Systematic lupus erythematosus(SLE)

The systematic lupus erythematosus(SLE) is chronic inflammatory connective tissue disease with unknown origin which affects the joint, kidney, surface of serous membrane and blood vessel s wall. Mainly occurs in youth females, but may also occurs in children. The clinical manifestation: SLE occurs more in female, especially in puberty and fertile period; chronic onset of disease, the common symptoms includes:1) fever: irregular subfebrile temperature.2) skin damages: seen commonly on the face- butterfly shaped red patches; from the bridge of the nose to two cheek, resembles butterfly shape, the edge may be clear or not clear, bright red or the purple red, aggravates after the exposure to sun; skin rash is widespread, symmetrical, polymorphic; mucous membrane of mouth, throat, vagina and others have light degree of ulcer.3) athralgia (joint pain) wandering athralgia of large and small joints, myalgia (muscular pain) may appear.4) urinary system: continuous or remittance proteinuria, hematuria, cylinduria adng hypertension, edema and kidney insufficiency.5) cardiobascular system: pericarditis, myocarditis, endocarditis, arrhythmias, cardiac insufficiency and etc .6) respiratory system: pneumothorax, pneumonia, pulmonary artery inflammation and etc.7) digestive system: poor appetite, nausea, vomiting, abdominal pain, diarrhea, melena (blood in stool), ascites and etc.8) nervous system: encephalitis, meningitis, brain stroke, spinitis; may also have slight enlargement of lymph nodes and etc.Additional inspection:Anemia: 90%above patient has anemia, mainly normocytic anemia, normochromic anemia, or hemolytic anemia.White blood cell: The white blood cell reduces, is lower than4.5*10 9/ L (4500/mm2), decrease of neutrophils and lymphocyte, eosinophil increases, which accounts for 10% of total white blood cell. When there is continuous infetions, the white blood cell may elevate (leukocytosis).Platelet reduction: The partial patients have mild or the severe blood platelet reduction (thrombocytopenia).Elevation of ESR (erythrocyte sedimentation rate).Routine urine test: different degree proteinuria, hematuria, cylinduria or pyuria (pus in urine).Biochemistry analysis: elevation of transaminase, unusual turbidity. When the kidney function is not sufficient, BUN, NPN and blood potassium are elevated; most patients protein electricity shows elevation of r-globulin.50% of patients have hypoproteinemia (low level of protein in blood).Immunology analysis:Lupus cell (LEcell) average positive rate50% - 80%.The anti-nuclear antibody (ANA) is the antibody that is produced against a cell s nucleus. Approximately more than 90%of patients are positive. Among the anti-nuclear antibody, anti-DNA antibody specificity is stronger, but among them anti-dsDNA are more specific, approximately 60-70% SLE manifestation stage is positive, its its fluctuation is parallel with the condition of disease. The anti-Sm antibody is a high specificity symbol of SLE, approximately 25-30% patient are positive. This antibody generally only appears in SLE, therefore, it has high early diagnostic value.Complement: more than 70 of patients blood serum always has decrease of complement, C3 and C4 decrease, especially C3 decreases significantly.The lupus belt test(LBT) has high specificity. It can also diagnose SLE which do not affect the skin and may estimate the condition and prognosis of the disease.The treatment includes:1) eliminates the other suspicious causes of disease, e.g control of infection, avoid using the influential drugs (for example oral contraceptive, penicillin, streptomycin, sulfonamide and etc.), avoids exposure to sun and etc.2) immunosuppressors (1) corticosteroids, e.g prednisolone 10-20 milligram or dexamethasone 3 milligrams, 3 times orally daily; gradually decrease of dosage, if it is effective, to maintenance dose;(2) mercaptopurine 50milligrams, 3 times orally daily.3) uses shift factors and the L-imidazole, the latter 50 milligrams, 3 times daily, 3 days consecutively, then stop for 10 days for one treatment course.4) symptomatic therapy e.g aspirin for fever and pain; besides, also use drugs for antihypertension, diuresis, anti-cardiac insufficiency, anti-kidney insufficiency and etc.[Clinical treatment results] Treated 356 cases; 335 cases with significant effectiveness (clinical symptoms disappeared, related laboratory analysis normal), 20 cases effective (clinical symptoms reduced, related laboratory analysis comparatively restored), 1 case of invalid (clinical symptoms and laboratory analysis comparatively no significant changes).