Classification and external resources
Systemic lupus erythematosus (SLE or lupus) is a chronic autoimmune disease that can be fatal, though with recent medical advances, fatalities are becoming increasingly rare. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings L00-L99 - Diseases of the Skin and Subcutaneous tissue (L00-L08 Infections of the Skin and Subcutaneous tissue M00-M99 - Diseases of the Musculoskeletal system and Connective tissue (M00-M25 Arthropathies (M00-M03 Infectious arthropathies The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Mendelian Inheritance in Man project is a Database that catalogues all the known Diseases with a genetic component, and—when possible—links them The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues As with other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic A joint is the location at which two or more Bones make contact The skin is the outer covering of living tissue of an animal (or plant lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive The blood vessels are part of the Circulatory system and function to transport Blood throughout the body The liver is a vital organ in the human body and is present in Vertebrates and some other animals The kidneys are complicated organs that have numerous biological roles The nervous system is a Network of specialized cells that communicate information about an animal's surroundings and itself The course of the disease is unpredictable, with periods of illness (called flares) alternating with remission. Lupus can occur at any age, and is most common in women, particularly of non-European descent.  Lupus is treatable symptomatically, mainly with corticosteroids and immunosuppressants, though there is currently no cure. Symptomatic treatment is any medical therapy of a Disease that only affects its Symptoms not its cause i Corticosteroids are a class of Steroid hormones that are produced in the Adrenal cortex. Immunosuppression involves an act that reduces the activation or Efficacy of the Immune system. Survival in patients with SLE in the United States, Canada, and Europe is approximately 95% at 5 years, 90% at 10 years, and 78% at 20 years. 
Lupus is a chronic autoimmune disease. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Clinically, it can affect multiple organ systems, including the heart, skin, joints, kidneys, and nervous system. There are several types of lupus; generally, when the word "lupus" alone is used, it refers to systemic lupus erythematosus or SLE, as discussed in this article. Other types include:
SLE is one of several diseases known as "the great imitators" because its symptoms vary so widely, it often mimics or is mistaken for other illnesses and because the symptoms come and go unpredictably. Diagnosis can be elusive, with patients sometimes suffering unexplained symptoms and untreated SLE for years. Common initial and chronic complaints are fever, malaise, joint pains, myalgias, and fatigue. Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris Malaise is a feeling of general discomfort or uneasiness an "out of sorts" feeling often the first indication of an infection or other disease Arthralgia (from Greek arthro-, joint + -algos, pain literally means joint pain; it is a symptom of injury infection illnesses -- in particular Myalgia means " Muscle Pain " and is a symptom of many diseases and disorders Because they are so often seen with other diseases, these signs and symptoms are not part of the diagnostic criteria for SLE. When occurring in conjunction with other signs and symptoms (see below), however, they are considered suggestive.
Other abnormalities include:
In SLE, the body's immune system produces antibodies against itself, particularly against proteins in the cell nucleus. FcεRI, or Fc epsilon RI, is the high- Affinity receptor for Immunoglobulin E (IgE an Antibody Isotype involved in See also Principality of Zeta Zeta (uppercase Ζ, lowercase ζ; Ζήτα Zita is the sixth letter of the Greek alphabet. T cells belong to a group of White blood cells known as Lymphocytes, and play a central role in Cell-mediated immunity. Inositol trisphosphate or inositol 145-trisphosphate (also commonly known as triphosphoinositol; abbreviated InsP3 or IP3 Protein kinase C ('PKC') is a family of protein kinases consisting of ~10 Isozymes. Mitogen-activated protein (MAP kinases ( are Serine/threonine-specific protein kinases that respond to extracellular stimuli ( Mitogens and regulate various cellular A protein kinase is a Kinase Enzyme that modifies other Proteins by chemically adding Phosphate groups to them ( Phosphorylation) SLE is triggered by environmental factors that are unknown (but probably include viruses) in people with certain combinations of genes in their immune system.
