Systemic lupus erythematosus

SLE is an autoimmune, multisystem disorder of unknown aetiology where the body becomes programmed to manufacture antibodies against its own tissues. These antibodies then proceed to destroy the tissues and this process gives rise to a myriad of symptoms.

Failure of the immune surveillance mechanisms at multiple levels result in development of SLE. Its cause is complex and varied involving interaction between genetic factors, environmental triggers and abnormal and inefficient responses of the immune mechanisms of the body.

Whenever a foreign molecule enters our body, our defence machinery sets into play a cascade of reactions at various levels to effectively route the foreign enemy. Problems arise when the body is unable to identify what is foreign and what is indigenous and this, coupled with defective responses, results in production of soldiers (antibodies) against its own tissues. To add to the damage, certain complexes circulating in the bloodstream get deposited in tissues. The resultant is widespread damage and destruction.

It is more commonly seen in women of child bearing age, frequently exacerbated after childbirth. It increases risk of spontaneous abortions and stillbirths.

What is the hallmark of SLE?

Antibodies develop against the cell membrane, the nuclear membrane, the DNA, the RNA, the red blood cells, lymphocytes, nerve cells etc.

What are the clinical features of SLE?

The features differ according to the tissue affected and depending on the severity of the disease process. The intensity ranges from mild, intermittent to continuous and ultimately fatal. General symptoms like fever, loss of appetite and tiredness are usually present.

Fever and joint pain is the most common presentation.

The typical butterfly rash is commonly seen on the face. Other lesions involving the skin are also seen frequently.

Certain gastric symptoms like nausea, abdominal pain, constipation may occur.

Damage to blood vessels results in symptoms of insufficient blood supply to the organ concerned.

Organs like the eyes, kidneys, lungs, heart, the nervous system may be affected leading to different symptoms as per the area and extent of damage.

There may be a general depletion of vital blood components due to widespread destruction induced by autoantibodies.

How is SLE diagnosed?

The clinical history coupled with positive tests for the presence of characteristic antibodies confirms the diagnosis of SLE.

ANA (Antinuclear antibody) is found to be positive in majority of cases but it is not exclusively diagnostic of SLE.

The DNA and Smith antibodies are specific for SLE.

Tests involving antibodies against chromatin, RNA, histone, complement levels are also useful in diagnosis and prognosis.

The ESR and C reactive protein is high.

Other tests to assess the level of damage to liver, kidney are carried out.

The scope of Homoeopathy in SLE is promising as evidenced by clinical improvement even in long standing and severe cases. The patient regains the joy of life as she continues to have longer periods of remissions and lesser acute attacks of mild intensity. Affection of vital organs like the lungs, heart, nervous system, kidneys are found to have diminished in intensity, albeit in some cases the symptoms associated with vital organ affection have vanished altogether. The patient remains well and is able to carry on with normal life, doing all the chores which she used to do earlier and travelling and doing things she loves without any major flare ups of the disease. These suggest that the medicines have somewhere acted as immunomodulators and managed to hold the deadly disease at bay.