Systemic lupus erythematosus history and symptoms: Difference between revisions
Jump to navigation
Jump to search
| Line 46: | Line 46: | ||
== Less Common Symptoms == | == Less Common Symptoms == | ||
=== Organ system based signs and symptoms === | |||
* Symptoms in the below table are listed based on their frequency in each organ system and the disease that is responsible for each sympton:<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 |year=2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref><ref name="pmid2319520">{{cite journal |vauthors=Finol HJ, Montagnani S, Márquez A, Montes de Oca I, Müller B |title=Ultrastructural pathology of skeletal muscle in systemic lupus erythematosus |journal=J. Rheumatol. |volume=17 |issue=2 |pages=210–9 |year=1990 |pmid=2319520 |doi= |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Organ system | !Organ system | ||
| Line 54: | Line 54: | ||
|- | |- | ||
| rowspan="7" |Gastrointestinal involvement | | rowspan="7" |Gastrointestinal involvement | ||
| | |[[Dysphagia]] | ||
| | | | ||
* Retrosternal chest pain | * Retrosternal chest pain | ||
| Line 61: | Line 61: | ||
* Odynophagia | * Odynophagia | ||
|- | |- | ||
|Peptic ulcer disease | |[[Peptic ulcer disease]] | ||
| | | | ||
* Epigastric pain | * Epigastric pain | ||
| Line 68: | Line 68: | ||
* Nausea | * Nausea | ||
|- | |- | ||
|Intestinal pseudo-obstruction | |[[Intestinal pseudoobstruction|Intestinal pseudo-obstruction]] | ||
| | | | ||
* Abdominal pain | * Abdominal pain | ||
| Line 74: | Line 74: | ||
* Distension | * Distension | ||
|- | |- | ||
|Protein-losing enteropathy | |[[Protein losing enteropathy|Protein-losing enteropathy]] | ||
| | | | ||
* Profound edema | * Profound edema | ||
| Line 80: | Line 80: | ||
* Severe diarrhea | * Severe diarrhea | ||
|- | |- | ||
|Acute pancreatitis | |[[Acute pancreatitis]] | ||
| | | | ||
* Severe persistent epigastric pain often radiating to the back | * Severe persistent epigastric pain often radiating to the back | ||
|- | |- | ||
|Mesenteric vasculitis | |[[Vasculitis|Mesenteric vasculitis]] | ||
| | | | ||
* Abdominal pain | * Abdominal pain | ||
| Line 94: | Line 94: | ||
** Due to chronic mesenteric ischemia | ** Due to chronic mesenteric ischemia | ||
|- | |- | ||
| | |[[Peritonitis]] | ||
| | | | ||
* Abdominal bloating or distention | * Abdominal bloating or distention | ||
| Line 103: | Line 103: | ||
|- | |- | ||
| rowspan="7" |Pulmonary involvement | | rowspan="7" |Pulmonary involvement | ||
|Pleural disease | |[[Pleural disease]] | ||
| | | | ||
* Cough | * Cough | ||
| Line 109: | Line 109: | ||
* Fever | * Fever | ||
|- | |- | ||
| | |[[Pneumonitis]] | ||
| | | | ||
* Fever | * Fever | ||
| Line 115: | Line 115: | ||
* Dyspnea | * Dyspnea | ||
|- | |- | ||
|Pulmonary hemorrhage | |[[Pulmonary hemorrhage]] | ||
| | | | ||
* Dyspnea | * Dyspnea | ||
| Line 121: | Line 121: | ||
* Hemoptysis | * Hemoptysis | ||
|- | |- | ||
|Interstitial lung disease | |[[Interstitial lung disease]] | ||
| | | | ||
* May be asymptomatic | * May be asymptomatic | ||
| Line 128: | Line 128: | ||
* Decreased exercise tolerance | * Decreased exercise tolerance | ||
|- | |- | ||
|Thromboembolic | |[[Thromboembolic disease]] | ||
| | | | ||
* Dyspnea | * Dyspnea | ||
* Sharp chest pain that may become worse with deep breathing or coughing | * Sharp chest pain that may become worse with deep breathing or coughing | ||
|- | |- | ||
|Pulmonary hypertension | |[[Pulmonary hypertension]] | ||
| | | | ||
* Dyspnea | * Dyspnea | ||
| Line 144: | Line 144: | ||
* Increased abdominal girth | * Increased abdominal girth | ||
|- | |- | ||