"All the key components of the immune system are involved in the underlying mechanisms" of SLE, according to Rahman, and SLE is the prototypical autoimmune disease. The immune system must have a balance (homeostasis) between being sensitive enough to protect against infection, and being too sensitive and attacking the body's own proteins (autoimmunity). Homeostasis (from Greek: ὅμος hómos, "equal" and ιστημι istēmi, "to stand" lit From an evolutionary perspective, according to Crow, the population must have enough genetic diversity to protect itself against a wide range of possible infection; some genetic combinations result in autoimmunity. The likely environmental triggers include ultraviolet light, drugs, and viruses. These stimuli cause the destruction of cells and expose their DNA, histones, and other proteins, particularly parts of the cell nucleus. In Biology, histones are the chief Protein components of Chromatin. Because of genetic variations in different components of the immune system, in some people the immune system attacks these nuclear-related proteins and produces antibodies against them. Ultimately, these antibody complexes damage blood vessels in critical areas of the body, such as the glomeruli of the kidney; these antibody attacks are the cause of SLE. A glomerulus is a Capillary tuft surrounded by Bowman's capsule in Nephrons of the vertebrate Kidney. Researchers are now identifying the individual genes, the proteins they produce, and their role in the immune system. Each protein is a link on the autoimmune chain, and researchers are trying to find drugs to break each of those links. 
SLE is a chronic inflammatory disease believed to be a type III hypersensitivity response with potential type II involvement. Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens Hypersensitivity (also called hypersensitivity reaction refers to undesirable (damaging discomfort-producing and sometimes fatal reactions produced by the normal immune system Hypersensitivity (also called hypersensitivity reaction refers to undesirable (damaging discomfort-producing and sometimes fatal reactions produced by the normal immune system 
The exact mechanisms for the development of systemic lupus erythematosus (SLE) are still unclear, since the pathogenesis is a multifactorial event. Beside discussed causations, impaired clearance of dying cells is a potential pathway for the development of this systemic autoimmune disease. Autoimmune diseases arise from an overactive Immune response of the body against substances and tissues normally present in the body This includes deficient phagocytic activity and scant serum components in addition to increased apoptosis.
Monocytes isolated from whole blood of SLE patients show reduced expression of CD44 surface molecules involved in the uptake of apoptotic cells. Monocyte is a type of Leukocyte, part of the Human body 's Immune system. Whole Blood is the term used in Transfusion medicine for human Blood from a standard Blood donation. Most of the monocytes and tingible body macrophages (TBM), which are found in the germinal centres of lymph nodes, even show a definitely different morphology in patients with SLE; they are smaller or scarce and die earlier. Germinal centres (GC are areas within Lymph nodes where B lymphocytes rapidly divide and are an important part of the humoral immune response. A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. Serum components like complement factors, CRP, and some glycoproteins are furthermore decisively important for an efficiently operating phagocytosis. The complement system is a Biochemical cascade that helps clear Pathogens from an organism C-reactive protein ( CRP) is a Plasma protein, an Acute phase protein produced by the Liver and by Adipocytes. Not to be confused with Peptidoglycan. Glycoproteins are proteins that contain Oligosaccharide chains ( Glycans) covalently attached In patients, these components are often missing, diminished, or inefficient.
The clearance of early apoptotic cells is an important function in multicellular organisms. It leads to a progression of the apoptosis process and finally to secondary necrosis of the cells if this ability is disturbed. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. Necrotic cells release nuclear fragments as potential autoantigens as well as internal danger signals, inducing maturation of dendritic cells (DC), since they have lost their membranes' integrity. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Dendritic cells (DCs are Immune cells and form part of the Mammalian Immune system. Increased appearance of apoptotic cells also simulates inefficient clearance. That leads to maturation of DC and also to the presentation of intracellular antigens of late apoptotic or secondary necrotic cells, via MHC molecules. Autoimmunity possibly results by the extended exposure to nuclear and intracellular autoantigens derived from late apoptotic and secondary necrotic cells. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues B and T cell tolerance for apoptotic cells is abrogated, and the lymphocytes get activated by these autoantigens; inflammation and the production of autoantibodies by plasma cells is initiated. T cells belong to a group of White blood cells known as Lymphocytes, and play a central role in Cell-mediated immunity. A lymphocyte is a type of White blood cell in the Vertebrate Immune system. Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens Plasma cells (also called plasma B cells or plasmocytes) are cells of the Immune system that secrete large amounts of antibodies. A clearance deficiency in the skin for apoptotic cells has also been observed in patients with cutaneous lupus erythematosus (CLE).
