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LUPUS ERYTHEMATOSUS, SYSTEMIC

DESCRIPTION

Systemic lupus erythematosus is an inflammatory disease of connective tissue. Lupus is not inherited or cancerous. The connective tissue (collagen) is involved. Many body systems are affected, including the joints, skin, kidneys, brain, heart, and lungs. Appropriate health care includes: self-care after diagnosis; doctor's treatment.

SIGNS & SYMPTOMS
Lupus symptoms frequently flare up and then subside. Episodes generally include fever and fatigue, plus any 4 of the following:

  • Rash, usually on the cheeks.
  • Ulcers in the child's mouth.
  • Red palms and hands.
  • Joint pain with redness, swelling, and tenderness--but no deformity.
  • Swelling of the child's face and legs.
  • Shortness of breath.
  • Rapid or irregular heartbeat.
  • Chest pain.
  • Hair loss.
  • Swelling of the lymph glands.
  • Protein in the child's urine.
  • Increased sensitivity to the sun.
  • Anemia.
  • Mental changes, including psychosis.

    CAUSES
    Unknown, but lupus is probably an autoimmune disorder. In an autoimmune disorder, the body's immune system functions abnormally and attacks its own normal tissue -- usually connective tissue.

    RISK FACTORS

  • Stress.
  • Use of drugs, such as hydralazine, procainamide, methyldopa, and chlorpromazine.
  • Genetic factors. The incidence is higher among blacks.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Cannot be prevented at present.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor. A child with vague, recurrent symptoms may require long-term observation before a final diagnosis can be made.
  • Laboratory studies of antinuclear antibodies, blood count and sedimentation rate (See Glossary).

    POSSIBLE COMPLICATIONS

  • Bacterial or viral pneumonia.
  • Impaired kidney function.
  • Pericarditis.
  • Seizures.
  • Hypertension.

    PROBABLE OUTCOME
    Lupus is currently considered incurable. The disease is characterized by remissions and relapses. Life expectancy is reduced, but your child's symptoms can be relieved or controlled for many years. Medical literature cites instances of unexplained recovery. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

    TREATMENT

    HOME CARE

  • Obtain prompt medical treatment for any infection in your child.
  • Your child should not take any immunizations or drugs without consulting the doctor. Immunizations and some drugs may cause relapses or worsen the child's current symptoms.
  • A woman with lupus should not become pregnant without consulting the doctor. Pregnancy may overload the kidneys and cause death.

    MEDICATION
    Your doctor may prescribe immunosuppressive, steroid, and non-steroidal anti-inflammatory drugs or anti-malarial drugs. These relieve the child's symptoms but don't cure the disease.

    ACTIVITY
    Your child should remain as active as possible.

    DIET & FLUIDS
    If your child's kidneys or heart are affected, restrict salt intake. Otherwise, no special diet is necessary.

    OK TO GO TO SCHOOL?

    When appetite returns and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of systemic lupus erythematosus.
  • Any of the following occurs after diagnosis: fever of 101F (38.3C) or higher; blood in the urine; shortness of breath; chest pain; bloody stool; severe abdominal pain; any illness with fever. ‡
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