Outside the renal manifestation of SLE

 Outside the renal manifestation of SLE

(1) general symptoms: most of the patients can appear fatigue, weight loss, angular, 90% of the patients with fever, of which 65% as first symptoms.Thermal type, can be intermittent fever, remittent fever and continued fever or chronic low grade fever.Whether can be more than 39 ℃, 40% should be paid attention to for infection caused by, especially in the large dose of hormone treatment.

(2) the skin mucous membrane damage: SLE damage a variety of skin mucous membrane, the incidence in more than 80%.50% of the patients can appear butterfly erythema, as the bridge of the nose and double zygomatic cheek is the distribution of the butterfly edematous erythema (no lesion in the nasolabial groove), capillary expansion and scales, serious when can have blisters and scab skin.Erythema receded after leaving no scar.20% ~ 30% of the patients can appear discoid lupus, located in the exposed parts of the skin, more for the circular, round or oval red uplift spot piece, the surface can be covered with scales and keratin plug, often left a scar after her lesions subsided.Butterfly erythema and discoid lupus are detected, the characteristic of SLE can aggravate the sunlight or ultraviolet radiation.35% ~ 58% of SLE patients can have light irritation.50% ~ 71% of the patients can appear hair loss, is one of sensitive indexes of SLE activity.About 50% of the patients with vascular lesions in the skin, there may be, for the small blood vessels and capillaries caused by inflammation or spasm.Including mesh green spot, vascular inflammatory skin lesions, Renault phenomenon, a week sample skin erythema, urticaria, chilblain lupus sample skin and blood capillary expansion.7% ~ 7% of the patients can appear mucosal erosion or painless ulcer.

(3) joint and muscle pathological changes: about 95% of the patients can appear joint pain and arthritis, common in limb joints.5% ~ 5% of the patients with aseptic necrosis of femoral head, more long-term, large, irregular using hormone.Half of the patients with fibromyalgia and myopathy, and even appear obvious symptoms of muscle weakness or muscle atrophy.Joints, muscle lesions often associated with disease activity.

(4) the lungs and pleural lesions: 28% ~ 50% of patients can appear pleurisy, pleural effusion.Effusion is yellow exudate more, give priority to with monocytes, tuberculous pleurisy and identify.ANA has the thought, pleural effusion 1:160 or higher, or pleural effusion/serum drops of degree 1 or higher, or SM antibody positive, help to the diagnosis of SLE pleural effusion.2.7% ~ 10.1% with acute pneumonia with lupus, the death rate is high, is the leading cause of respiratory failure and pulmonary embolism.Acute hypoxia with lupus pneumonia symptoms, X-ray performance for double lung diffuse punctate shadows, the following lung field, the more the change of shadow, and large dose hormone treatment effect is obvious.

(5) the cardiovascular system performance: 50% ~ 55% of SLE patients with heart disease, including cp, myocarditis, valvular heart disease, arrhythmia, and high blood pressure.

(6) blood system disease: 50% ~ 75% of the patients is pigment are cell anemia.For autoimmune hemolytic anemia, some with SLE inflammation, renal insufficiency, blood loss, eating disorders, drug and so on.50% ~ 60% of the patients can appear leukopenia, more under 4.0 x 109 / L.Lymphopenia syndrome (< 1.5 x 109 / L) more in disease activity.20% ~ 50% of the patients with mild thrombocytopenia, concurrently in more (50 ~ 150) x 109 / L, 5% ~ 5% of the patients may be less than 50.0 x 109 / L, is a common clinical manifestations of SLE disease activity.In addition, 25% of SLE patients exist multiple lupus anticoagulant substances, such as anti Ⅷ, Ⅸ, Ⅺ, Ⅻ, clotting factors, cause coagulant function abnormality.

Gastrointestinal symptoms (7) : 25% ~ 50% of the patients can appear loss of appetite, nausea, vomiting, abdominal pain and diarrhea.30% of the patients had hepatomegaly and liver function abnormalities, a few splenomegaly.

(8) the spirit of the nervous system performance: 50% ~ 60% can appear spirit of nerve lesions, complex and varied clinical manifestations.Symptoms include mental abnormalities (such as depression, mania, mental retardation, mental disorder, etc.), epilepsy, hemiplegia, migraine, chorea, peripheral neuritis, and retinopathy.Most associated with lupus activity, prognosis is poor, is an important cause of death in SLE.

(9) other: irregular menstruation, dysmenorrhea, the quantity is too little or too much.Some patients may have painless swollen lymph nodes, parotid gland swelling, conjunctivitis, etc.