Lupus nephritis history and symptoms: Difference between revisions
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{{Lupus nephritis}} | {{Lupus nephritis}} | ||
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] | '''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:Okamal|Omer Kamal, M.D.]] [Mailto:okamal@bidmc.harvard.edu| <nowiki>[2]</nowiki>] | ||
== Overview == | == Overview == | ||
A positive history of familial [[lupus]], [[skin rashes]] (especially [[Photosensitivity|photosensitive]] [[skin rashes]]), [[arthritis]], and [[fatigue]] may be suggestive of [[systemic lupus erythematosus]]. The most common symptoms of [[SLE]] include constitutional symptoms like [[fatigue]], [[fever]], [[myalgia]], and [[Weight|weight changes]]. The organ-specific symptom mostly occur with disease progression. [[SLE]] may show a variety of symptoms in different organs depending on its complications. eg.g Foamy urine. | As a manifestation of [[SLE]], [[Lupus nephritis]] shares most of the symptoms with [[SLE]]. A positive history of familial [[lupus]], [[skin rashes]] (especially [[Photosensitivity|photosensitive]] [[skin rashes]]), [[arthritis]], and [[fatigue]] may be suggestive of [[systemic lupus erythematosus]]. The most common symptoms of [[SLE]] include constitutional symptoms like [[fatigue]], [[fever]], [[myalgia]], and [[Weight|weight changes]]. The organ-specific symptom mostly occur with disease progression. [[SLE]] may show a variety of symptoms in different organs depending on its complications. eg.g Foamy urine. | ||
== History | == History == | ||
Obtaining the history is one of the most important aspects in making a diagnosis of [[systemic lupus erythematosus]]. It provides insight into disease course and severity, precipitating risk factors, and associated [[comorbid]] conditions. Complete history will help determine the correct complication diagnosis, and helps in determining the prognosis as well. Specific histories about the symptoms (duration, onset, progression), associated symptoms, and [[drug]] usage have to be obtained. Specific areas of focus when obtaining the history are outlined below: | Obtaining the history is one of the most important aspects in making a diagnosis of [[systemic lupus erythematosus]]. It provides insight into disease course and severity, precipitating risk factors, and associated [[comorbid]] conditions. Complete history will help determine the correct complication diagnosis, and helps in determining the prognosis as well. Specific histories about the symptoms (duration, onset, progression), associated symptoms, and [[drug]] usage have to be obtained. Specific areas of focus when obtaining the history are outlined below:<ref name="pmid11085805">{{cite journal |vauthors=Tench CM, McCurdie I, White PD, D'Cruz DP |title=The prevalence and associations of fatigue in systemic lupus erythematosus |journal=Rheumatology (Oxford) |volume=39 |issue=11 |pages=1249–54 |date=November 2000 |pmid=11085805 |doi= |url=}}</ref><ref name="pmid9598886" /><ref name="pmid14530779" /><ref name="pmid20572299" /><ref name="pmid7779127">{{cite journal |vauthors=McKinley PS, Ouellette SC, Winkel GH |title=The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. A proposed model |journal=Arthritis Rheum. |volume=38 |issue=6 |pages=826–34 |date=June 1995 |pmid=7779127 |doi= |url=}}</ref><ref name="pmid27329649" /> | ||
* Onset, duration and progression of symptoms | * Onset, duration and progression of symptoms<ref name="pmid14530779">{{cite journal |vauthors=Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR |title=Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=299–308 |date=September 2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref> | ||
* History of [[Weight change|weight changes]] (gain or loss) | * History of [[Weight change|weight changes]] (gain or loss)<ref name="pmid9598886">{{cite journal |vauthors=Wang B, Gladman DD, Urowitz MB |title=Fatigue in lupus is not correlated with disease activity |journal=J. Rheumatol. |volume=25 |issue=5 |pages=892–5 |date=May 1998 |pmid=9598886 |doi= |url=}}</ref> | ||
* Foamy urine | * Foamy urine<ref name="pmid14530779">{{cite journal |vauthors=Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR |title=Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=299–308 |date=September 2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref> | ||
* [[Anorexia]] | * Dark urine | ||
* [[Arthritis]], [[Arthralgia|arthralgias]], or [[muscle pain]] | * [[Anorexia]]<ref name="pmid14530779">{{cite journal |vauthors=Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR |title=Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=299–308 |date=September 2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref><ref name="pmid20572299">{{cite journal |vauthors=Tian XP, Zhang X |title=Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment |journal=World J. Gastroenterol. |volume=16 |issue=24 |pages=2971–7 |date=June 2010 |pmid=20572299 |pmc=2890936 |doi= |url=}}</ref><ref name="pmid27329649">{{cite journal |vauthors=Alves SC, Fasano S, Isenberg DA |title=Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review |journal=Lupus |volume=25 |issue=14 |pages=1509–1519 |date=December 2016 |pmid=27329649 |doi=10.1177/0961203316655210 |url=}}</ref> | ||