|Shrinking lung | |Shrinking lung syndrome | ||
| | | | ||
* Dyspnea | * Dyspnea | ||
* Pleuritic chest pain (episodic) | * Pleuritic chest pain (episodic) | ||
|- | |- | ||
| rowspan=" | | rowspan="4" |Cardiac involvement | ||
|Valvular disease | |[[Valvular disease]] | ||
| | | | ||
* Tachycardia | * Tachycardia | ||
| Line 157: | Line 157: | ||
* Peripheral edema | * Peripheral edema | ||
|- | |- | ||
| | |[[Pericarditis]] | ||
| | | | ||
* Sharp, stabbing chest pain with a sudden start | * Sharp, stabbing chest pain with a sudden start | ||
* Positional pain that decreases when sitting up and leaning forward | * Positional pain that decreases when sitting up and leaning forward | ||
|- | |- | ||
| | |[[Myocarditis]] | ||
| | | | ||
* Tachycardia | * Tachycardia | ||
* Fever and chills | * Fever and chills | ||
|- | |- | ||
|Coronary heart disease | |[[Coronary heart disease]] | ||
| | | | ||
* Chest pain | * Chest pain | ||
| Line 186: | Line 180: | ||
* Neuropathies | * Neuropathies | ||
|- | |- | ||
|Stroke | |[[Stroke]] | ||
| | | | ||
* Speech disturbance | * Speech disturbance | ||
* Weakness on one-half of the body | * Weakness on one-half of the body | ||
|- | |- | ||
|Seizures | |[[Seizure|Seizures]] | ||
| | | | ||
* Tonic-clonic seizure | * Tonic-clonic seizure | ||
|- | |- | ||
|Psychosis | |[[Psychosis]] | ||
| | | | ||
* Hallucinations | * Hallucinations | ||
| Line 202: | Line 196: | ||
|- | |- | ||
|Genitourinary | |Genitourinary | ||
|Nephrotic syndrome | |[[Nephrotic syndrome]] | ||
| | | | ||
* Hypertension | * Hypertension | ||
| Line 210: | Line 204: | ||
|- | |- | ||
| rowspan="3" |Musculoskeletal | | rowspan="3" |Musculoskeletal | ||
|Arthritis | |[[Arthritis]] | ||
| | | | ||
* Mostly symmetrical | * Mostly symmetrical | ||
| Line 217: | Line 211: | ||
* Morning stiffness that will last less than 1 hour | * Morning stiffness that will last less than 1 hour | ||
|- | |- | ||
|Avascular necrosis | |[[Avascular necrosis]] | ||
| | | | ||
* Asymptomatic | * Asymptomatic | ||
| Line 223: | Line 217: | ||
* Secondary pain amplification | * Secondary pain amplification | ||
|- | |- | ||
| | |[[Osteoporosis]] | ||
| | | | ||
* Loss of height | * Loss of height | ||
| Line 229: | Line 223: | ||
|- | |- | ||
| rowspan="4" |Skin disorder | | rowspan="4" |Skin disorder | ||
|Cutaneous lupus erythematosus | |[[Cutaneous lupus erythematosus]] | ||
| | | | ||
* Malar rash | * Malar rash | ||
| Line 241: | Line 235: | ||
* Nail fold infarcts | * Nail fold infarcts | ||
|- | |- | ||
|Photosensitivity | |[[Photosensitivity]] | ||
|Common theme for skin lesions associated with SLE | |Common theme for skin lesions associated with SLE | ||
|- | |- | ||
Revision as of 15:50, 19 July 2017
|
Systemic lupus erythematosus Microchapters |
|
Differentiating Systemic lupus erythematosus from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Systemic lupus erythematosus history and symptoms On the Web |
|
American Roentgen Ray Society Images of Systemic lupus erythematosus history and symptoms |
|
Systemic lupus erythematosus history and symptoms in the news |
|
Directions to Hospitals Treating Systemic lupus erythematosus |
|
Risk calculators and risk factors for Systemic lupus erythematosus history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Systemic lupus erythematosus (SLE) is one of several diseases known as the great imitator[1] because its symptoms vary so widely it often mimics or is mistaken for other illnesses, and because the symptoms come and go unpredictably. Diagnosis can be elusive, with patients sometimes suffering unexplained symptoms and untreated SLE for years.
