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The best black man in the galaxy (ChadWick Boseman. Clemency synonym. Clemency vs pardon. Lupus erythematosus Specialty Rheumatology Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy tissues. [1] Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. The most common and most severe form is systemic lupus erythematosus. Signs and symptoms [ edit] Symptoms vary from person to person, and may come and go. Almost everyone with lupus has joint pain and swelling. Some develop arthritis. Frequently affected joints are the fingers, hands, wrists, and knees. Other common symptoms include: chest pain during respiration joint pain oral ulcer fatigue weight loss fever with no other cause general discomfort, uneasiness, or ill feeling ( malaise) hair loss sensitivity to sunlight a "butterfly" facial rash, seen in about half people with SLE swollen lymph nodes [2] Photosensitivity [ edit] Photosensitivity is a known symptom of lupus, but its relationship to and influence on other aspects of the disease remain to be defined. [3] Causes of photosensitivity may include: change in autoantibody location cytotoxicity induction of apoptosis with autoantigens in apoptotic blebs upregulation of adhesion molecules and cytokines induction of nitric oxide synthase expression ultraviolet -generated antigenic DNA. tumor necrosis factor alpha Genetics [ edit] It is typically believed that lupus is influenced by multiple genes. Lupus is usually influenced by gene polymorphisms, 30 of which have now been linked with the disorder. Some of these polymorphisms have been linked very tentatively however, as the role that they play or the degree to which they influence the disease is unknown. Other genes that are commonly thought to be associated with lupus are those in the human leukocyte antigen (HLA) family. There have been several cases where a single gene influence appears to be present, but this is rare. When a single gene deficiency does cause lupus, it is usually attributed to the complement protein genes C1, C2, or C4. The influence of sex chromosomes and environmental factors are also noteworthy. Usually, these factors contribute to lupus by influencing the immune system. [4] Several studies also indicate a potential association of lupus with mutations in DNA repair genes [5] Age difference [ edit] Lupus can develop in any age, but most commonly in ages 15 to 44, with varying results. Typically, the manifestation of the disease tends to be more acute in those affected who are of younger age. Women are more likely to get it than men. Patients with juvenile-onset lupus are more vulnerable to mucocutaneous manifestations of the disease (alopecia, skin rash, and ulceration of the mucus membranes) than any other age group. However, patients with late-onset lupus have a much higher mortality rate. Nearly 50% of those with late-onset lupus die of their affliction. Women who are of childbearing age are also particularly at risk. [6] Differences in ethnicity [ edit] Substantial data have been found to indicate that certain ethnic populations could be more at risk for lupus erythematosus, and have a better or worse prognosis. Asian, African, and Native Americans are more likely to get lupus than Caucasians. Caucasians seem to generally have a more mild manifestation of the disease. Their survival rates after five years were typically around 94–96%, while patients of African and some Asian ethnicities had survival rates closer to 79–92%. The only documented ethnicity that had a higher survival rate than Caucasians were Koreans, who had survival rates nearer to 98%. Among Caucasians, the most common causes of death were complications involving the cardiovascular system, the respiratory system and malignancies. [7] [8] Atherosclerotic cardiovascular disease is more prevalent in African Americans with lupus than in Caucasians with lupus. [9] Diagnosis [ edit] For the diagnosis of lupus, four out of 11 signs must be present. [10] Testing may include: Antinuclear antibody (ANA) CBC with differential Chest X-ray Serum creatinine Urinalysis [10] Classification [ edit] Lupus erythematosus may manifest as systemic disease or in a purely cutaneous form also known as incomplete lupus erythematosus. Lupus has four main types: systemic discoid drug-induced neonatal Of these, systemic lupus erythematosus (also known as SLE) is the most common and serious form. A more thorough categorization of lupus includes the following types: [11] [12] acute cutaneous lupus erythematosus subacute cutaneous lupus erythematosus discoid lupus erythematosus (chronic cutaneous childhood discoid lupus erythematosus generalized discoid lupus erythematosus localized discoid lupus erythematosus chilblain lupus erythematosus (Hutchinson) lupus erythematosus-lichen planus overlap syndrome lupus erythematosus panniculitis (lupus erythematosus profundus) tumid lupus erythematosus verrucous lupus erythematosus ( hypertrophic lupus erythematosus) cutaneous lupus mucinosis complement deficiency syndromes drug-induced lupus erythematosus neonatal lupus erythematosus systemic lupus erythematosus Treatment [ edit] Treatment consists primarily of immunosuppressive drugs (e. g., hydroxychloroquine and corticosteroids). A second-line drug is methotrexate in its low-dose schedule. [13] In 2011, the U. S. Food and Drug Administration (FDA) approved the first new drug for lupus in more than 50 years to be used in the US, belimumab. [14] In addition to medical