Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus (SLE)

• A chronic, inflammatory autoimmune disorder affecting multiple organ systems including skin, joints, blood cells, internal organs, kidneys and sometimes, the brain.
• Women are nine times more likely to be affected than men.
• The onset typically occurs between 20-40 years of age, but can also affect children, newborns, and older adults.
• Higher incidence is observed in people of African and Asian descent.
• The exact cause is unknown, but it is believed to involve a combination of inherited factors and environmental triggers or hormones.
• Certain drugs can induce SLE.

Types of SLE

• Systemic Lupus Erythematosus affects many parts of the body.
• Discoid Lupus is characterized by a chronic skin rash usually on the face or scalp and 15-20% of individuals progress to SLE.
• Subacute Cutaneous Lupus involves skin lesions on sun exposed areas.
• Drug-Induced Lupus is triggered by certain medications including anti-seizure, high blood pressure, and anti-thyroid drugs such as isoniazid, hydralazine and procainamide.
• Neonatal Lupus is a rare form affecting newborns, characterized by skin rash, liver problems, and low blood counts. Typically resolves within months. It may be triggered by maternal autoantibodies (anti-SSA and anti-SSB) that cross the placenta.

Signs and Symptoms

• Lupus symptoms vary among individuals and depend on the specific type of lupus.
• A butterfly-shaped rash across the nose and cheeks, known as a malar rash, can occur.
• A red rash of round or oval shaped patches, referred to as discoid rash, can occur.
• Rashes may occur on sun-exposed areas, commonly on the face and extremities.
• A rash is the only symptom in discoid and subacute cutaneous lupus, but other types of lupus may include a combination of symptoms:
  • Muscle pain
  • Arthritis-like pain in one or more joints with little to no joint damage
  • Fever
  • Persistent fatigue
  • Swollen lymph nodes
  • Sensitivity to sunlight
  • Raynaud phenomenon: fingers change color in response to cold or stress.
  • Hair loss
  • Chest pain
  • Anemia
  • Mouth ulcers
  • Inflammation and damage to organs and tissues, including the kidneys, lungs, heart, central nervous system, and blood vessels
  • Kidney disease is common in lupus patients and lupus causes glomerulonephritis, which can lead to kidney failure.
  • Nervous system involvement may result in headaches, seizures, depression, or psychosis.
• Lupus symptoms can fluctuate, with periods of worsening and improvement and flare-ups that may be triggered by health status changes, physical or emotional stressors, or exposure to sunlight.
• Women may experience flare-ups during pregnancy or postpartum.

Additional Risks

• Lupus patients face an increased risk of infections like UTIs, respiratory infections, yeast infections, salmonella, herpes, and shingles due to a weakened immune system.
• Higher risks of cancer, bone tissue death, and pregnancy complications such as miscarriage and pre-eclampsia. – Antiphospholipid Syndrome, which can occur with or without underlying lupus, increases the risk of blood clots leading to strokes, deep vein thrombosis, pulmonary embolism, and miscarriages.

Treatment

• There is currently no cure for lupus.
• Treatment goals include alleviating symptoms, minimizing flare-ups, and managing complications associated with SLE.
• To reduce flare-ups, individuals should prioritize rest, exercise, stress reduction and avoid ultraviolet light exposure.

SLE Test: Principle

• SLE-Latex Test is a rapid agglutination procedure for the direct detection and semi-quantitation of anti-deoxyribonucleoprotein antibodies (anti-DNP) in human serum.
• An assay tests a suspension of latex particles coated with DNP against unknown serums.
• The presence or absence of visible agglutination indicates the presence or absence of anti-DNP antibodies

SLE Test: Material

• SLE latex
• Blood serum
• Stick
• Rick tube

SLE Test: How to work

• Bring the test reagents and samples to room temperature.
• Resuspend the Reagent vial gently and aspirate dropper several times to obtain thorough mixing.
• Using an automatic pipette, place 1 drop (30 mL) of the test serum into one of the circles on the card, dispense 1 drop of positive control, and 1 drop of negative control into additional circles.
• Add 1 drop of SLE-Latex Reagent (40 mL) to each circle to the sample being tested.
• Mix the contents of each circle with a disposable stirrer and use separate stirrers for each mixture.
• Rotate the slide by means of a mechanical rotator (100 r.p) for a period of 1 minute.
• Immediately observe under a suitable light source for the degree of agglutination.