Systemic lupus erythematosus (SLE)

A)Systemic lupus erythematosus (SLE)


*Systemic is use
*Lupus is Latin for wolf. It refers to the rash that extends across the bridge of the nose and upper cheekbones and was thought to resemble a wolf bite
*Erythematosus is from the Greek word for red and refers to the color of the rash

*chronic autoimmune connective tissue damage
*autoimmunity=production of antibodies against tissue of one's own body
*results in tissue damage and inflammation


normal person:

-white blood cells (WBC) mobilized to rid infections (eg viruses)
-WBC gathers & produces factors
-surrounding swells & healthy tissues injured
-immune system repairs wounds/clots
-healing process is stable, controlled and limits itself

SLE patient:

-overactive immune cells
-antigens induces formation of antibodies because immune system recognises it as a threat
-immune cells attacks antigens
-the interaction of immune cells and antigens causes antibodies to recognise a higher, stronger more persistent range, beyond the normal healthy
-the skin, joints, kidneys, brain, heart, lungs, and blood are affected
-also causeskidney disease, stroke, and premature cardiovascular disease in women of childbearing age
-might be passed down through inheritance



*Dermatological manifestations: butterfly rash, lesions on the skin, mouth, nasal, and vaginal ulcers

*Musculoskeletal manifestations: lupus arthritis, deformaties or joint/knee discomfort

*Hematological manifestations: anemia, low platelet and white blood cell count

*Pulmonary manifestations: shrinking lung syndrome, pulmonary hemorrhage

*Renal involvement: acute/chronic renal impairment

*Neuropsychiatric manifestations: seizures or psychosis

*Systemic manifestations: fatigue, poor sleep, depression, poor physical fitness

Butterfly Rash

__________________________________________________________________


B)Causation of autoimmune type I diabetes mellitus (caused by own body)

*pancreas have beta-cells
*beta-cells are responsible for production of insulin
*insulin brings blood glucose levels down especially during hyperglycaemic conditions (blood pressure above 90mg/100ml of blood)
*beta-cells detect the changes in blood glucose


normal condition: beta-cells maintains homeostasis by secreting the hormone insulin into the bloodstream

patient with type I diabetes: autoimmunity occurs causing immune system to attack and destroy beta-cells

*autoimmunity occurs when there is an overproduction of antibodies or white blood cells over-recognising

*patients with type I diabetes, their beta-cells are affected and are unable to produce insulin, hence, are unable to lower blood glucose levels
*this is a permanent affair
*this affects glycolytic pathways by:

1.increasing glycogenesis (more glucose converts to glycogen due to excess)
2.increase conversion of glucose->fat (liver)
3.increase amino acid degradation

type 1 diabetes is due to absence of insulin (usually of inheritance-insulin injections into blood)

type 2 diabetes is due to insulin resistance (diet & medications to reduce prevalence/onset)



REFERENCES
http://www.medicinenet.com/systemic_lupus/article.htm
http://www.lupusny.org/lupus.php
http://health.howstuffworks.com/systemic-lupus-erythematosus-in-depth.htm/printable
http://en.wikipedia.org/wiki/Systemic_lupus_erythematosus#Abnormalities_in_apoptosis
http://en.wikipedia.org/wiki/Diabetes_mellitus_type_1#Prevention
http://en.wikipedia.org/wiki/Diabetes_type_2
http://en.wikipedia.org/wiki/Autoimmunity



By: Michelle

Causation of autoimmune type I diabetes mellitus

(b) Type 1 diabetes, or Insulin Dependent Diabetes Mellitus (IDDM), is a disease characterized by “auto-destruction” of the pancreatic beta cells that produce insulin. Overtime, the body silently destroys these cells creating an insulin deficiency.


Diagram showing insulin producing cells destroyed

IDDM appears to stem from an inherited defect in the immune system, triggered by some environmental stimuli.

The exact cause of the disease is still unknown but a study found that genetic predisposition, autoimmunity, and viral infection are the main etiological factors implicated in the pathogenesis of type 1 diabetes mellitus.

Many of the patients with type 1 DM have associated autoimmune diseases like thyroid disorders, autoimmune adrenal disorders, celiac disease and connective tissue disorders, e.g. systemic lupus erythematosus (SLE).

Source: http://ezinearticles.com/?Type-1-Diabetes-Mellitus-and-Possible-Causes-of-It&id=140245

Muthukrishnan J, Kiranmayi L, Verma A, Modi KD. Type 1 diabetes mellitus: Correlation between etiological factors and associated conditions. Int J Diab Dev Ctries [serial online] 2007 [cited 2009 Feb 8];27:46-9. Available from: http://www.ijddc.com/text.asp?2007/27/2/46/37034

By: Eveleen

Lupus




http://www.youtube.com/watch?v=mlRzu9mbz78&feature=related


(belinda)

http://www.youtube.com/watch?v=_OOWhuC_9Lw


(belinda)

Systemic lupus erythematosus

(a) Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, characterized by a multitude of autoantibody production, complement activation and immune-complex deposition, which causes tissue and organ damage. In other words, SLE (or lupus) is an autoimmune disease of the body's connective tissues.

