Lupus - neurological sequelae

Human autoimmune disease

Lupus
Synonyms	Systemic lupus erythematosus (SLE)
Pronounce	sih-STEM-ik LOOP-əs ERR-i-thee-mə-TOH-səs
Field	Rheumatology
Symptoms	Painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, red rash
Complications
Onset	15–45 years of age
Duration	Long term
Types	N/A
Causes	Unclear
Risks
Diagnosis	Based on symptoms and blood tests
Differential diagnosis
Prevention
Treatment
Medication	NSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, methotrexate
Prognosis	15 year survival ~80%
Frequency	2–7 per 10,000
Deaths

Lupus (also called systemic lupus erythematosus) is a disorder of the immune system. Normally, the immune system protects the body against invading infections and cancers. In lupus, the immune system is over-active and produces increased amounts of abnormal antibodies that attack the body's tissues and organs. Lupus can affect many parts of the body, including the joints, skin, kidneys, lungs, heart, nervous system, and blood vessels. The signs and symptoms of lupus differ from person to person; the disease can range from mild to life threatening.

Initial symptoms of lupus may begin with a fever, vascular headaches, epilepsy, or psychoses. A striking feature of lupus is a butterfly shaped rash over the cheeks. In addition to headache, lupus can cause other neurological disorders, such as mild cognitive dysfunction, organic brain syndrome, peripheral neuropathies, sensory neuropathy, psychological problems (including personality changes, paranoia, mania, and schizophrenia), seizures, transverse myelitis, and paralysis and stroke.

Treatment

There is no cure for lupus. Treatment is symptomatic. With a combination of medication, rest, exercise, proper nutrition, and stress management, most individuals with lupus can often achieve remission or reduce their symptom levels. Medications used in the treatment of lupus may include aspirin and other nonsteroidal anti-inflammatory medications, antimalarials, corticosteroids, and immunosuppressive drugs.

Prognosis

The prognosis for lupus varies widely depending on the organs involved and the intensity of the inflammatory reaction. The course of lupus is commonly chronic and relapsing, often with long periods of remission. Most individuals with lupus do not develop serious health problems and have a normal lifespan with periodic doctor visits and treatments with various drugs.

Lupus nephritis

• Minimal mesangial glomerulonephritis Class I (Minimal mesangial glomerulonephritis Minimal mesangial glomerulonephritis)
• Mesangial proliferative lupus nephritis Class II (Mesangial proliferative lupus nephritis Mesangial proliferative lupus nephritis)
• Focal proliferative nephritis Class III (Focal proliferative nephritis Focal proliferative nephritis)
• Diffuse proliferative nephritis Class IV (Diffuse proliferative nephritis Diffuse proliferative nephritis)
• Membranous glomerulonephritis Class V (Membranous glomerulonephritis Membranous nephritis)
• Glomerulosclerosis Class VI (Glomerulosclerosis Glomerulosclerosis)

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