Systemic lupus erythematosus is a common disease can occur at any age and
sex, is common in young women, the most common 20 to 30 years. Extrarenal
manifestations are:
(1) General symptoms: Most patients showed generalized weakness, weight loss,
90% of patients have fever, heat-type variable, 40% more than 39 ℃.
(2) skin and mucous membranes: 50% of patients, there may be facial butterfly
erythema, lesions confined to the two cheeks and the nose bridge, was mild edema
and erythema, telangiectasia and scaly blisters, severe exudative inflammation
and crusts, erythema subsided in general does not leave scars and pigmentation.
The hair loss seen in 50% of patients, is a sensitive indicator of lupus
activity. Livedo reticularis is common, is a typical characteristic of
vasculitis. Many symptoms of the nervous system. In addition, also visible
urticaria, Discoid erythema, A Zhou erythema, purpura, crack haemorrhage, oral
and nasal ulcers.
(3) joint and muscle: 90% of patients with joint pain, common in the limbs,
joints, about 10% of patients may have mild joint deformity, but generally no
bone erosion signs.Long-term, large, irregular use of hormones, can lead to some
patients with aseptic necrosis of femoral head. 1/3 of patients with muscle
pain, and some even appear obvious symptoms of muscle weakness or muscle
atrophy.
(4) cardiovascular: up to 2/3 of patients with active lupus erythematosus
pericarditis cases, usually short and mild clinical manifestations. 10% of
patients with myocarditis.Mitral and aortic valve may also be involved,
generally at the apex and the heart at the bottom of smell and systolic murmur,
which may also be related to anemia, tachycardia, or fever, diastolic murmur
rare. There is also the Raynaud's phenomenon (25%), pulmonary hypertension and
recurrent thrombophlebitis, which can be lupus erythematosus in the first
symptom.
(5), lung and pleura: 40% ~ 46% of patients can occur in pleurisy, it is a
reliable indicator of lupus erythematosus forthcoming involving the kidneys.
Acute lupus pneumonitis and rare, difficulty breathing, chest pain and cough,
and severe cases, massive hemoptysis, and some patients present with recurrent
pulmonary atelectasis, a few may develop as diffuse interstitial pulmonary
fibrosis.
(6) the blood system: 50% ~ 75% of the patients showed positive pigment cell
anemia; 60% of patients with white blood cells <4.5 × 109 / L; platelet is
generally slightly lower, a small number of <30 × 109 / L (approximately 50%
).
(7) of the gastrointestinal tract: some patients have nausea, vomiting,
abdominal pain is common (approximately 50%) may be associated with peritonitis
and abdominal viscera. Liver, splenomegaly were found in 30% and 20% of
patients.
(8) of the nervous system: the incidence of symptoms and signs of about 50%
to 60%, complex and diverse clinical manifestations, and manifests itself as
mental disorders such as depression, mental confusion. Or epilepsy, migraine,
paralysis, chorea, peripheral neuropathy and retinopathy.
(9) Other: menstrual irregularity, premenstrual symptoms increased,
especially migraine. Some patients may occur painless lymph nodes, parotid gland
swelling, conjunctivitis.
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