Mintalevél

Dr Tim Bell                                                                                       Bath Polyclinics

Family Health Care Centre                                                           6 Pine Lane

10 Oak Lane                                                                                    Bath BA1

Bath BA2                                                                                          UK

UK 

                                                                                                           16 Apr 2015

 

Dear Dr. Bell,

 

Thank you for referring this unusual case of a 23-year-old female patient of African origin who was taken to the emergency department because of unbearable joint pain and skin rash. In the past couple of weeks she has frequently had low grade fever, has become more and more tired and weak and has developed a severe headache, weight loss and patchy hear loss. She has also complained of having night sweats.

 

I agree with your preliminary diagnosis of systemic lupus erythematosus (SLE), which is an autoimmune disease. Further thorough examination is necessary in such a case.

 

You have to bear in mind that SLE is characterised by recurrent fever, weakness, fatigue, general malaise, photophobia, skin erythema, and hair loss. Besides the skin and the joints, SLE can also affect several other organs, e.g. the kidneys, the heart and the hematopoietic organs.

 

It should be highlighted that the incidence of SLE is nine times as high in the African and Asian populations as in other ones. The most characteristic clinical sign of the disease is the appearance of antinuclear autoantibodies and those against other antigens in the blood.

 

I wish to stress the fact that despite the gradually improving treatment options, SLE still cannot be cured.

 

It is wise to avoid unnecessary medication. The most important therapy is based on lessening the increased immune activity, reducing the symptoms, and in the case of damage to organs, organ supportive measures should be taken. The treatment strategy should be adapted to the actual clinical presentation of the patient.

 

Yours sincerely,

 

Dr Ede Bor