SYSTEMIC LUPUS ERYTHEMATOSIS

• Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease characterised by the presence of auto antibodies directed against various cells or their components
• It is characterised by periods of remissions or low disease activity and disease flares and predominantly affects women of childbearing age
• The presentation of the disease is variable and may range from mild localized symptoms to life-threatening systemic disease. Typical findings include fever and fatigue, a malar rash (facial butterfly rash), myalgia, and arthritis

The exact etiology is unknown

• Genetic predisposition: HLA-DR2 and HLA-DR3 are commonly present in individuals with SLE
• Environmental factors: UV light, stimulation of immune cells through infection with bacteria and viruses, medications (e.g. Phentyoin ,hydralazine)
• Hormonal factors: Hyperestrogenic states (e.g. due to oral contraceptive use, postmenopausal hormonal therapy, endometriosis) are associated with an increased risk of SLE

 SLE is typically characterized by phases of remission and relapse

Muco cutaneous:

• Photosensitivity, Malar rash (butterfly rash) with sparing of the nasolabial folds
• Discoid lesions over sun exposed areas
• Alopecia areata or patchy hair loss
• Buccal or lingual ulcers
• Painful ulcers over hard palate 

Musculo skeletal

• Polyarticular joint pain without selling
• Early morning stiffness
• Arthritis – non deforming
• Mostly nonerosive polyarthritis (normal x-ray)
• Myalgia

Others

• Kidneys: nephritis with proteinuria , nephritic syndrome
• Neurologic: Headache, seizures, psychosis, personality changes, aseptic meningitis, polyneuropathy
• Cardiovascular : Pericarditis , Libman-Sacks endocarditis (LSE)
• Pulmonary : Pleural effusion, pleuritis
• Vascular: Raynaud phenomenon, vasculitis, thromboembolism
• Haematologic: Haemolytic anaemia, thrombocytopenia, leukopenia
• Eyes: keratoconjunctivitis sicca

• ACR criteria for SLE
• ↑ESR
• ↑ ANA titer confirms diagnosis
• Anti-dsDNA antibody testing -Positive in 70% of patients and highly specific
• Anti-Sm antibody - Positive in only 30% of patients, but highly specific for SLE

Avoid exposure to UV light (sunlight)

Internal Medicines

• Pachanamruta kashaya
• Manjishtadi kashaya
• Kokilaksha kashaya
• Balaguduchyadi kashaya
• Kaisora guggulu
• Gokshuradi guggulu
• Ksheerabala taila
• Chyavanaprasha

Procedures

• Virechana – Nimbamruta eranda
• Anuvasana – Madhuyashtyadi taila
• Vasti – Yapana vasti