Medical Care ,  Health & Wellness

Decoding The Autoimmune Disease Systemic Lupus Erythematosus

June 15, 2024

Systemic Lupus Erythematosus (SLE) is an autoimmune disease. Learn about causes, risk factors, symptoms, treatment options, and how to manage SLE. Includes information on reducing the risk of flares.


Decoding The Autoimmune Disease Systemic Lupus Erythematosus

In December 2023, a well known Hong Kong actress, Kathy Chow passed away at 57 years old. While the cause of her death remains confidential, a leaked document that surfaced suggested that she had suffered from Systemic Lupus Erythematosus (SLE) and high blood pressure (hypertension). Following her demise, an experienced Rheumatologist, Dr Annie Law will be demystifying SLE, the autoimmune condition that Chow allegedly had, in the hope of promoting a better understanding of SLE.

SLE’s definition and early warning signs

SLE is a chronic autoimmune condition that occurs when your body’s immune system targets its own tissues and organs. SLE can come with certain early warning signs. Some patients may develop symptoms of fatigue, weight loss, unexplained fever, rashes or hair loss from weeks to months before the disease onset. 

 

Causal and risk factors for SLE

The exact cause of lupus is not fully known. However, it is believed to result from a combination of genetic, environmental, and hormonal factors.

 

In particular, Asian women are typically more prone to developing SLE relative to Caucasian counterparts due to the following risk factors.

  • Asian descent: Asians are at higher risk of getting SLE and tend to have more severe disease than Caucasians, because of genetic predisposition and environmental factors.
  • Female: Similarly, women are more likely than men to have SLE due to gene variants on the X chromosomes and the potential hormonal effect of oestrogen.

 

Consequences of SLE on the body

Individuals with SLE produce autoantibodies which target healthy cells, tissues, and organs, causing inflammation. SLE typically causes joint pain, skin rash, hair loss, oral or nasal ulcers and Raynaud’s phenomenon (fingers or toes turn white or blue when exposed to cold or stress). If left untreated, it may cause organ damage to the kidneys, neurological system, heart, lungs, and gastrointestinal tract.

Not only does SLE cause chronic inflammation and potential organ damage, but it also increases the risk of developing cardiovascular disease, hypertension, diabetes and obesity compared to individuals without SLE. These heightened risks are attributed to the disease itself and prolonged use of steroids, which accelerates the development of atherosclerosis (build-up of fats, cholesterol, and other substances in and on the blood vessel walls). Studies have shown that individuals with SLE face a twofold increased likelihood of developing hypertension, with contributing factors including obesity,  kidney disease and prolonged use of steroids.

 

Prevention of SLE

Environmental factors, including infections, certain medications, sunlight, smoking and stress, can trigger lupus. Thankfully, there are lifestyle tips that help keep SLE at bay. It is important to lower your risk of developing  SLE by applying sunscreen, wearing protective clothing (long sleeve shirts, sunglasses, and hats) that reduces excessive sunlight exposure, refraining from smoking and managing stress effectively.



Treatment and management of SLE

While there is no cure for SLE, effective treatments control disease activity by reducing inflammation and preventing organ damage. SLE patients can still lead normal, healthy lives with appropriate care from a rheumatologist. 

 

The following practices can help individuals with SLE better manage their condition:

  • Lifestyle modifications: maintaining a healthy lifestyle, which includes regular exercise, a balanced diet, stress management and sufficient sleep, can help to reduce the risk of lupus flares and enhance overall well-being. 
  • Regular monitoring: close follow-up with your rheumatologist is essential for ongoing care and medication adjustments.
  • Preventive measures: vaccinations are recommended to reduce the risk of infections, as some individuals with SLE are more susceptible to being infected.
  • Guarding against cardiovascular diseases: it is advisable to follow dietary measures to improve your lipid profile (choose unsaturated fats available in olive oil, avocados, nuts, and seeds, as well as limit saturated fats from sources like red meat, full-fat dairy, and processed foods) and abstain from smoking.
    • Some other measures to reduce the risk of cardiovascular disease include:
    • Antimalarial drugs such as hydroxychloroquine are often prescribed to SLE patients. It is known to reduce the risk of clot and cholesterol profiles, lower the chance of organ damage and increase survival in SLE patients.
    • Use of lipid-lowering agent is recommended to control cholesterol levels.
    • Stay compliant with your medications to minimise disease flares with the lowest possible glucocorticoid dose.

When to see a rheumatologist

If you experience symptoms associated with SLE, like fatigue, fever, photosensitive rash and joint pain, it is advisable to see a rheumatologist. Rheumatologists are doctors who specialise in treating and managing autoimmune diseases like SLE. They will take a detailed history, examine you and conduct appropriate tests to confirm the diagnosis of SLE. 

 

Senior Consultant Rheumatologist Dr Annie Law and her Team at Asia Arthritis & Rheumatology Centre (AARC) are committed to supporting you on your journey to understanding, managing, and thriving despite SLE. AARC is part of the Beyond Medical Group, a collective of medical specialists that has also been ranked as one of Singapore’s Top 100 Fastest-Growing Companies for 2024. For more in-depth information, feel free to book a consultation with Dr Annie Law to explore AARC’s comprehensive services and stay informed on the latest developments in SLE care.

 

Asia Arthritis & Rheumatology Centre Website: https://aarc.sg/

Dr Annie Law Profile: https://aarc.sg/dr-annie-law/

Appointment Line: +(65) 8030 7862

Email: info@aarc.sg




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