therapy, cognitive behavioural therapy has also been demonstrated to be effective in reducing stress, anxiety, and depression due to the psychological and social impacts that lupus may have. [15] People with SLE treated with standard care experience a higher risk of opportunistic infections and death than the general population. This risk is higher in men and in African Americans. [16] Epidemiology [ edit] Worldwide [ edit] an estimated 5 million people worldwide have some form of lupus disease. [17] 70% of lupus cases diagnosed are systemic lupus erythematosus. [17] 20% of people with lupus will have a parent or sibling who already has lupus or may develop lupus. [17] about 5% of the children born to individuals with lupus will develop the illness. [17] United Kingdom [ edit] Females in the UK are seven times more likely to have the disease than males. [18] The estimated number of females in the UK with SLE is 21, 700, and the number of males is 3000—a total of 24, 700, or 0. 041% of the population. [18] SLE is more common amongst certain ethnic groups than others, especially those of African origin. [18] United States [ edit] Lupus occurs from infancy to old age, with peak occurrence between ages 15 and 40. [14] Lupus affects females in the US 6 to 10 times more often than males. [14] Prevalence data are limited. Estimates vary and range from 1. 8 to 7. 6 cases per 100, 000 persons per year in parts of the continental United States. [14] In popular culture [ edit] In the early seasons of the TV show House, members of the eponymous character's medical team often suggested lupus as a diagnosis for their patients, only to be rebuked. The rarity of legitimate lupus diagnoses in the show eventually became a running gag. See also [ edit] List of cutaneous conditions List of target antigens in pemphigoid List of immunofluorescence findings for autoimmune bullous conditions List of human leukocyte antigen alleles associated with cutaneous conditions References [ edit] ^ Fitzpatrick, Thomas B. ; Klauss Wolff; Wolff, Klaus Dieter; Johnson, Richard R. ; Suurmond, Dick; Richard Suurmond (2005). Fitzpatrick's color atlas and synopsis of clinical dermatology. New York: McGraw-Hill Medical Pub. Division. ISBN 978-0-07-144019-6. [ page needed] ^ "Systemic Lupus Erythematosus (Lupus, SLE)". PubMed Health. National Library of Medicine. ^ Scheinfeld, Noah; Deleo, Vincent A (2004). "Photosensitivity in lupus erythematosus". Photodermatology, Photoimmunology and Photomedicine. 20 (5): 272–9. doi: 10. 1111/j. 1600-0781. 2004. 00094. x. PMID 15379880. ^ Kiriakidou, Marianthi; Cotton, D; Taichman, D; Williams, S (2013). "Systemic Lupus Erythematosus". Annals of Internal Medicine. 159 (7): ITC4–1. CiteSeerX 10. 1. 1008. 5428. 7326/0003-4819-159-7-201310010-01004. PMID 24081299. ^ Meas R, Burak MJ, Sweasy JB (August 2017). "DNA repair and systemic lupus erythematosus". DNA Repair (Amst. ). 56: 174–182. 1016/. PMC 5543809. PMID 28623091. ^ Feng, X. ; Zou, Y. ; Pan, W. ; Wang, X. ; Wu, M. ; Zhang, M. ; Tao, J. ; Zhang, Y. ; Tan, K. ; Li, J. ; Chen, Z. ; Ding, X. ; Qian, X. ; Da, Z. ; Wang, M. ; Sun, L. (2013). "Associations of clinical features and prognosis with age at disease onset in patients with systemic lupus erythematosus". Lupus. 23 (3): 327–34. 1177/0961203313513508. PMID 24297642. ^ Voss, A. ; Laustrup, H. ; Hjelmborg, J. ; Junker, P. "Survival in systemic lupus erythematosus, 1995–2010. A prospective study in a Danish community". 22 (11): 1185–91. 1177/0961203313498796. PMID 23873432. ^ "Lupus Facts, Symptoms, Rash, Effects, Complications, and More. " WebMD, n. d. Web. 6 October 2014.. ^ Alenghat, Francis J (2016). "The Prevalence of Atherosclerosis in Those with Inflammatory Connective Tissue Disease by Race, Age, and Traditional Risk Factors". Scientific Reports. 6: 20303. Bibcode: 2016NatSR... 620303A. 1038/srep20303. PMC 4740809. PMID 26842423. ^ a b "Systemic lupus erythematosus: MedlinePlus Medical Encyclopedia". Medline Plus. US National Library of Medicine. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Disease of the Skin: Clinical Dermatology. (10th ed. Saunders. Chapter 8. ISBN 0-7216-2921-0. [ page needed] ^ Rapini, Ronald P. ; Bolognia, Jean L. ; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1. [ page needed] ^ Böhm I (2004). "Increased peripheral blood B-cells expressing the CD5 molecules in association tp autoantibodies in patients with lupus erythematosus and evidence to selectively down-modulate them". Biomed Pharmacother. 58 (5): 338–43. PMID 15194170. ^ a b c d "Lupus - Arthritis". CDC. 2018-10-18. ^ Greco, Carol M; Rudy, Thomas E; Manzi, Susan (2004). "Effects of a stress-reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: A randomized controlled trial". Arthritis Care & Research. 51 (4): 625–34. 1002/art. 20533. PMID 15334437. ^ Dospinescu, Paula; Shamliyan, Tatyana A. (2017-07-01). "Additional Improvements in Clinical Response From Adjuvant Biologic Response Modifiers in Adults With Moderate to Severe Systemic Lupus Erythematosus Despite Immunosuppressive Agents: A Systematic Review and Meta-analysis". Clinical Therapeutics. 39 (7): 1479–1506. e45. 1016/inthera. 2017. 05. 359. ISSN 0149-2918. PMID 28673504. ^ a b c d "Media Relations". Archived from the original on June 29, 2013. Retrieved August 24, 2013. ^ a b c "Lupus". Arthritis Research UK. Archived from the original on February 1, 2014. Retrieved August 24, 2013. External links [ edit] Classification D ICD - 10: L93 ( ILDS L93. 010) ICD - 9-CM: 695. 4.


