SLE - women of childbearing age most at risk
FOR those diagnosed with slE, or systemic lupus erythematosus, it marks the beginning of a long and challenging journey in navigating their health.
This autoimmune disease is characterised by the production of autoantibodies which mistakenly attack normal human tissue, causing an abnormal inflammatory response and damage.
While there is a genetic component to the disease, other factors such as gender (hormonal) and environmental triggers (ultraviolet light, infection, and toxins) do play a role, says Pantai Hospital Cheras internal medicine and rheumatology specialist Dr Ong Yew Chong.
“While slE can affect people of any age group, women of childbearing age are at the highest risk.”
Early signs and symptoms like lethargy, weight loss and fever can be subtle and non-specific, adds Dr Ong.
Rashes, arthritis, and oral ulcers are common too. Typically, the rash appears on the face (butterfly or malar rash) and sun exposed areas (photosensitive rash).
“Patients might experience early morning joint stiffness which might gradually progress to pain and swelling. Oral ulcers usually come and go too.”
But the involvement of other parts of the body such as the kidney, central nervous system, heart, lungs, and blood vessels can be severe and lifethreatening.
Patients with slE should practise a healthy lifestyle, which includes wellbalanced nutritious meals and taking supplements such as vitamin D and fish oil, adds Dr Ong.
However, certain supplements which might stimulate the immune system should be avoided, like alfalfa, echinacea and spirulina.
“Regular physical activity, adequate rest and smoking cessation are important. In addition, compliance with clinic follow-ups and treatment cannot be overemphasised.”
Most women with slE can have children, but pre-pregnancy planning is essential and slE should ideally be in remission for at least six months prior to conception.
Dr Ong says a thorough discussion should be made with the managing rheumatologist and some medications which can be harmful to the baby must be stopped or switched several months earlier.
Treatment of patients with slE is very individualised and the intensity of treatment is guided by the severity of the organ system involved.
The overall aim is to achieve control of disease activity (inflammation), reduce flare ups and minimise organ damage.