Accumulation in germinal centres (GC)
In healthy conditions, apoptotic lymphocytes are removed in germinal centres by specialised phagocytes, the tingible body macrophages (TBM); that’s why no free apoptotic and potential autoantigenic material can be seen. In some patients with SLE, accumulation of apoptotic debris can be observed in GC because of an ineffective clearance of apoptotic cells. Most generally the accumulation of capital refers simply to the gathering or amassment of objects of value the increase in wealth or the creation of wealth Debris (ˈdeɪbriː/ /dɛˈbriː is a word used to describe the remains of something that has been otherwise destroyed In close proximity to TBM, follicular dendritic cells (FDC) are localised in GC, which attach antigen material to their surface and, in contrast to bone marrow-derived DC, neither take it up nor present it via MHC molecules. Follicular dendritic cells (FDC are cells of the Immune system found in Lymph follicles They are probably not of Hematopoietic origin but simply look Bone marrow is the flexible tissue found in the hollow interior of Bones In adults marrow in large bones produces new Blood cells It constitutes 4% of The major histocompatibility complex ( MHC) is a large genomic region or Gene family found in most Vertebrates It is the most gene-dense region Autoreactive B cells can accidentally emerge during somatic hypermutation and migrate into the GC light zone. B cells are Lymphocytes that play a large role in the humoral immune response (as opposed to the cell-mediated immune response, which is governed by Somatic hypermutation (or SHM is a mechanism inside cells that is part of the way the immune system adapts to the new foreign elements which confront it (for example Autoreactive B cells, maturated coincidentally, normally don’t receive survival signals by antigen planted on follicular dendritic cells and perish by apoptosis. In the case of clearance deficiency, apoptotic nuclear debris accumulates in the light zone of GC and gets attached to FDC. This serves as a germinal centre survival signal for autoreactive B-cells. After migration into the mantle zone, autoreactive B cells require further survival signals from autoreactive helper T cells, which promote the maturation of autoantibody-producing plasma cells and B memory cells. In the presence of autoreactive T cells, a chronic autoimmune disease may be the consequence. Autoimmune diseases arise from an overactive Immune response of the body against substances and tissues normally present in the body
One manifestation of lupus is abnormalities in apoptosis, a type of programmed cell death in which aging or damaged cells are neatly disposed of as a part of normal growth or functioning.
Tingible body macrophages (TBMs) are large phagocytic cells in the germinal centers of secondary lymph nodes; they express CD68 protein. Germinal centres (GC are areas within Lymph nodes where B lymphocytes rapidly divide and are an important part of the humoral immune response. A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. These cells normally engulf B cells that have undergone apoptosis after somatic hypermutation. Somatic hypermutation (or SHM is a mechanism inside cells that is part of the way the immune system adapts to the new foreign elements which confront it (for example In some patients with SLE, significantly fewer TBMs can be found, and these cells rarely contain material from apoptotic B cells. Also, uningested apoptotic nuclei can be found outside of TBMs. This material may present a threat to the tolerization of B cells and T cells. Dendritic cells in the germinal center may endocytose such antigenic material and present it to T cells, activating them. Dendritic cells (DCs are Immune cells and form part of the Mammalian Immune system. Also, apoptotic chromatin and nuclei may attach to the surfaces of follicular dendritic cells and make this material available for activating other B cells that may have randomly acquired self-specificity through somatic hypermutation. Somatic hypermutation (or SHM is a mechanism inside cells that is part of the way the immune system adapts to the new foreign elements which confront it (for example 
Some physicians make a diagnosis on the basis of the ACR classification criteria (see below). The criteria, however, were established mainly for use in scientific research (i. e. , inclusion in randomized controlled trials), and patients may have lupus but never meet the full criteria. A randomized controlled trial (RCT is a type of scientific Experiment most commonly used in testing the Efficacy or Effectiveness of Healthcare