A positive history of familial lupus, skin rashes (especially photo-sensitive skin rashes), arthritis, and fatigue may be suggestive of systemic lupus erythematosus. The most common symptoms of SLE include .
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:
- Onset, duration and progression of symptoms
- History of weight changes (gain or loss)
- Anorexia
- Arthritis, arthralgias, or muscle pain
- Morning stiffness
- Skin rashes and their association to flare ups, especially after exposure to sunlight
- Medications and their association to flare ups
- Infections especially mononucleosis
- Sores in the mouth, nose, or other mucous membranes
- Symptoms of other organ failure
- Renal failure: Recent extremity edema and weight gain
- Cardiac involvement: Tachycardia, dyspnea, chest pains
- History of having a pet
- Hair loss
- Job history
- Co-morbid conditions include:
- Other rheumatologic diseases
- Hypertension
- diabetes, immunodeficiency
- 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:[2][3][4]
- Fatigue
- Fever
- Myalgia
- Muscle 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 gastro-intestinal problems
Less Common Symptoms
Organ system based signs and symptoms
- Symptoms in the below table are listed based on their frequency in each organ system and the disease that is responsible for each sympton:[5][6]
| Organ system | Disease | Sympton |
|---|---|---|
| Gastrointestinal involvement | Dysphagia |
|
| Peptic ulcer disease |
| |
| Intestinal pseudo-obstruction |
| |
| Protein-losing enteropathy |
| |
| Acute pancreatitis |
| |
| Mesenteric vasculitis |
| |
| Peritonitis |
| |
| Pulmonary involvement | Pleural disease |
|
| Pneumonitis |
| |
| Pulmonary hemorrhage |
| |
| Interstitial lung disease |
| |
| Thromboembolic disease |
| |
| Pulmonary hypertension |
| |
| Shrinking lung syndrome |
| |
| Cardiac involvement | Valvular disease |
|
| Pericarditis |
| |
| Myocarditis |
| |
| Coronary heart disease |
| |
| Neurological involvement | CNS small vessle vasculitis |
|
| Stroke |
| |
| Seizures |
| |
| Psychosis |
| |
| Genitourinary | Nephrotic syndrome |
|
| Musculoskeletal | Arthritis |
|
| Avascular necrosis |
| |
| Osteoporosis |
| |
| Skin disorder | Cutaneous lupus erythematosus |
|
| Photosensitivity | Common theme for skin lesions associated with SLE | |
| Oral and/or nasal ulcers | Usually painless | |
| Nonscarring alopecia | May occur at some point during the course of their disease |
References
- ↑ Lupus: The Great Imitator
- ↑ Tench CM, McCurdie I, White PD, D'Cruz DP (2000). "The prevalence and associations of fatigue in systemic lupus erythematosus". Rheumatology (Oxford). 39 (11): 1249–54. PMID 11085805.
- ↑ McKinley PS, Ouellette SC, Winkel GH (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.
- ↑ Wang B, Gladman DD, Urowitz MB (1998). "Fatigue in lupus is not correlated with disease activity". J. Rheumatol. 25 (5): 892–5. PMID 9598886.
- ↑ 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 (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.
- ↑ Finol HJ, Montagnani S, Márquez A, Montes de Oca I, Müller B (1990). "Ultrastructural pathology of skeletal muscle in systemic lupus erythematosus". J. Rheumatol. 17 (2): 210–9. PMID 2319520.