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Clemency movie 2019. Overview Lupus is a systemic autoimmune disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms. Symptoms No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes — called flares — when signs and symptoms get worse for a while, then improve or even disappear completely for a time. The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include: Fatigue Fever Joint pain, stiffness and swelling Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body Skin lesions that appear or worsen with sun exposure (photosensitivity) Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud's phenomenon) Shortness of breath Chest pain Dry eyes Headaches, confusion and memory loss When to see a doctor See your doctor if you develop an unexplained rash, ongoing fever, persistent aching or fatigue. Causes Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's likely that lupus results from a combination of your genetics and your environment. It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown. Some potential triggers include: Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people. Infections. Having an infection can initiate lupus or cause a relapse in some people. Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped. Risk factors Factors that may increase your risk of lupus include: Your sex. Lupus is more common in women. Age. Although lupus affects people of all ages, it's most often diagnosed between the ages of 15 and 45. Race. Lupus is more common in African-Americans, Hispanics and Asian-Americans. Complications Inflammation caused by lupus can affect many areas of your body, including your: Kidneys. Lupus can cause serious kidney damage, and kidney failure is one of the leading causes of death among people with lupus. Brain and central nervous system. If your brain is affected by lupus, you may experience headaches, dizziness, behavior changes, vision problems, and even strokes or seizures. Many people with lupus experience memory problems and may have difficulty expressing their thoughts. Blood and blood vessels. Lupus may lead to blood problems, including anemia and increased risk of bleeding or blood clotting. It can also cause inflammation of the blood vessels (vasculitis). Lungs. Having lupus increases your chances of developing an inflammation of the chest cavity lining (pleurisy), which can make breathing painful. Bleeding into lungs and pneumonia also are possible. Heart. Lupus can cause inflammation of your heart muscle, your arteries or heart membrane (pericarditis). The risk of cardiovascular disease and heart attacks increases greatly as well. Other types of complications Having lupus also increases your risk of: Infection. People with lupus are more vulnerable to infection because both the disease and its treatments can weaken the immune system. Cancer. Having lupus appears to increase your risk of cancer; however the risk is small. Bone tissue death (avascular necrosis). This occurs when the blood supply to a bone diminishes, often leading to tiny breaks in the bone and eventually to the bone's collapse. Pregnancy complications. Women with lupus have an increased risk of miscarriage. Lupus increases the risk of high blood pressure during pregnancy (preeclampsia) and preterm birth. To reduce the risk of these complications, doctors often recommend delaying pregnancy until your disease has been under control for at least six months. The Mayo Clinic experience and patient stories Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients. Oct. 25, 2017 Ferri FF. Systemic lupus erythematosus. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa. : Elsevier; 2018.. Accessed Sept. 2, 2017. Handout on health: Systemic lupus erythematosus. National Institute of Arthritis and Musculoskeletal and Skin Diseases.. 7, 2017. Goldman L, et al., eds. In: Goldman-Cecil Medicine. 25th ed. : Saunders Elsevier; 2016.. 2, 2017. Gladman DD. Overview of the clinical manifestations of systemic lupus erythematosus in adults.. 2, 2017. Wallace DJ. Overview of the management and prognosis of systemic lupus erythematosus in adults.. 2, 2017. Chowdhary VR. Broad concepts in management of systemic lupus erythematosus. Mayo Clinic Proceedings. 2017;92:744. Greco CM, et al. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus. Current Rheumatology Report. 2013;15:378.

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