Antinuclear antibody testing and anti-extractable nuclear antigen (anti-ENA) form the mainstay of serologic testing for lupus. Anti-nuclear antibodies ( ANA s also known as anti-nuclear factor or ANF) are antibodies directed against contents of the cell nucleus Serology is the scientific study of blood serum. In practice the term usually refers to the Diagnostic identification of antibodies in the serum Antiphospholipid antibodies occur more often in SLE and can predispose for thrombosis. Thrombosis is the formation of a blood Clot ( Thrombus) inside a Blood vessel, obstructing the flow of Blood through the Circulatory More specific are the anti-Smith and anti-dsDNA antibodies. biology LSm proteins are a family of RNA -binding Proteins found in virtually every cellular Organism. Other tests routinely performed in suspected SLE are complement system levels (low levels suggest consumption by the immune system), electrolytes and renal function (disturbed if the kidney is involved), liver enzymes, and a complete blood count. The complement system is a Biochemical cascade that helps clear Pathogens from an organism An electrolyte is any substance containing free Ions that behaves as an electrically conductive medium Renal function, in Nephrology, is an indication of the state of the Kidney and its role in Renal physiology. Liver function tests (LFTs or LFs which include liver enzymes, are groups of Clinical biochemistry laboratory blood assays designed to give information about the A complete blood count ( CBC) also known as full blood count ( FBC) or full blood exam ( FBE) or blood panel, is
Previously, the lupus erythematosus (LE) cell test was not commonly used for diagnosis because those LE cells are only found in 50–75% of SLE patients, and are also found in some patients with rheumatoid arthritis, scleroderma, and drug sensitivities. Because of this, the LE cell test is now performed only rarely and is mostly of historical significance. 
The American College of Rheumatology (ACR) established eleven criteria in 1982, which were revised in 1997 as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individual patients and do not do well in that capacity. For inclusion in clinical trials, patients must meet the following three criteria to be classified as having SLE: (i) patient must present with four of the below eleven symptoms, (ii) either simultaneously or serially, (iii) during a given period of observation.
A useful mnemonic for these 11 criteria is SOAP BRAIN MD: Serositis (8), Oral ulcers (4), Arthritis (5), Photosensitivity (3), Blood Changes (9), Renal involvement (proteinuria or casts) (6), ANA (10), Immunological changes (11), Neurological signs (seizures, frank psychosis) (7), Malar Rash (1), Discoid Rash (2).
Some patients, especially those with antiphospholipid syndrome, may have SLE without four criteria, and SLE is associated with manifestations other than those listed in the criteria. Antiphospholipid syndrome (APS or APLS or antiphospholipid antibody syndrome is a disorder of Coagulation, which causes blood clots ( Thrombosis) in both 
Recursive partitioning has been used to identify more parsimonious criteria. Recursive partitioning is a statistical method for Multivariable analysis.  This analysis presented two diagnostic classification trees:
1. Simplest classification tree: LSE is diagnosed if the patient has an immunologic disorder (anti-DNA antibody, anti-Smith antibody, false positive syphilis test, or LE cells) or malar rash. In Medicine, malar rash, also called butterfly rash, is a Medical sign consisting of a characteristic form of facial rash
2. Full classification tree: Uses 6 criteria.
Other alternative criteria have been suggested. 
Porphyrias are complex genetic disorders that share many symptoms with lupus, but impact the enzymes responsible for building heme, a component needed in heme proteins. Porphyrias are a group of inherited or acquired disorders of certain Enzymes in the Heme biosynthetic pathway (also called Porphyrin pathway A heme ( American English) or haem ( British English) is a Prosthetic group that consists of an Iron atom contained in the center of Porphyrias are ecogenic disorders requiring both environmental and genetic backgrounds to manifest with a variety of symptoms and medical complications. They are noted for photosensitivity and have been associated with transient and permanent production of autoantibodies. The five major forms of dominantly inherited porphyrias (acute intermittent porphyria, porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria, and erythropoietic protoporphyria) have been detected in systemic lupus erythematosus and discoid lupus patients over the past 50 years. Hereditary coproporphyria (HCP is a form of hepatic Porphyria associated with a deficiency of the enzyme Coproporphyrinogen III oxidase. Physicians should have a high degree of suspicion of porphyrias in all lupus cases and act accordingly when patients are in a medical crisis that may be due to an underlying acute hepatic porphyria. Drug-induced lupus and photosensitivity warrant an investigation for an underlying porphyria, since multiple drug reactions are a hallmark complication of porphyrias. Patients with both lupus and porphyrias should avoid porphyrinogenic drugs and hormone preparations, but the effects of these drugs on lupus patients is undetermined.