SLE sufferers can experience rashes which are red, itchy and painful and can show up on any part of the body. The most common one is the butterfly rash as seen in Michelle's post. They are sensitive to sunlight and a short period of exposure might cause them to develop a painful rash.

Joint pain or inflammation would be evident in SLE patients. The more common spots are hands, wrists and knees. The pain can be acute or chronic. It may also cause muscle swelling.

SLE can cause headaches, seizures, abnormal blood vessels in the head, and many other problems with the nervous system. SLE can also cause organic brain syndrome. This disorder involves serious problems with memory and concentration, emotional problems, and severe agitation and hallucinations.

SLE also causes inflammation to the internal organs' membranes.

The digestive system of SLE sufferers may experience abdominal pain, loss of appetite, nausea, and sometimes vomiting.

Diagram showing the summary of the factors known to contribute to abnormal lipid profiles in SLE

SLE can cause many lung problems like inflammation of the lungs, a hemorrhage (burst blood vessel) occuring in the lungs, blood clot forming in the artery going to the lungs, blood vessels in the lungs begin to contract and a shrinking lung which decreases lung capacity.

SLE causes very low levels of red and white cells in your blood which can lead to anemia.

In the cases of pregnant women who are suffering from SLE, the chances of miscarriage, premature birth, and death of the baby in the uterus are high.

Diagram illustrating osteonecrosis in the late stages of SLE

In its late stages, SLE can also cause areas of bone tissue to die, called osteonecrosis. Osteonecrosis can cause serious disability. It can be caused at least in part by using high doses of corticosteroids over a prolonged period of long time.

Source: http://www.eorthopod.com/public/patient_education/6590/systemic_lupus_erythematosus.html

By: Eveleen

Attention to bones important in women with lupus


NEW YORK (Reuters Health) - Among premenopausal women taking steroids for lupus, various treatments preserve bone mineral density and "should be considered" for preventing the bone-thinning disease osteoporosis, advise researchers in a report published this month.
Lupus, technically known as systemic lupus erythematosus or SLE, is a chronic "autoimmune" disease in which the immune system can confuse healthy and foreign tissues and sometimes attacks both.
"Whether due to the corticosteroid treatment, or to the disease itself, osteoporosis is being increasingly recognized in patients with SLE," Dr. Swan S. Yeap, of the University of Malaya, Kuala Lumpur, and colleagues explain in the Journal of Rheumatology.
Yeap's team assessed changes over 2 years in bone mineral density (BMD) in 98 premenopausal women with SLE on long-term steroid therapy while taking calcium only, calcium plus calcitriol (the active form of vitamin D) or calcium plus the bone-strengthening drug alendronate (Fosamax).
Women taking calcium plus alendronate saw significant increases in BMD at both the lumbar spine (2.69 percent) and hip (1.41 percent) compared to baseline, the researchers report.
In contrast, there were no significant changes found in the calcium-only and the calcium plus calcitriol groups, except for a 0.93 percent reduction in hip BMD in the calcium-only group. The medications were well tolerated.
In premenopausal women taking steroids for SLE, the researchers conclude, bone mineral density can be preserved or increased with prophylactic therapy.

SOURCE: Journal of Rheumatology, December 2008.

By Revathi

What Is Lupus?
Systemic lupus erythematosus (S.L.E.), commonly called lupus, is a chronic autoimmune disorder that can affect virtually any organ of the body. In lupus, the body's immune system, which normally functions to protect against foreign invaders, becomes hyperactive, forming antibodies that attack normal tissues and organs, including the skin, joints, kidneys, brain, heart, lungs, and blood. Lupus is characterized by periods of illness, called flares, and periods of wellness, or remission.

Because its symptoms come and go and mimic those of other diseases, lupus is difficult to diagnose. There is no single laboratory test that can definitively prove that a person has this complex illness.

http://www.lupusny.org/news.php Retrieved 5th Feb 2009


By Revathi

Type 1 Diabetes Mellitus

The development of Type 1 diabetes usually occurs when a persons immune system destroys the insulin-producing cells aka beta cells in the pancreas. This is known as an autoimmune response.

This process can take place over long period of time, in months or years, and no signs or symptoms of diabetes will be seen during this period of time. Unfortunately, by the time a person is aware that something is wrong and goes to the doctor with symptoms type 1 diabetes, by then about 80-90% of the beta cells have been destroyed.

When more than 90% of the beta cells are destroyed, the secretion of insulin will be greatly reduced, this is then hyperglycemia and its associated symptoms (frequent urination, excessive thirst) start to take place.

