Systemic Lupus Erithematus

1 Systemic Lupus Erythematous (SLE) SLE is the common form of lupus, an autoimmune condition in which the immune system mistakenly attacks healthy cells in the body (Tsokos, 2016). This condition can affect the joints, brain, kidneys, and skin cells. SLE is associated with hormonal, genetic, and environmental factors (Gordon & Isenberg, 2016). The triggers of SLE include infections, sunlight exposure, and medications like antibiotics, anti-hypertensives, and anti-seizures. This paper elucidates this disease's subjective and objective clinical findings and its management.

Subjective Clinical Findings Patients with suspected SLE show up in health facilities with malaise and fever, prolonged extreme fatigue, decreased appetite, and weight loss. Some patients also complain of body weakness, joint pain, and muscle pain (Gordon & Isenberg, 2016). Abdominal symptoms, including diarrhea, nausea, and vomiting, are also common in SLE. The patient might also complain of headaches, shortness of breath, increased sun sensitivity, and chest pain when taking deep breaths.

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2 Objective Clinical Findings The objective findings of SLE include inflamed and stiff joints, hair loss, and inflamed glands. This condition affects the skin leading to butterfly-shaped rash, ulcers on the mucous membranes in the mouth and nose, and red patches on the skin surface (Tamirou et al., 2019).

The joints appear swollen and tender. The eyes might appear dry, and the toes turn white when exposed to cold.

Diagnostic Tests SLE is challenging to diagnose since most symptoms are similar to other health disorders, and they vary from one person to another. These symptoms also tend to change with time (Gordon & Isenberg, 2016). Therefore, clinicians must use designated tests to make accurate diagnoses. Laboratory tests for SLE include Complete Blood Count (CBC), urinalysis, erythrocyte sedimentation rate, Antinuclear Antibody Test (ANA), and kidney and liver assessment (Tamirou et al., 2019). CBC reveals the number of different blood cells. Clinicians use CBC results to determine if the client has anemia, thrombocytopenia, and leukopenia, which typify lupus. Urinalysis helps determine if the client has elevated protein levels in urine, indicating affected kidneys (Gordon et al., 2018). A positive ANA test reveals that the immune system is activated. A chest X-ray is also performed to reveal lung abnormalities such as fluid retention and inflammation.

Management Clinicians do not treat SLE with a specific medication. Treatment is based on the client’s signs and symptoms. The clinician must discuss the risks and benefits of medications for treating this disease (Gordon et al., 2018). Patients with severe symptoms involving the kidneys, lungs, and heart are referred to specialists. Patients are first given NSAIDs to avert pain and

3 inflammation (Tamirou et al., 2019). The doctor modifies the dosage based on treatment outcomes. Since SLE is associated with an overactive immune system, the doctor might prescribe immunosuppressant drugs such as methotrexate (Gordon et al., 2018). Corticosteroids might also be used in treating this disease to lower the risk of kidney and brain complications.

Antimalarial drug Hydroxychloroquine is used to reduce the danger of lupus flares.

4 References Gordon, C., & Isenberg, D. (2016). Systemic lupus erythematosus. Oxford University Press Gordon, C., Amissah-Arthur, M. B., Gayed, M., Brown, S., Bruce, I. N., D’Cruz, D., ... & British Society for Rheumatology Standards. (2018). Guideline for the management of systemic lupus erythematosus in adults. Rheumatology, 57(1), e1-e45. https://doi.org/10.1093/rheumatology/kex286 Lam, N. C., Ghetu, M. V., & Bieniek, M. L. (2016). Systemic lupus erythematosus: primary care approach to diagnosis and management. American Family Physician, 94(4), 284-294. https://pubmed.ncbi.nlm.nih.gov/27548593/ Tamirou, F., Arnaud, L., Talarico, R., Scirè, C. A., Alexander, T., Amoura, Z., ... & CostedoatChalumeau, N. (2019). Systemic lupus erythematosus: state of the art on clinical practice guidelines. RMD Open, 4(Suppl 1), e000793. https://doi.org/10.1136/rmdopen-2018000793 Tsokos, G. C. (2016). Systemic lupus erythematosus: Basic, applied, and clinical aspects.

Academic Press.