Patients with acute hepatic porphyrias (acute intermittent porphyria, hereditary coproporphyria, variegate porphyria) have been detected in lupus patients with severe life-threatening "lupus" complications known as neurolupus. The liver is a vital organ in the human body and is present in Vertebrates and some other animals Symptoms are identical to acute hepatic porphyria attacks and include seizures, psychosis, peripheral neuropathy, and syndrome of inappropriate antidiuretic hormone (SIADH) associated with dangerously low sodium levels (hyponatremia). Psychosis (from the Greek ψυχή "psyche" for mind or soul and -οσις "-osis" for abnormal condition with adjective psychotic Peripheral neuropathy is the term for damage to Nerves of the Peripheral nervous system, which may be caused either by diseases of the Nerve or from the Porphyria attacks require intervention with intravenous glucose, heme preparations, and the discontinuation of dangerous porphyrinogenic drugs, including antiseizure drugs. Several other lupus complications have been associated with porphyrias, including pancreatitis and pericarditis. Pancreatitis is the Inflammation of the Pancreas. See also Acute pancreatitis and Chronic pancreatitis for more details Pericarditis is an Inflammation ( -itis) of the Pericardium (the fibrous sac surrounding the heart Porphyrin testing should be performed on urine, stool/bile, and blood to detect all types of porphyrias; repeat testing should be performed in suspicious cases. Appropriate enzyme tests or DNA testing should also be pursued to obtain a complete diagnosis, which could include a dual porphyria.
SLE is sometimes diagnosed in conjunction with other conditions, including rheumatoid arthritis, scurvy, and fibromyalgia. Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where Scurvy (NLat scorbutus is a disease resulting from a deficiency of Vitamin C, which is required for the synthesis of Collagen in humans Fibromyalgia (FM is a disorder classified by the presence of chronic widespread Pain and tactile Allodynia.
As lupus erythematosus is a chronic disease with no known cure, treatment is restricted to dealing with the symptoms. Symptomatic treatment is any medical therapy of a Disease that only affects its Symptoms not its cause i Essentially, this involves preventing flares and reducing their severity and duration when they occur. There are several means of preventing and dealing with flares, including drugs, alternative medicine, and lifestyle changes.
Due to the variety of symptoms and organ system involvement with lupus patients, the severity of the SLE in a particular patient must be assessed in order to successfully treat SLE. Mild or remittent disease can sometimes be safely left untreated. If required, nonsteroidal anti-inflammatory drugs and antimalarials may be used. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAID s or NAID s, are drugs with Analgesic, Antipyretic and in higher Malaria is a vector -borne Infectious disease caused by Protozoan Parasites It is widespread in tropical and subtropical regions including
Disease-modifying antirheumatic drugs (DMARDs) are used preventively to reduce the incidence of flares, the process of the disease, and lower the need for steroid use; when flares occur, they are treated with corticosteroids. Disease-modifying antirheumatic drugs ( DMARDs) is a category of drugs used in many autoimmune disorders to slow down disease progression Corticosteroids are a class of Steroid hormones that are produced in the Adrenal cortex. DMARDs commonly in use are antimalarials and immunosuppressants (e. An immunosuppressant is a substance that performs Immunosuppression of the Immune system. g. , methotrexate and azathioprine). Azathioprine is an immunosuppressant used in Organ transplantation Autoimmune disease such as Rheumatoid arthritis and Pemphigus or inflammatory Hydroxychloroquine (trade name Plaquenil) is an FDA-approved antimalarial used for constitutional, cutaneous, and articular manifestations, while cyclophosphamide (trade names Cytoxan and Neosar) is used for severe glomerulonephritis or other organ-damaging complications. Hydroxychloroquine is an Antimalarial drug sold under the trade name Plaquenil, also used to reduce inflammation in the treatment of Rheumatoid arthritis Cyclophosphamide (the generic name for Cytoxan Neosar Revimmune also known as cytophosphane is a Nitrogen mustard alkylating agent, from the oxazophorines group Glomerulonephritis, also known as glomerular nephritis, abbreviated GN, is a renal disease characterized by Inflammation of the glomeruli In 2005, mycophenolic acid (trade name CellCept) became accepted for treatment of lupus nephritis. Mycophenolic acid ( INN) (ˌmaɪkoʊˈfɛnɒlɪk or mycophenolate is an immunosuppressant drug used to prevent rejection in Organ transplantation
