Central Nervous System
General Manifestations of SLE
Fatigue is a nearly universal complaint of persons with Systemic Lupus Erythematosus (SLE), even when no other manifestations of the disease are present. The cause of this debilitating fatigue is not known. The person should be evaluated for factors that may exacerbate fatigue, such as overexertion, insomnia, depression, stress, anemia, and other inflammatory diseases. Fatigue in SLE people may be lessened by adequate rest, healthful diet, exercise, and attention to psychosocial factors.
Many people with SLE experience changes in weight. At least one-half of people report weight loss before being diagnosed with SLE. Weight loss in SLE persons may be attributed to a decreased appetite, side effects of medications, gastrointestinal problems, or fever. Weight gain can occur in some people and may be due in part to prescribed medications, especially corticosteroids, or fluid retention from kidney disease.
Episodic fever is experienced by more than 80 percent of SLE patients, and there is no particular fever pattern. Although high fevers can occur during a Lupus flare, low-grade fevers are more frequently seen.
A complicating infection is often the cause of an elevated temperature in a person with SLE. The person’s white blood count (WBC) may be normal to elevated with an infection, but low with SLE alone. However, certain medications, such as immunosuppressives, will suppress the WBC even in the presence of fever. Therefore, it is important to rule out other causes of a fever, including an infection or a drug reaction. Urinary and respiratory infections are common in SLE people.
Psychological and emotional effects, such as grief, depression, and anger, are commonly experienced by those with lupus. These can be related to the outward changes caused by the disease, such as skin alterations, as well as by other aspects of the disease and its treatment. It is important for health professionals to be alert to potential psychological repercussions and to assist in alleviating them.