Systemic lupus erythematosus (SLE) is an autoimmune inflammatory connective tissue disease that primarily affects multiple visceral organs in young women. The incidence of initial, mild, and atypical cases is increasing. Some severe patients (except for patients with diffuse proliferative glomerulonephritis) can sometimes relieve themselves. Some patients have an

Etiology

The etiology of the disease has not been conclusively determined to date. Many scientific studies show that genetic information, endocrine, infection, immune abnormalities, and some environmental factors are related to the onset of the disease.

Under the influence of various factors such as genetic elements, environmental factors, and estrogen levels, T lymphocytes decrease, the function of T suppressor cells decreases, and B cells over-proliferate, resulting in a large number of autoantibodies. These autoantibodies fuse with relative antigens of the body to produce relative immune complexes, which accumulate in skin, joints, small blood vessels, renal tubules, and other locations. With the participation of complement, it causes acute inflammation and tissue necrosis (such as lupus nephritis) or immediate interaction between antigens and tissue cell antigens, causing cell destruction (such as specific antigens of red blood cells, reticulocytes, and platelet walls fusing with relative autoantibodies, respectively causing hemolytic anemia, reticulocytopenia, and thrombocytopenia), thereby causing multi-system damage to the body.

Clinical symptoms

1. General symptoms

The male-to-female ratio of the disease is 1:7-9, with the highest incidence age between 20-40 years, and children or the elderly may also be affected. Symptoms include fatigue, fever, and weight loss.

2. Skin and mucous membranes

The manifestations are various, and can be roughly divided into two major categories: specific and non-specific. Specific skin lesions include butterfly rash, acute cutaneous lupus erythematosus, and discoid lupus. Non-specific skin lesions include photosensitivity, alopecia, oral ulcers, cutaneous vasculitis (petechiae), melanosis (pigmentation or desquamation), reticular purpura, Raynaud’s phenomenon, urticarial rashes, and rare cases of lupus panniculitis or superficial lupus and bullous lupus erythematosus.

3. Skeletal muscle

The main manifestations include joint pain, arthritis, joint deformity (10% have destruction on X-ray), and muscle pain, muscle weakness, avascular necrosis, and osteoporosis.

4. Heart involvement

It may involve pericarditis (4% of patients have signs of pericardial tamponade), myocarditis, which manifests as congestive heart failure, valvular heart disease, such as Libman-Sacks endocarditis. Coronary arteritis is rare, manifested as chest pain, abnormal electrocardiogram, and elevated myocardial enzymes.

5. Respiratory tract involvement

Pleurisy, pleural effusion, and pulmonary restrictive syndrome may manifest as a feeling of shortness of breath and diaphragmatic dysfunction; interstitial lung disease, pulmonary embolism, pulmonary hemorrhage, and pulmonary hypertension can also occur.

6. Kidney

Clinical symptoms include nephritis or nephrotic syndrome. During nephritis, blood cells, white blood cell count, casts, and proteinuria may appear in the urine. Renal function tests are normal at the initial stage, and gradually progress, with uremia appearing in the middle and late stages. Nephrotic syndrome and laboratory findings include general edema, varying degrees of ascites, pleural effusion, and pericardial effusion, massive proteinuria, decreased serum albumin, reversed albumin-to-globulin ratio, and hyperlipidemia.

7. Central nervous system involvement

It may involve twitching, mental disorder, organic brain syndrome including organic amnesia/cognitive impairment, dementia, and change of ideas. Others may include aseptic meningitis, cranial injury, transverse myelitis, lupus-like sclerosis, and jugular venous palsy.

8. Hematological system

It may involve anemia, decreased white blood cell count, low platelets, lymphadenopathy, and splenomegaly.

9. Gastrointestinal tract

It may involve dizziness, nausea, vomiting, diarrhea, ascites, liver enlargement, abnormal liver function, and pancreatitis. Rarely, it may involve mesenteric angiitis, Budd-Chiari syndrome (Budd-Chiari syndrome), and protein-losing enteropathy.

10. Others

Can be combined with hyperthyroidism or hypothyroidism, dry syndrome, and other diseases.