Systemic lupus erythematosus (SLE) is an inflammatory connective tissue disease with variable manifestations.
It is an autoimmune disease, where the immune system of the body mistakenly attacks healthy tissue.
The key defect is thought to result from a loss of self-tolerance to autoantigens.
The disease tends to have a relapsing and remitting course.
SLE can affect multiple components of the immune system like:
Complement system
T-suppressor cells
Cytokine production.
SLE has a myriad of clinical features:
CNS manifestations
Gastrointestinal manifestations
Musculoskeletal manifestations
renal manifestations of systemic lupus erythematosus
thoracic manifestations of systemic lupus erythematosus.
Clinical presentation:
Though SLE can affect many organs of the body, it need not affect them all. But symptoms may be revealed as the disease progresses. The below symptoms are in the order of more to less prominence.
Fatigue and a low-grade fever
Achy joints (arthralgia)
Arthritis (inflamed joints)
Skin rashes
Pulmonary involvement (symptoms include: chest pain, difficulty breathing, and cough)
Anemia
Kidney involvement (lupus nephritis)
Sensitivity to the sun or light (photosensitivity)
Hair loss
Raynaud’s phenomenon
CNS involvement (seizures, headaches, peripheral neuropathy, cranial neuropathy, cerebrovascular accidents, organic brain syndrome, psychosis)
Mouth, nose, or vaginal ulcers” The most common signs and symptoms of SLE in children and adolescents are: "fever, fatigue, weight loss, arthritis, rash, and renal disease."
Associated comorbidities Include:
Atherosclerosis
Lupus Nephritis- leads to End Stage Renal Disease (ESRD)
Anemia
certain types of cancers (especially non-Hodgkin's lymphoma and lung cancer)
Hypertension
Dyslipidemia
Medical Management
The choice of treatment is dictated by the organ system/systems involved and the severity of involvement and ranges from minimal treatment (NSAIDs, antimalarials) to intensive treatment (cytotoxic drugs, corticosteroids).
Patient education, physical and lifestyle measures and emotional support play a central role in the management of SLE.
Stress reduction techniques, good sleep hygiene, exercises, and use of emotional support shall be encouraged.
Dietary recommendations - avoiding alfalfa sprouts and echinacea and including a diet rich in vitamin-D.
Photoprotection is vital. Patients with SLE shall avoid direct sun exposure by timing their activities appropriately. sunscreens with a sun protection factor (SPF) of 30 or more, loose fitting clothes covering maximum portion of body may be advised.
Physical therapy management
Exercise is beneficial for patients with SLE because it decreases their muscle weakness while simultaneously increases their muscle endurance.
Physical therapists can play an important role for patients with SLE during and between exacerbations.
The patient's need for physical therapy will vary greatly depending on the systems involved.
Education on:
-Skin care to avoid skin breakdowns
-Avoidance of smoking
-Stress reduction
Energy conservation techniques to save energy as well as to protect joints that are susceptible to damage.
Aerobic exercises
-Generalized fatigues limits the activities of patients with SLE. Graded aerobic exercise programs can decrease the fatigue levels of these patients.
- Generalized fatigues limits the activities of patients with SLE. Graded aerobic exercise programs can ling) with a heart rate corresponding to 60% of the patient's peak oxygen consumption.
- Aerobic exercise for 20-30 minutes at 70-80% of their maximum heart rate,3 times a week for 50 minutes sessions has also been found helpful.
- Both aerobic exercise and range of motion/muscle strengthening exercises can increase the energy level, cardiovascular fitness, functional status, and muscle strength in patients with SLE.
Researches indicate:
12 weeks of an aerobic exercise program that is supervised by health professionals could reduce fatigue and increase vitality for patients with SLE.
Supervised aerobic and resistance exercise seems to help improve health, vitality and self perceived physical capacity in SLE patients
We, AT Valley Healing Hands, Brownsville, Texas provide the best Physical Therapy services for SLE. We have highly skilled Physical Therapists who will identify your complaints and customize your exercise plan accordingly. Our patients are completely satisfied with our services. You may learn about what they have to say about us here. You may also get connected to us here. Our patients love us and you too will!!!