PSYCHOSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS: A REVIEW
Abstract
Key words – Lupus, Psychosis, SLE, NP SLE, steroids, reversible
INTRODUCTION
Systemic lupus erythematosus (SLE) is a chronic inflammatory and autoimmune disease of multifactorial etiology that can affect many organs and systems (Sato, 2002).
The studies show a higher prevalence in women (approximately 90% of cases), especially during childbearing years, i.e. between 15 and 45 years of age; more common in women of black ethnicity than in Caucasian ones at a ratio of 3:1 , but it can occur in all ethnic groups and geographic regions (Bonfá, 2011).
The central nervous system is often affected by this disease, causing neurological and/or psychiatric symptoms. Psychiatric syndromes in patients with SLE include a variety of psychiatric findings causing chronic disabilities (Jarpa, 2011).
SLE may cause a wide range of neurological and psychiatric symptoms including those due to central, peripheral and autonomic nervous system and different psychiatric syndromes. In 1999, the ACR developed a standardized nomenclature system for the NP syndromes of SLE for the purposes of classification and reporting (The American College of Rheumatology, 1997; 1999). It distinguishes three subsets of syndromes: psychiatric disorders, cognitive deficits and acute confusional states; neurological syndromes of the CNS and neurological syndromes of the peripheral nervous system (The American College of Rheumatology, 1997; 1999). Anxiety,
Reality: "Between the ages of 15 and 45, close to 90% of diagnosed patients are women
Let alone the cause of this horrible disease. One of the most commonly suspected reasons for systemic lupus erythemotosus (SLE) is a very low iron count. Low iron has a veriaty of effects on the body including the feeling of being cold, low blood count (anemia), and impaired immune defiecency, ect.. Thus the low iron syptom seems to add up with lupus making doctor think that low iron can have a leading from in the disease.
Multiple Sclerosis, also known as “MS” is a chronic condition where the immune system begins to destroy the myelin sheath that covers the nerves in the body and affects the brain and spinal cord (Mayo Clinic Staff, 2014). The myelin sheath is used for protection of the nerves in which these nerves aid to transport nerve impulses all over the body (Ruto, 2013). Once the body’s immune system attacks the myelin sheath, it begins to disintegrate which affects the conductivity of the nerve impulse and impedes the message transmission from the brain to the rest of the body (Ruto, 2013). In turn, the impulses are changed which results in problems in the muscle such as weakness, imbalance and spasms and the body could end up
Lupus is an autoimmune disease in an overly active state that attacks healthy, functioning tissue. This disease is not well known mainly for two reasons, firstly, it is not given enough hype in social media. Secondly, many people show symptoms during the early stages of lupus however, the victims do not recognize its severity until the disease has afflicted permanent damage. This is usually because some symptoms are similar to other less threatening ailments. Lupus affects many systems of the body which include the gastrointestinal system, the cardiopulmonary system, the musculoskeletal system, the renal system, and the integumentary system. This disease is formerly caused by genetic inheritance however, there are a great number of factors that trigger the immediate onset of lupus, as it is not necessarily prevalent on a person who has the genes from birth. Although there is no known cure for lupus, efficacious forms of treatment are possible.
Systematic lupus Erythematous (SLE or Lupus) can affect any organ in the body and may cause a wide range of symptoms. SLE symptoms can vary from person to person and can change over time. Lupus affects 1.5 million Americans and millions more worldwide lupus.org (N.d) 2016. The cause of lupus is unknown some research have found genetics and hormones are to play a role. The majorities of people with lupus 90% are female, and they seemed to develop signs and symptoms of the illness between the ages of 15 and 44 (2016). Children are affected with lupus. Approximately 5,000 to 10,000 of the million Americans with lupus are diagnosed while under the age of 18 (2016).African American women are three times more likely than Caucasian women to get lupus
Lupus is still somewhat of a mystery to physicians and scientists today. Historically, the disease has stumped medical professionals. The first known discovery and identification of lupus, specifically systemic lupus erythematosus, was made by Hippocrates, a Greek physician, around the time of 400 BC. The disease became more well known after many years, and by the late 1700’s, two British dermatologists Robert Willan and Thomas Bateman had started to “use the term “lupus” to describe a destructive skin disease preferentially affecting the face and the nose” (Konya, 2016). Then the modern era of lupus began in 1923, when one doctor discovered four cases with similar symptoms. The physical details of the disease became more specific and by 1967, doctors were able to find a way to test for the antibodies that were associated with the disease. In the past, people thought the symptoms of lupus resembled a wolf bite, and some theorized the skin swelling and color changing was caused by werewolves. This theory has since been proven wrong, clearly. Because of this theory though, some people with the disease may have been wrongfully mistreated in the past. Today, lupus is a disease that allows people to receive help from the government under disability status. People with Lupus are not mistreated and in most places, are even protected by disability discrimination acts.
