Symptoms of Lupus
The patient, usually female, produces substances harmful to her system. The antibodies, which are a defense mechanism, become a self-harm mechanism. Therefore, what characterizes the autoimmune disease is the formation of antibodies against its own constituents.
These multiple forms of clinical manifestation can sometimes confuse and delay diagnosis. Lupus requires careful treatment by medical specialists. People adequately addressed, are able to lead normal lives, but those not treated, may end up having serious complications, sometimes incompatible with life.
The typical patient has small joint inflammation, spots on the skin, which are exposed to sunlight, fever and fatigue. But the disease can vary in presentation, making diagnosis sometimes difficult.
There have been great misdiagnosis regarding lupus in the past, until the American Society of Rheumatology enunciated eleven diagnostic criteria in 1971. An individual who fills only four of them surely has the disease.
The first two refer to the oral mucosa. Among other important oral lesions, there will appear sores in the mouth, and in the initial phase, may require a differential diagnosis with pemphigus, a common disease in tropical countries. What may also occur, is mucositis, an inflammatory lesion caused by factors such as aphthous stomatitis repetition, as one example. The second, is characterized by the presence of discoid rash in the oral cavity.
The third criteria involves the so-called butterfly rash, or butterfly wing, which many acknowledge as the most important sign, but it is not necessarily. There is a lesion which appears in the lateral regions of the nose and extends horizontally into the malar region, as a butterfly winged shape. It becomes reddish by erythema, which generally presents a clinical appearance desquamation, i.e. when the lesion is scraped, it flakes off profusely.
The fourth criteria is photosensitivity. This is why the physician should always investigate whether the patient has presented problems when exposed to sunlight, and will know that minimum exposure may cause very severe skin burns, especially to the face, the back, and other parts of the exposed body that the sun reaches while at the beach or in the pool.The fifth criteria is articular pain, or pain in the joints. It is an asymmetrical joint pain that shifts, and that manifests itself preferably in the upper and lower members on one side of the body, and migrates from one joint to another. Generally, it is a pain without heat or flushing (redness) or edema (swelling), which are the three signs of inflammation. There are cases, however, that when those three symptoms are present, as well as arthritis, there may also occur an inflammation in the first outbreak 90% of patients.
The sixth criteria, and one of the most important is renal damage. Patients with renal impairment accompanied by hypertension in the first outbreak end up with a poor outcome. Hypertension denotes the inflammatory process that appears on the membranes of the structures involved in blood filtration systems, that crosses the kidneys and then the patient is affected by glomerulonephritis.
If this disorder is not appropriately treated, the patient will develop a rapidly progressive renal failure. Indeed, the kidneys dictate the prognosis of 90% of cases, and it will be worse if accompanied with the seventh criteria: a brain injury. Its first sign is a seizure, a common seizure that can be mistaken as a characteristic of an exclusively convulsive disease and confuse the diagnosis and treatment of lupus background.
The eighth criterion relates to disorders of the blood test, also changes in the blood, such as – anemia (low red blood cell count), leukopenia (low white blood cell count), lymphopenia (low level of specific white blood cells), or thrombocytopenia (low platelet count).
The ninth criteria says it is the immunologic criteria. SLE patients present a falsely positive reaction for syphilis, and manifest lupus anticoagulant syndrome characterized by thrombosis, embolism and recurrent miscarriages.
The tenth test cite, the incidence of pericarditis (inflammation of the pericardium, a membrane that externally surrounds the heart) and pleuritis (inflammation of the pleura, the membrane covering the lungs) can also occur in patients with lupus. In 70% of cases, The pericarditis was subclinical and is only diagnosed at the autopsy.
The eleventh is the antinuclear factor, ANA, this result can be positive up to nine years before the first manifestation.
Lupus can manifest in other organs with diffuse symptoms as well, and this makes rapid diagnosis and medical history of the patient crucial for better treatment and subsequent prognosis.
General symptoms include fever, joint pain and fatigue.