Women with these antibodies can have a higher incidence of spontaneous miscarriages. Although clotting problems in SLE typically lead to bleeding and bruising, some patients who develop antiphospholipid antibodies show evidence of thrombosis. This can lead to chest pain, shortness of breath, and cough and can be confused with pulmonary embolism and pneumonia.Ībout 50% of SLA patients have signs of hemolytic anemia, leukopenia, and thrombocytopenia. SLE can cause inflammation of the pleural membranes of the lung and accumulation of fluid in the pleural space. Swelling of hands and feet indicates renal involvement, which can lead to nephritis. The affected skin feels numb, tingly, and cold to the touch. In affected individuals, cold or stress can cause spasms in the impaired blood vessels, resulting in pain in the fingers and toes. Some patients with SLE develop Raynaud’s phenomenon. Pericarditis can mimic a heart attack, as it presents with severe, sudden pain in the center of the left side of the chest that may spread to the neck, back, shoulders, or arms. The inflammatory process can cause pericarditis, development of vegetations on heart valves (Libman-Sachs endocarditis), and vasculitis. SLE also affects the heart and blood vessels. The most common symptom is headaches, although others, such as thought and memory disturbances, personality changes, and numbness or weakness in arms and legs, can be present as well. They include seizures, nerve paralysis, severe depression, psychosis, and stroke. Nervous system disorders can develop as part of the disease. Alopecia can be permanent because of follicle damage caused by skin lesions or transient if it occurs without skin rashes. Some patients have only skin symptoms (discoid lupus). Inflammation of blood vessels in the skin causes red welts, small reddish spots on the skin or nail beds, and ulcers on mucous membranes. Typical findings in the skin include a butterfly-shaped rash across the cheeks and bridge of the nose and discoid lesions (coin-shaped, round, raised scaly formations that can lead to scarring). About half of these lesions are photosensitive (i.e., they worsen if exposed to sunlight). Skin inflammation and skin lesions can be seen in about 75% of patients. It can flare up during an acute lupus crisis. It is usually caused by the inflammatory process of the disease, not by infection. Low-grade fever occurs in 90% of patients. The severity of the pain ranges from mild to severe. The pain is rarely uniform it improves during the day and then recurs. The most frequently affected joints are fingers, wrists, elbows, knees, and ankles, often simultaneously on both sides of the body. Joint pain, one of the most common symptoms, is often accompanied by redness and swelling.
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