Type 1 diabetes mellitus is a ceaseless medical condition that occurs when the pancreas produces very little or no insulin. Thus, leading to the elevation of blood glucose levels as the body is unable to absorb and use glucose and other nutrients from food, store fat and build up protein.


belinda

Systemic Lupus Erythematosus (SLE)

Lupus means "wolf." Eryrhematosus means "redness."
This name was coined for this disease by the doctor (in 1985), as the facial rash that usually appears with lupus looked like the bite of the wolf.

Addition:
SLE often begins with a skin rash over the nose and cheeks that is shaped like a "butterfly"and is usually worsened by exposure to the sun. Light sensitivity is a common feature of lupus, affecting about 60% of sufferers. Some find that no matter what measures and prevention they take to tolerate with small amounts of exposure to sunlight and artificial lighting that emits UV is difficult and unbearable. For these people, light avoidance becomes a way of life which males their situation very isolated affecting their normal lives.

Systemic Lupus Erythematosus (SLE) and its implications in health

Systemic lupus erythematosus (SLE) is a common form of lupus. Lupus is an auto-immune disorder whereby the body destroys healthy cells and tissues present in the body. When this continues, it eventually leads to swelling and damage of body tissues in the joints, kidneys, lungs, blood vessels and or brain. Lupus is also regarded as a rheumatic disorder due to the pains, aches and stiffness cause by it in the, muscles, joints and bones. (University of Maryland Medical Centre, 2006)
Lupus usually affects those between the ages of 15 - 45 years, and 90% of SLE cases occur in women of childbearing age.
People with lupus usually show signs and symptoms such as extreme fatigue, arthiritis, muscle cramps, pain and stiffness, skin rashes that include the ‘butterfly’ rash on the nose and near the cheek areas, nausea, seizures and photosensitivity. (University of Maryland Medical Centre, 2006)
Researchers have also observed that those diagnosed with SLE appear to have more food allergies than healthy people as well as those with other types of auto-immune disorders. Another study that was conducted suggests that beef and dairy foods increase allergic reactions in people with SLE due to the milk protein casein which has immune-stimulating properties. This explains why those with SLE have a higher intolerance to milk products. (Health monthly, 2006)
It is also reported that there is a higher possibility of getting SLE in smokers and that people with SLE have lower antioxidants level as compared to healthy individuals. (Health monthly, 2006)
Reference: University of Maryland Medical Centre, (2008). Systemic lupus erythematosus. Retrieved on 1 February 2009 from the website, http://www.umm.edu/altmed/articles/systemic-lupus-000161.htm

Reference: Health Monthly: Your Guide to Healthy Living, (2006). Systemic Lupus Erythematosus. Retrieved on 1 February 2009 from the website, http://www.healthmonthly.co.uk/health/health-concerns/lupus.html

By: Sharmila

Cause of the autoimmune disorder in Diabetes Type 1

Prior to the diagnosis period, it is speculated that the regulatory T cells are unable to control cytotoxic T cells directed against self proteins.

CD4 and CD8 T cells coordinate to attack and destroy insulin-producing cells.

At the same time, B cells from the bone marrow are making antibodies against beta cell proteins. Thus, both T and B cells are engaged in the destruction process.

Though there may be some beta cell reformation that replaces destroyed cells, over the years there is a greater net destruction than replacement.

When the 80% of the beta cells are reduced the body is unable to secrete insulin.

Thus, blood sugar levels increase causing diabetes.

Cause of the autoimmune disorder in Diabetes Type 1

Prior to the diagnosis period, it is speculated that the regulatory T cells are unable to control cytotoxic T cells directed against self proteins.

CD4 and CD8 T cells coordinate to attack and destroy insulin-producing cells.

At the same time, B cells from the bone marrow are making antibodies against beta cell proteins. Thus, both T and B cells are engaged in the destruction process.

Though there may be some beta cell reformation that replaces destroyed cells, over the years there is a greater net destruction than replacement.

When the 80% of the beta cells are reduced the body is unable to secrete insulin.

Thus, blood sugar levels increase causing diabetes.

-KANTHEA

Type 1 Diabetes a Autoimmune disorder!

In the case of Type 1 Diabetes, the islet cells of the pancreas that produce insulin are seen as the "enemy" (antigent) by mistake.

The body then creates antibodies to fight this ''enemy'' and destroys the islet cells ability to produce insulin.

Insulin a hormone needed to bring glucose into the cells for energy metabolism.

The lack of sufficient insulin thereby results in diabetes. (Type 1 diabetes)

-KANTHEA

What is autoimmune diseases ?

Autoimmune diseases are disorders in which the body's immune system reacts against some of its own tissue and produces antibodies to attack itself, thus destroying itself. (self destruction)

-KANTHEA

Incidence of Diabetes

- KANTHEA