What are the physical Effects Joints - Arthritis (pain, swelling, redness, morning stiffness, warmth). It may be very painful, often involves small joints of the hands and wrists (although other joints are also involved). It can be migratory - moving from one joint to another, or intermittent - coming and going. However, it virtually never produces the bony and sever deformity associated with rheumatoid arthritis.
Blood vessels -The most common blood vessel involvement is Raynaud's Phenomenon, a condition where small blood vessels in finger tips, toes etc, are hyperactive to cold and/or emotion causing digits to become blue, then white, then red as they recover. More severe, and less common is inflamation of the larger blood vessels, causing rashes on lower legs and hands. If the vessels of the internal organs become inflaed, this can result in damage to the organd themselves.
Serosal membranes - Membranes surroundingthe lungs, heart or lining the abdominal cavity can become inflamed producing pain and/or the collection of fluid. Clinically this is Pricarditis, Pleuritis or Peritonitis, depending on location.
Blood cells - RBS anaemia is quite common and most often due to poor production of red cells. A special type of anaemia is that caused by antibodies which react with red blood cells to cause their destruction. This can cause fatigue. Platelets can also be destroyed by an immunological mechanism causing a bleeding and/or bruising tendency.
Nervous system - Peripheral nerves - numbness, tingling, weakness due to damage of a peripheral nerve - Often resolves.
Central nervous system - Headaches are frequent, so is depression. More involvements include seizures, marked mental changes, psychosis, and strokes.
Kidneys - Kidney involvement can range from very mild to a severe and progressive type which can destroy the kidneys and lead to dialysis. Symptoms patients may notice include diffuse fluid retention and puffiness, but for the most part early detection of kidney involvement requires frequent monitoring of blood and urine tests. Lupus renal disease, if it is going to develop, usually appears in the first year or two of th edisease. It rarely develops later, and almost never occurs in drug induced Lupus.
Pregnancy - There may be an increased risk of miscarriage in the Lupus patient, sometimes recurrent, with the miscarriage frequently occuring in the third or fourth month of pregnancy. Some miscarriages may relate to problems arising through the lupus anticoagulant and anticardiolipin antibody, whereas the possibility of having a stillborn child is more likely for those Lupus patients with kidney problems which can lead to toxaemia. Certain Lupus patients have antiphospholipid intibodies where the blood is 'stickier', this can lead to clotting in the placenta and thus to miscarriage. A number of successful lupus pregnancies are now being achieved through careful monitoring and the use of anticoagulating medication. |
