49. Systemic lupus erythematosus

Chronic polysyndromic disease, predominantly of young women and girls predisposed to it.

Classification (according to V. A. Nasonova). When making a diagnosis, it is necessary to separate:

1) according to the form of the course: acute, subacute, chronic, with a continuously relapsing course (malignant);

2) according to the degree of activity (I - minimal, II - moderate, III - maximum);

3) by stages: I - initial, II - generalized, III - terminal.

Clinic. In an acute course, an acute onset, the development of polysyndromicity over the next 3-6 months (lupus nephritis or CNS damage).

In the subacute course, the onset is gradual, arthralgia and nonspecific skin lesions are pronounced. The flow is characterized by undulation.

In the chronic course, relapses of individual syndromes are observed for a long time, the development of polysyndromicity at the 5-10th year, the development of deforming polyarthritis at the 10-15th year.

Lupus crises are manifestations of the activity of the lupus process. Characterized by pronounced clinical polysymptomatics, changes in laboratory parameters, general trophic disorders.

Criteria for diagnosis: rash in the zygomatic region ("butterfly"), discoid rash, photosensitivity, ulcers in the oral cavity - painless or painless, arthritis without destruction of cartilage, two or more peripheral joints, serositis (pleurisy, pericarditis), kidney damage ( persistent proteinuria, 0,5 g / day or more), neurological disorders (convulsions), hematological disorders, immune disorders (the appearance of antinuclear antibodies with an increase in their titer).

If four or more signs are present, the diagnosis is considered reliable.

Diagnostic study. A general blood test is carried out (anemia, hemoglobin less than 100 g/l, normo- or hypochromic leukopenia, thrombocytopenia, increased ESR during exacerbations), a biochemical blood test (dysproteinemia, hypoalbuminemia, increased a2-globulins in the acute period of the disease, g-globulins to chronic). An immunological blood test is required (LE cells, antibodies to DNA, to native DNA, ribonucleoprotein, and other nuclear substances). A general urine test (specific gravity, protein, formed elements, epithelium, salts) and a skin biopsy are performed.

Treatment. Glucocorticoids are prescribed (prednisolone 50-60 mg followed by a decrease by 2,5-5 mg per week - for many years), immunosuppressants (azathioprine 100-150 mg, 6-mercaptopurine 150-200 mg, leukeran 10-15 mg ) - several months, then a maintenance dose of 50-100 mg for many months. It is possible to use pulse therapy: 1000 mg of methylprednisolone 3 days in a row or 3 times every other day in 100 ml of isotonic sodium chloride solution or 500 mg 2 times with the addition of 5000 units of heparin and suprastin; addition to conventional hormone therapy. 4-aminoquinoline drugs (chloroquine, delagil, plaquenil) are used for several years, non-steroidal anti-inflammatory drugs (butadione, indomethacin, etc.) for several years, anticoagulants for several months, antiplatelet agents for several months, plasmapheresis, hemosorption - up to 5-6 sessions.

Forecast. The prognosis of the disease is unfavorable.

Author: Myshkina A.K.

<< Back: Chronic renal failure

>> Forward: Systemic scleroderma

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ General and clinical immunology. Crib

▪ Strategic management. Crib

▪ Enterprise economy. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive Fabric with built-in heating 28.04.2002 The American company Maiden Mills presented a fabric equipped with a built-in heating system. Polartec jackets and sheepskin coats made with it are quickly becoming popular with athletes and the military. Instead of traditional wires, stainless steel microfibers are woven into the fabric. These microfibers are thinner than a human hair. In terms of softness, they do not differ from ordinary threads and are not damaged during washing and wearing. Miracle jackets work in two modes: moderate, in which the fibers are able to heat up to a temperature of 42 ° C for 5 hours, and intensive, when clothes are heated to 2,5 ° C in 46 hours. Maiden Mills plans to include heated gloves, air-conditioned clothing, as well as heart rate and body temperature indicators. The only problem at the moment is the fragility and bulkiness of lithium batteries used as batteries.

Other interesting news:

▪ What do whales sing

▪ Memory on Senet crystals

▪ Wristwatch with built-in MP3 player and recorder

▪ SAMSUNG: hard drives have no future

▪ Physiognomy and credit

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ section of the site Metal detectors. Article selection

▪ dog kennel article. Tips for the home master

▪ article Who Created the Piano? Detailed answer

▪ Car window tinting article. Standard instruction on labor protection

▪ article Miscellaneous electronic devices. Directory

▪ article Operational amplifiers of the KR1446 and KF1446 series. Encyclopedia of radio electronics and electrical engineering

Leave your comment on this article:

All languages ​​of this page

Arabic	Hebrew	Polish
Bengali	Hindi	Portuguese
Chinese	Italian	Spanish
English	Japanese	Turkish
French	Korean	Ukrainian
German	Malay	Vietnamese

Home page | Library | Articles | Website map | Site Reviews

www.diagram.com.ua
2000-2024