In more severe cases, medications that modulate the immune system (primarily corticosteroids and immunosuppressants) are used to control the disease and prevent recurrence of symptoms (known as flares). For a list of immunosuppressive drugs see the Transplant rejection page. Patients who require steroids frequently may develop obesity, diabetes mellitus, diabetes, and osteoporosis. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Osteoporosis is a Disease of Bone that leads to an increased risk of fracture. Depending on the dosage, corticosteroids can cause other side effects, such as a puffy face, an unusually large appetite, and difficulty sleeping. Those side effects can subside if and when the large initial dosage is reduced, but long-term use of even low doses can cause elevated blood pressure and cataracts. Blood pressure is also the title of a short story by Damon Runyan in Guys and Dolls and Other Stories A cataract is a clouding that develops in the crystalline lens of the Eye or in its envelope varying in degree from slight to complete opacity Due to these side effects, steroids are avoided if possible.
Since a large percentage of lupus patients suffer from varying amounts of chronic pain, stronger prescription analgesics may be used if over-the-counter drugs (mainly nonsteroidal anti-inflammatory drugs) do not provide effective relief. Chronic pain is defined as Pain that persists longer than the temporal course of natural healing associated with a particular type of injury or disease process Moderate pain in lupus patients is typically treated with mild prescription opiates such as dextropropoxyphene (trade name Darvocet) and co-codamol (trade name Tylenol #3). Dextropropoxyphene is an Analgesic in the Opioid category It is used to treat mild to moderate pain and as an Anti-tussive. Co-codamol ( BAN) is a non- Proprietary name used to denote a Compound analgesic, a combination of Codeine phosphate and Paracetamol Moderate to severe chronic pain is treated with stronger opioids, such as hydrocodone (trade names Lorcet, Lortab, Norco, Vicodin, Vicoprofen) or longer-acting continuous-release opioids, such as oxycodone (trade name OxyContin), MS Contin, or Methadone. Hydrocodone or dihydrocodeinone is a semi-synthetic Opioid derived from two of the naturally occurring Opiates Codeine and Thebaine An opioid is a chemical Substance that has a Morphine -like action in the body Oxycodone is an Opioid Analgesic Medication synthesized from Thebaine. MS Contin is a time-released formulation of Morphine, usually taken every twelve hours for chronic pain Methadone ( Dolophine Amidone Methadose Physeptone Heptadon and many others is a synthetic Opioid, used medically as an Analgesic, Antitussive The Fentanyl Duragesic Transdermal patch is also a widely used treatment option for the chronic pain of lupus complications because of its long-acting timed release and ease of use. Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. When opioids are used for prolonged periods, drug tolerance, chemical dependency, and (rarely) addiction may occur. Opiate addiction is not typically a concern for lupus patients, since the condition is not likely to ever completely disappear. Thus, lifelong treatment with opioids is fairly common in lupus patients who exhibit chronic pain symptoms, accompanied by periodic titration that is typical of any long-term opioid regimen. Titration is a common laboratory method of Quantitative chemical analysis that is used to determine the unknown Concentration of a known Reactant
In 1987, Tina Lomardi, M. D. first reported that long-wave ultraviolet radiation (UVA1) had a favorable effect on disease activity in SLE-model mice. In 1987, McGrath, Bak, and Michalski reported in Arthritis and Rheumatism, Vol. 30, No. 5, May, that long-wave ultraviolet radiation (UVA1) had a favorable effect on disease activity in SLE-model mice ( "Ultraviolet-A Light Prolongs Survival and Improves Immune Function in Hybrid Mice"). Both McGrath and independent Dutch researchers have repeatedly reproduced these findings in SLE patients.  Devices for administering therapeutic doses of UVA1 are available in Europe but not in the U. S. The U. S. Food and Drug Administration's Office of Science and Technology conducted UVA1 phototherapy studies in an SLE-model mouse in 1997 to "prepare for future reviews of UVA-emitting tanning devices for such clinical applications. " Some patients, however, have taken matters into their own hands. Chicago-based reporter and lupus patient Anthony DeBartolo built his own 8-lamp UVA1 home tanning device, which delivers the same 6- to 8-joule therapeutic dose of McGrath's 24-lamp clinical research equipment. DeBartolo's experiences were published in the 2004 book Lupus Underground. 
