Possible symptomatology of systemic lupus erythematosus

Branka Sošić, Marijana Tomić Smiljanić

Keywords: Lupus erythematosus systemicus, symptoms, therapy

Introduction:

- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that has a multisystem character. It affects blood vessels and connective tissue of various organs. It manifests on the skin, joints, lungs, heart, while the most severe forms affect kidneys and central nervous system.

Case:

In 2013, a 29-year-old patient complained of pain in the small joints of her hands, feet, shoulders and occasional swelling. She had photosensitivity and skin changes in places exposed to the sun, a short-term impaired consciousness, no cramps or foaming at the mouth. Clinical findings included mild facial erythema, suspected hard palate enanthem, pronounced PIP without clear arthritis, palpation sensitivity of most joints. In the immunological profile found positive ANA in a titer of 1: 320 homogeneous type, anti-RO antibodies significantly elevated 109.6, and anti-LAneg, anti-DNA over 200, anti-SM pos, C3 0.89. Prednisone 20 mg and hydroxychloroquine 200 mg were introduced as part of the therapy. After half a year, prednisone was replaced with methylprednisolone 2x16mg. In 2015, she got panic attacks, a feeling of suffocation, difficulty swallowing, palpitations, and tingling in the hands, referred to a psychiatrist, prescribed escitalopram 10 mg/day. Due to tingling in the hands and feet - polyneuropathy, pregabalin75 mg/day prescribed by a neurologist. MRI of the brain, finding normal. On her own initiative, at the beginning of 2018, she stopped the therapy and the disease worsened. Livid erythema occurs in the area of the root of the nose and zygomatically, hospitalized at the dermatology department, mycophenolic acid 2x500 mg was introduced with antimalarial and corticosteroid. The patient is now under therapy, she feels well, the skin changes have receded, she does not need antidepressants. She goes for regular check-ups with a rheumatologist

Discussion:

Joint pain should be taken seriously and immediate immunodiagnostics should be made due to timely treatment.

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