Systemic Lupus Erythematosus

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Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the development of antibodies against own body tissues. It is a chronic disease capable of affecting virtually all the organ systems of the body with protean manifestations and a relapsing and remitting course. It’s predominantly a disease of the females in the reproductive age (>90% of cases). However there is an entity called childhood-onset SLE.

The aetiology is not fully known but the development of SLE has been associated with genetic, epigenetic, hormonal, and environmental factors. Affected individuals may present with some of the following features: fever, fatigue, joint pain, facial rash (malar rash, photosensitivity, and discoid rash), kidney failure, seizures, psychosis, pericarditis, myocarditis, leukopenia, anemia, thrombocytopenia, pleural effusion, etc.

The diagnosis according to the American College of Rheumatology (ACR) is based on combination of clinical findings and laboratory evidences. The presence of at least 4 of the following is diagnostic: malar rash, discoid rash, photosensitivity, oral ulcers, serositis, arthritis, neurological disorders, renal involvement, blood disorders, presence of  antinuclear antibodies.

Treatment is majorly with the use of immunosuppressive drugs (e.g. corticosteroid, azathioprine, mycophenolate, cyclosporine), NSAIDS (ibuprofen, diclofenac), antimalarial (hydroxychloroquine) etc.

Traditional Chinese Medicine (TCM) has demonstrated advantage over other modalities of management in terms of causing disease remission and prolongation of survival in patients with SLE. A cohort retrospective study conducted between 1999 and 2009 using the database of the Taiwan National Health Insurance program showed that combined therapy with TCM may improve the survival in SLE patients.

Newly diagnosed SLE patients (23,084) participated in the study and 9,267 (40.15%) used TCM for SLE treatment and exhibited a significant decrease in the risk of death. Patients who have also used TCM for up to 1 year before diagnosis also had reduced the risk of death.

Thus, the use of TCM in the management of patients with systemic lupus erythematosus will significantly prolong patients’ survival with improved quality of life.

 

Reference:

Ma YC, Lin CC, Li CI, Chiang JH, Li TC, Lin JG. Traditional Chinese medicine therapy improves the survival of systemic lupus erythematosus patients. Semin Arthritis Rheum. 2016 Apr;45(5):596-603. doi: 10.1016/j.semarthrit.2015.09.006. Link

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