Other measures, such as avoiding sunlight or covering up with sun-protective clothing, can also be effective in preventing photosensitivity problems. Weight loss is also recommended in overweight and obese patients to alleviate some of the effects of the disease, especially where joint involvement is significant.
Other immunosuppressants (drugs that lower the body's normal immune response), and bone marrow transplant autologous stem cell transplants are under investigation as a possible cure. Recently, treatments that are more specific in modifying the particular subset of the immune cells (e. g. , B or T cells) or the cytokine proteins they secrete have been gaining attention. Cytokines are a category of signalling Proteins and Glycoproteins that like Hormones and Neurotransmitters, are used extensively in cellular Research into new treatments has recently been accelerated by genetic discoveries, especially mapping of the human genome. According to a June 2006 market analysis report by Datamonitor, treatment for SLE could be on the verge of a breakthrough, as there are numerous late-phase trials currently being carried out.  There have been promising advances in the area of stem cell research, implicating a treatment with adult stem cells being harvested from the patients themselves. Stem cells are cells found in most if not all multi-cellular Organisms. 
Lupus is not understood well enough to be prevented, but when the disease develops, quality of life can be improved through flare prevention. The warning signs of an impending flare include increased fatigue, pain, rash, fever, abdominal discomfort, headache, and dizziness. Early recognition of warning signs and good communication with a doctor can help individuals with lupus remain active, experience less pain, and reduce medical visits. 
While most infants born to mothers with lupus are healthy, pregnant mothers with SLE should remain under a doctor's care until delivery. Neonatal lupus is rare, but identification of mothers at highest risk for complications allows for prompt treatment before or after birth. In addition, SLE can flare during pregnancy, and proper treatment can maintain the health of the mother longer. Women pregnant and known to have the antibodies for anti-Ro (SSA) or anti-La (SSB) should have echocardiograms during the 16th and 30th weeks of pregnancy to monitor the health of the heart and surrounding vasculature. 
In the 1950s, most patients diagnosed with SLE lived fewer than five years. Advances in diagnosis and treatment have improved survival to the point where over 90% of patients now survive for more than ten years, and many can live relatively asymptomatically. The most common cause of death is infection due to immunosuppression as a result of medications used to manage the disease. An infectious disease is a clinically evident Disease resulting from the presence of Pathogenic microbial agents including Pathogenic viruses Pathogenic Immunosuppression involves an act that reduces the activation or Efficacy of the Immune system. Prognosis is normally worse for men and children than for women; fortunately, if symptoms are present after age 60, the disease tends to run a more benign course. The ANA is the most sensitive screening test, while anti-Sm (anti-Smith) is the most specific. biology LSm proteins are a family of RNA -binding Proteins found in virtually every cellular Organism. The ds-DNA (double-stranded DNA) antibody is also fairly specific and often fluctuates with disease activity; the ds-DNA titer is therefore sometimes useful to diagnose or monitor acute flares or response to treatment. Deoxyribonucleic acid ( DNA) is a Nucleic acid that contains the genetic instructions used in the development and functioning of all known 
Previously believed to be a rare disease, lupus has seen an increase in awareness and education since the 1960s. This has helped many more patients get an accurate diagnosis, making it possible to estimate the number of people with lupus with some certainty. In the United States alone, it is estimated that between 270,000 and 1. 5 million people have lupus, making it more common than cystic fibrosis or cerebral palsy. Cystic fibrosis (also known as CF, mucoviscoidosis, or mucoviscidosis) is a hereditary disease affecting the exocrine (mucus glands of the lungs Cerebral palsy ( CP) is an Umbrella term encompassing a group of non-progressive, non- contagious conditions that cause Physical disability The disease affects both females and males, though young women are diagnosed nine times more often than men. SLE occurs with much greater severity among African-American women, who suffer more severe symptoms as well as a higher mortality rate.  Worldwide, a conservative estimate states that over 5 million people have lupus.
