fully understand SLE, one must first understand what an autoimmune disease is and the process of inflammation.
Our immune system is developed to help protect us against anything that is foreign to the body. These “foreign” things can include bacteria, viruses, parasites, splinters, dirt, pollen, etc. Normally our immune system produces chemicals to help destroy these “foreign” substances.
In an "autoimmune" disease the body mistakenly recognizes its own healthy cells as foreign and begins to destroy them. This process of destruction of healthy cells leads to a great deal of inflammation.
The process of inflammation is very complex. I will briefly describe this to you in the following steps, so you can better understand what is happening in the body in patients with SLE.
As an example, let's imagine a patient with SLE who is experiencing symptoms in their knee joint. (Remember the process that I am describing to you, is what happens in ANY tissue that is affected by SLE. I chose to focus on the knee joint because its easier to visualize the ultimate effects of inflammation on the knee)
1. Since SLE is an autoimmune disease, the immune system mistakenly recognizes the healthy knee joint tissue as "foreign".
2. An immune cell, called the macrophage, releases chemical signals to increase blood flow towards the knee. As the blood flow increases to the knee joint it appears more red and warm.
3. The chemical signals released by the macrophage, also cause the blood vessels to become porous. These pores allow red blood cells, white blood cells, and fluid to exit freely into the space surrounding the knee tissue. This leads to swelling of the knee joint.
4. White blood cells also recognize the chemical signals sent out by the macrophage and enter into the space surrounding the knee joint.
5. The white blood cells begin to attack the healthy knee tissue cells that it mistakenly recognizes as "foreign" and consumes all destroyed cells in a process called "phagocytosis".
Here is a picture of what you might have pictured the knee to look like during a SLE flare of the knee. Now you can understand why the knee appears red, warm, swollen, and tender --> the classic signs of inflammation! (left knee is abnormal and right knee is normal).
image from http://kneeswellingnopainsrgl.wordpress.com/
Now that you understand what is happening to the body with SLE, let's discuss the symptoms.
Every SLE patient is different - some might have disease that is mild and some might have disease that is life-threatening. Some patients might have symptoms every day, and some might have symptoms only a few times in their lifetime after which they go into remission ("a symptom free period").
As mentioned before SLE symptoms are caused by inflammation, which can affect the whole body or any individual part of the body.
When SLE affects the whole body symptoms might include fatigue, fevers, and changes in weight.
When SLE affects the joints this may result in pain, swelling, stiffness, and difficulty with walking. The most commonly affected joints include the fingers, wrists, and knees.
SLE can affect the kidneys causing problems in filtering waste products from the blood stream. If kidney disease is left untreated. the patient may require dialysis or kidney transplantation.
When SLE affects the digestive system, patients may experience abdominal pain, nausea, vomiting, and/or diarrhea.
SLE can affect the lungs in a variety of ways leading to shortness of breath and pain with breathing ("pleurisy").
SLE can affect any part of the heart leading to chest pain, shortness of breath, and increases the patient's risk for having a heart attack.
Some of the most common problems affecting the nervous system in patients with SLE include difficulty concentrating, memory loss, depression and anxiety, headaches, pain in the hands or feet (called peripheral neuropathy), weakness or numbness, or even stroke.
Skin changes associated with SLE include a rash, hair loss, ulcerations in the mouth, and "Raynaud's Phenomenon". Raynaud's Phenomenon occurs when blood vessels in the fingers and toes narrow in response to cold temperatures, stress, cigarette smoking, and other triggers.
As the blood vessels narrow, less blood flows to the area, causing the fingers or toes to become pale and then blue, purple, and/or red. Below is an example of how Raynaud's Phenomenon progresses as the fingers turn from pale to blue/purple:
image taken from wikimedia.org
I hope you now feel comfortable understanding what the body is experiencing during a SLE flare and how this inflammation can affect any organ in the body leading to the symptoms discussed above.
As always please feel free to leave comments below, and continue to email your questions to DoctorDeenaMD@gmail.com.
**PLEASE REMEMBER IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR HEALTH AND/OR BEFORE STARTING OR STOPPING ANY TREATMENT OR ACTING UPON INFORMATION CONTAINED ON THE SITE, YOU SHOULD CONTACT YOUR OWN PHYSICIAN OR HEALTH-CARE PROVIDER**