* [[Arthritis]], [[Arthralgia|arthralgias]], or [[muscle pain]]<ref name="pmid14530779" /><ref name="pmid9598886">{{cite journal |vauthors=Wang B, Gladman DD, Urowitz MB |title=Fatigue in lupus is not correlated with disease activity |journal=J. Rheumatol. |volume=25 |issue=5 |pages=892–5 |date=May 1998 |pmid=9598886 |doi= |url=}}</ref><ref name="pmid20572299">{{cite journal |vauthors=Tian XP, Zhang X |title=Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment |journal=World J. Gastroenterol. |volume=16 |issue=24 |pages=2971–7 |date=June 2010 |pmid=20572299 |pmc=2890936 |doi= |url=}}</ref><ref name="pmid7779127" /> | |||
* Morning [[stiffness]] | * Morning [[stiffness]] | ||
* [[Skin rashes]] and their association to flare ups, especially after exposure to sunlight | * [[Skin rashes]] and their association to flare ups, especially after exposure to sunlight | ||
* [[Medications]] and their association to flare ups | * [[Medications]] and their association to flare ups<ref name="pmid9598886">{{cite journal |vauthors=Wang B, Gladman DD, Urowitz MB |title=Fatigue in lupus is not correlated with disease activity |journal=J. Rheumatol. |volume=25 |issue=5 |pages=892–5 |date=May 1998 |pmid=9598886 |doi= |url=}}</ref><ref name="pmid20572299">{{cite journal |vauthors=Tian XP, Zhang X |title=Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment |journal=World J. Gastroenterol. |volume=16 |issue=24 |pages=2971–7 |date=June 2010 |pmid=20572299 |pmc=2890936 |doi= |url=}}</ref> | ||
* [[Infections]] especially [[mononucleosis]] | * [[Infections]] especially [[mononucleosis]] | ||
* Sores in the mouth, nose, or other [[Mucous membrane|mucous membranes]] | * Sores in the mouth, nose, or other [[Mucous membrane|mucous membranes]] | ||
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* [[Family history]] of [[Rheumatologic disease|rheumatologic diseases]] | * [[Family history]] of [[Rheumatologic disease|rheumatologic diseases]] | ||
== Common Symptoms | == Common Symptoms == | ||
The early manifestations of [[systemic lupus erythematosus]] include common constitutional symptoms that may be seen in many other diseases as well: | The early manifestations of [[systemic lupus erythematosus]] include common constitutional symptoms that may be seen in many other diseases as well: | ||
* [[Fatigue]] | * [[Fatigue]] | ||
Latest revision as of 15:21, 20 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D. [2]
Overview
As a manifestation of SLE, Lupus nephritis shares most of the symptoms with SLE. A positive history of familial lupus, skin rashes (especially photosensitive skin rashes), arthritis, and fatigue may be suggestive of systemic lupus erythematosus. The most common symptoms of SLE include constitutional symptoms like fatigue, fever, myalgia, and weight changes. The organ-specific symptom mostly occur with disease progression. SLE may show a variety of symptoms in different organs depending on its complications. eg.g Foamy urine.
History
Obtaining the history is one of the most important aspects in making a diagnosis of systemic lupus erythematosus. It provides insight into disease course and severity, precipitating risk factors, and associated comorbid conditions. Complete history will help determine the correct complication diagnosis, and helps in determining the prognosis as well. Specific histories about the symptoms (duration, onset, progression), associated symptoms, and drug usage have to be obtained. Specific areas of focus when obtaining the history are outlined below:[1][2][3][4][5][6]
- Onset, duration and progression of symptoms[3]
- History of weight changes (gain or loss)[2]
- Foamy urine[3]
- Dark urine
- Anorexia[3][4][6]
- Arthritis, arthralgias, or muscle pain[3][2][4][5]
- Morning stiffness
- Skin rashes and their association to flare ups, especially after exposure to sunlight
- Medications and their association to flare ups[2][4]
- Infections especially mononucleosis
- Sores in the mouth, nose, or other mucous membranes
- Symptoms of other organ failure
- Renal failure: Recent peripheral edema and weight gain
- Cardiac involvement: Tachycardia, dyspnea, chest pains
- History of having a pet
- Hair loss
- Job history
- Co-morbid conditions include:
- Seizures, or other nervous system symptoms
- Family history of rheumatologic diseases
Common Symptoms
The early manifestations of systemic lupus erythematosus include common constitutional symptoms that may be seen in many other diseases as well:
- Fatigue
- Fever
- Myalgia
- Joint tenderness
- Muscle weakness
- Weight change
- Weight gain due to increase in water retention and increase in appetite
- Weight loss due to medication side effect and gastrointestinal problems
References
- ↑ Tench CM, McCurdie I, White PD, D'Cruz DP (November 2000). "The prevalence and associations of fatigue in systemic lupus erythematosus". Rheumatology (Oxford). 39 (11): 1249–54. PMID 11085805.
- ↑ 2.0 2.1 2.2 2.3 Wang B, Gladman DD, Urowitz MB (May 1998). "Fatigue in lupus is not correlated with disease activity". J. Rheumatol. 25 (5): 892–5. PMID 9598886.
- ↑ 3.0 3.1 3.2 3.3 3.4 Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR (September 2003). "Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients". Medicine (Baltimore). 82 (5): 299–308. doi:10.1097/01.md.0000091181.93122.55. PMID 14530779.
- ↑ 4.0 4.1 4.2 4.3 Tian XP, Zhang X (June 2010). "Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment". World J. Gastroenterol. 16 (24): 2971–7. PMC 2890936. PMID 20572299.
- ↑ 5.0 5.1 McKinley PS, Ouellette SC, Winkel GH (June 1995). "The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. A proposed model". Arthritis Rheum. 38 (6): 826–34. PMID 7779127.
- ↑ 6.0 6.1 Alves SC, Fasano S, Isenberg DA (December 2016). "Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review". Lupus. 25 (14): 1509–1519. doi:10.1177/0961203316655210. PMID 27329649.