Lupus also known as Lupus Erythematosus is a long standing autoimmune disease. In an autoimmune disease the body immune system attacks itself. The inflammation that has develop by these attacks causes damage to the bodies tissue and organ. The frequently affected bodies tissue and organ are the brain, joints, skin, kidney, heart, lung, and blood vessel. Nevertheless, this disease is difficult to assess due to the widespread of affected age groups, ethnics, gender geography area and socioeconomic differences researcher and scientists cannot determine its origin. There is different form of lupus and the most common is SLE or systemic Lupus Erythematosus which affect many parts of the body, Discoid lupus erythematosus that causes skin rashes that doesn’t go away, Subacute cutaneous lupus erythematosus causes skin sores on parts of the body that are exposed to sun, Drug
Lupus also known as the systemic lupus erythematosus (SLE), is an autoimmune disease which signifies that the body’s immune system attacks the healthy tissues and organs by mistake. Lupus can affect any parts of the body including skins, joints, kidneys, blood vessels and as well as cause large inflammations in the organs that are affected by the disease. When an individual is diagnosed with Lupus, their immune system becomes hyperactive and begin to attack normal healthy tissues. The immune system makes antibodies which help fights against bacteria and viruses. Lupus cause the immune system to not able to distinguish between antigens and healthy tissues. As a result of not being able to distinguish between antigens and healthy tissues, the immune system starts to direct antibodies against healthy tissues. Lupus can be mild
Multiple sclerosis is a rare disease in which the immune system eats away at the protective covering of nerves. Multiple sclerosis causes many different symptoms, including vision loss, pain, fatigue, and impaired coordination. The symptoms, severity, and duration can vary from person to person. Some people may be symptom free most of their lives, while others can have severe chronic symptoms that never go away. This disease can occur for years or be lifelong and can't be cured, but treatment may
Systemic Lupus Erythematosus (SLE) is an autoimmune disease. Consequently, all organs and tissues are at risk of being damaged by inflammation. The most affected organs are the kidneys, lungs, heart, and skin (Harvery and Zieve; Simanta, and Mohan). The most affected tissues are the joints, and nervous tissues. The renal system controls blood pressure and blood volume. It also removes waste products and toxins from the blood. SLE causes inflammation of the nephrons, preventing the kidney to properly maintain blood volume and properly filter waste products and toxins (Harvery and Zieve). Kidney inflammation alone will trigger complications throughout the entire body. The lungs are responsible for the gas exchange with the
The disease is milder and survival is higher among persons with isolated cutaneous and musculoskeletal disease than in those with renal and CNS involvement. the most frequent causes of death in SLE patients are Infections and diseases of the cardiovascular, renal, pulmonary, and central nervous systems (Bartels et al., 2012).
SLE is manifested through many different symptoms because it can affect different organs. Initially present usually general symptoms such as weight loss , exhaustion , fever , swollen lymph nodes and skin rashes that can appear gradually or suddenly. After some time also they tend to be pain in multiple joints.
SLEDAI has been shown to be reliable and reproducible when used by various investigators, and sensitive to change in patient condition but it doesn 't measure worsening of an already existing sign or symptom, nor does it detect partial improvement if some degree of residual symptom remains. Both of these limits might contribute in narrowing the gap between the observed effects of placebo treatment and that of a potentially useful medication. The SLEDAI also doesn 't account for subjective symptoms like fatigue, dysphoria, arthralgia or myalgia, which might genuinely reflect lupus activity, and may be of high importance to patients (Fortin et al. 2000; E. Chang et al. 2002).
SLE is an autoimmune disease characterized by the formation of immune complexes (ICs), which contain a complex mixture of autoantigens nucleic acids, nucleic acids-associated proteins and corresponding autoantibodies (Sun et al., 2013) .
Systemic Lupus Erythematosus is a chronic autoimmune disease which causes inflammation of your joints, tissues, and organs. The inflammation presents itself as heat, pain, swelling and redness. SLE is a variable disease that doesn’t take any one particular course; therefore its unpredictability makes it even more devastating. No two people will experience the same disease symptoms or severity level. As S.L.E progresses there will be periods of very subtle to no symptoms at all called remission or an exacerbation of symptoms called flares.