Systemic Lupus Erythematosus (SLE) in Seniors -
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Systemic Lupus Erythematosus (SLE) in Seniors


Systemic lupus erythematosus, commonly referred to simply as lupus, is an autoimmune disorder where the immune system attacks any organ or tissue in the body. It frequently affects the skin, kidneys, joints and brain. Although this condition tends to start in the forties, it can in some instances arise only in the senior years. Often the condition is mistaken for rheumatoid arthritis at the outset due to the joint symptoms. The skin symptoms are often confused by elderly women as a condition known as melasma. By not seeking prompt medical attention, SLE can be fatal.

Systemic Lupus Erythematosus Symptoms

The skin lesions in systemic lupus erythematosus are characterized by the development of fixed, reddish rashes that often have a butterfly configuration over the cheek region and across the bridge of the nose. In some cases the rashes may spread diffusely and have a wide area of skin involvement. These skin rashes produce itching or burning sensation which is often aggravated by exposure to sunlight. The disease often causes hyperpigmentation of the skin.

Patchy or extensive loss of hair from the scalp is a very common finding in systemic lupus erythematosus. The oral lesions are usually white in color and flat in appearance resembling lichen planus. Occasionally the presence of reddish lesions in the oral cavity can be seen, which later on becomes ulcerated.

Vegetations in the heart valves can be also present due to systemic lupus erythematosus. Systemic manifestations include fever, bodyache, fatigue, vomiting, diarrhea and loss of appetite. Difficulty swallowing, spleenomegaly and enlargement of lymph nodes may also be seen. The urine excretes large amounts of protein substances. Joint pain and anemia are also very commonly seen in systemic lupus erythematosus.

Causes of SLE

Systemic lupus erythematosus is an autoimmune disease where the body attacks its own cells by producing antibodies against it. The disease is more prevalent in females. The age group most commonly involved is around 40 years of age.

  • The exact cause of systemic lupus erythematosus is not known.
  • Certain environmental and genetic factors also predispose an individual to develop this condition.
  • Genetic predisposition is not exactly familial, but relatives of patients have higher incidences of auto-antibody formation, immune deficiency and connective tissue disorders.
  • Phenytoin, isoniazide, procainamide and quinidine are the drugs which may induce similar episodes like systemic lupus erythematosus in patients being treated for other chronic diseases. This condition is usually reversible.

Systemic lupus erythematosus some times co-exist with other disease like Sjögren’s syndrome, scleroderma and Raynaud’s phenomenon.

Treatment of SLE

Treatment of systemic lupus erythematosus includes analgesic, anti-malarial drugs and corticosteroids. The analgesics are given to relieve the chronic pain associated with systemic lupus erythematosus. Non-steroidal anti-inflammatory drugs and opioid analgesics can be used.

Dextropropoxyphene, methadone and oxycodone are few of the opioid drugs that are commonly used. Transdermal patches of fentanyl can also be used to relieve pain. Anti malarial used for treating systemic lupus erythematosus includes hydroxychloroquine. The corticosteroids such as prednisolone are also useful as the condition is of autoimmune nature.

The patients are advised to avoid exposure to sunlight and lifestyle modifications. Renal transplantation can be considered in conditions with severe kidney damage.


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