Although SLE can occur in anyone, at any age, it is most common in women of childbearing age. It affects 1 in 4000 people in the United States, again with women becoming afflicted far more often than men. The disease appears to be more prevalent in women of African, Asian, Hispanic, and Native American origin, but this may be due to socioeconomic factors. People with relatives who suffer from SLE, rheumatoid arthritis, or thrombotic thrombocytopenic purpura are at a slightly higher risk than the general population. Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where Thrombotic thrombocytopenic purpura ( TTP or Moschcowitz disease) is a rare disorder of the blood-coagulation system causing extensive microscopic
Medical historians have theorized that people with porphyria (a disease that shares many symptoms with lupus) generated folklore stories of vampires and werewolves, due to the photosensitivity, scarring, hair growth, and porphyrin brownish-red stained teeth in severe recessive forms of porphyria (or combinations of the disorder, known as dual, homozygous, or compound heterozygous porphyrias). Porphyrias are a group of inherited or acquired disorders of certain Enzymes in the Heme biosynthetic pathway (also called Porphyrin pathway
The history of lupus erythematosus can be divided into three periods: classical, neoclassical, and modern. The classical period began when the disease was first recognized in the Middle Ages and saw the description of the dermatological manifestation of the disorder. The term lupus is attributed to 12th-century physician Rogerius, who used it to describe the classic malar rash. A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health Rogerius (before 1140-c 1195 also called Rogerius Salernitanus, Roger Frugard, Roger Frugardi, Roggerio Frugardo, Rüdiger Frutgard The neoclassical period was heralded by Móric Kaposi's recognition in 1872 of the systemic manifestations of the disease. Moritz Kaposi (Kaposi Mór (born 23 October 1837 in Kaposvár, Hungary - 6 March 1902 in Vienna, Austria Year 1872 ( MDCCCLXXII) was a Leap year starting on Monday (link will display the full calendar of the Gregorian Calendar (or a Leap year The modern period began in 1948 with the discovery of the LE cell (the lupus erythematosus cell—a misnomer, as it occurs with other diseases as well) and is characterised by advances in our knowledge of the pathophysiology and clinical-laboratory features of the disease, as well as advances in treatment. Year 1948 ( MCMXLVIII) was a Leap year starting on Thursday (link will display the 1948 calendar of the Gregorian calendar.
Useful medication for the disease was first found in 1894, when quinine was first reported as an effective therapy. Year 1894 ( MDCCCXCIV) was a Common year starting on Monday (link will display the full calendar of the Gregorian calendar (or a Common Quinine (ˈkwaɪnaɪn kwɪˈniːn ˈkwiːniːn is a natural white Crystalline Alkaloid having Antipyretic (fever-reducing antimalarial, Four years later, the use of salicylates in conjunction with quinine was noted to be of still greater benefit. Salicylic acid (from the Latin word for the willow tree Salix, from whose bark it can be obtained is a Beta hydroxy acid (BHA with the formula This was the best available treatment to patients until the middle of the twentieth century, when Hench discovered the efficacy of corticosteroids in the treatment of SLE. Corticosteroids are a class of Steroid hormones that are produced in the Adrenal cortex.
There are several explanations ventured for the term lupus erythematosus. Lupus is Latin for wolf, and "erythro" is derived from ερυθρός, Greek for "red. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. " All explanations originate with the reddish, butterfly-shaped malar rash that the disease classically exhibits across the nose and cheeks. In Medicine, malar rash, also called butterfly rash, is a Medical sign consisting of a characteristic form of facial rash