Lupus Erythematosus

Description

Lupus erythematosus is a chronic inflammatory degenerative disorder of the skin and connective tissues. There are two major forms: discoid lupus erythematosus and systemic lupus erythematosus.

Discoid lupus erythematosus
The milder form, affects the skin only. For unknown reasons antimalarial drugs are effective treatment for this disorder; they are particularly effective against the rash which develops.

Systemic lupus erythematosus
Characterized by remission and exacerbation, is a disease of the blood vessels and connective tissues. It affects the joints, skin and other body organs. It can be mild or severe, causing irreversible damage to the blood vessels and kidneys. Death is also possible. Systemic lupus erythematosus occurs in about 75 per one million persons. During non-childbearing years, women are affected eight times as often as men and during childbearing years, 15 times as often. At present no cure is available. A mild case of systemic lupus erythematosus may require little or no treatment. For more severe forms, aspirin and other analgesics for pain, cortisone and other steroids for inflammation and antimalarial drugs may be prescribed.

Causes

The exact cause of lupus erythematosus is not known.

Three major theories exist:
One theory states that systemic lupus erythematosus is caused by an abnormal body reaction to its own tissues, resulting from an autoimmune breakdown. The body produces anti-self bodies, such as antinuclear antibody (ANA), which react against different tissues, resulting directly in their damage. Antigen-antibody complexes can subsequently deposit in the kidneys and joints, indirectly predisposing them to further damage by the immune system.

Another theory states certain predisposing factors make a person susceptible to systemic lupus erythematosus:

Physical or mental stress	Streptococcal or viral infections
Immunization	Pregnancy
Genetic disposition	Exposure to sunlight or ultraviolet

The third theory states systemic lupus erythematosus is triggered or aggravated by the use of certain medications:

Procainamide	Hydralazine
Anticonvulsants	Penicillins
Sulfa drugs	Oral contraceptives

Signs & Symptoms

Discoid lupus erythematosus

Rash on the cheeks, nose and, less frequently, on other body parts; this may occur after the skin is exposed to sunlight
Raised, red, scaly plaques with follicular plugging and central atrophy
Hypo- or hyperpigmentation
Hair loss

Systemic lupus erythematosus

Depression	Non-deforming arthritis
Severe joint pain	Photosensitivity
Headache	Fatigue
Aches	Malaise
Low grade or spiking fever	Chills
Anorexia	Weight loss
Lymph node enlargement	Abdominal pain
Nausea	Diarrhea
Constipation	Irregular menstruation
Amenorrhea	Patchy baldness
Mucous membrane ulcers	Irritability

Stiffness, especially of the hands, feet, and large joints
Red patches on the nose and cheeks which resemble open-winged butterflies
Joints may be: Red, warm, tender, or have synovial effusion; associated muscles may be weak and tender

Blood disorders

Blood clotting defects	Leukopenia
Thrombocytopenia	Hemolytic anemia

Vasculitis leading to

Infarctive lesions	Digital gangrene
Necrotic leg ulcers

Cardiopulmonary abnormalities

Pleuritis	Endocarditis
Pericarditis	Tachycardia
Dyspnea	Pneumonitis
Myocarditis

Kidney diseases which may progress to total renal failure include

Bloody urine	Cellular casts
Protein in urine	Urinary tract infections
Urinary sediments

Neurological damage such as:

Convulsive disorders	Psychosis
Mental dysfunction	Organic brain damage
Emotional instability

Nutritional Supplements

Structure & Function:
        Antioxidants
        Immune System Support
        Intestinal Health
        Circulatory Support &
        Nutrients for Brain Support

---------------------------------
General Supplements
---------------------------------

	Adult	Child/Adolescent
Beta-carotene	10 - 20 mg	5 - 10 mg
Bioflavonoids	100 - 500 mg	50 - 200 mg
DHEA*
Fish oils	1 - 3 g	1 - 2 g
PABA	100 - 200 mg	50 - 100 mg
Selenium	100 - 200 mcg	50 - 100 mcg
Spirulina*
Vitamin E	800 - 2,000 IU	400 - 800 IU

* Please refer to the respective topic for specific nutrient amounts.

Discussion:-

* EPA as fish oils may be taken up to 6 gms daily.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

Low Fat Diet (Pritikin)

Homeopathic Remedy

1. Thuja occidentalis tinct. - 30C long term
2. Arsenicum Album - 30C long term
3. Hydrocotyle tinct.- 30C long term
4. Rhus Toxicodendron - 30C long term

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

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Herbs
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Aloe vera plant
Comfrey
Marshmallow
Yarrow

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Contraindications:

Although evidence is slight, it is always better to err on the side of caution.

Progressive conditions (e.g. multiple sclerosis and lupus as well as auto-immune disorders, including AIDS) are considered by some authorities to warrant a warning against the use of echinacea.

More research is needed to ascertain whether the whole extract, or which part, has this effect and if it translates to the clinical situation.

Alfalfa is antagonistic and contra-indicated.

References:

Blumenthal, M. German Commission E Monograph for Echinacea purperea herb. HerbalGram, 1994, 30:48.

Bodinet, C. et al: Host resistance increasing activity of root extracts from Echinacea species. Planta Med. 1993, 59(Supp): A672.

Bukovsk? M et al., [Immunomodulating activity of ethanol-water extracts of the roots of Echinacea gloriosa L., Echinacea angustifolia DC. and Rudbeckia speciosa Wenderoth tested on the immune system in C57BL6 inbred mice] Cesk Farm, 1993 Aug, 42:4, 184-7.

DeSmet, P. et al. (Eds.), Adverse Effects of herbal Drugs 2. Springer Verlag, Berlin, 1994.

Lersch C et al., Nonspecific immunostimulation with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea extracts (echinacin) in patients with far advanced colorectal cancers: preliminary results. Cancer Invest, 1992, 10:5, 343-8.

Luettig B et al., Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst, 1989 May 3, 81:9, 669-75.

Mengs U et al., Toxicity of Echinacea purpurea. Acute, subacute and genotoxicity studies. Arzneimittelforschung, 1991 Oct, 41:10, 1076-81.

See DM et al., In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients.

Wichtl, M. Herbal Drugs & Phytopharmaceuticals. CRC, Boca Raton, 1994.

Aromatherapy - Essential Oils

Clove Essence.

Related Health Conditions

Aches	Infection
Anemia	Inflammation
Arthritis	Kidney disease
Blood clot	Menstruation
Constipation	Oral contraceptives
Depression	Pain
Diarrhea	Pregnancy
Fatigue	Stress
Fever	Urethritis
Headache

Abstracts

References

Ayres, S. & R. Mihan. Is Vitamin E Involved in the Autoimmune Mechanism? Cutis, 21. 1978.

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Blumenthal, M. German Commission E Monograph for Echinacea purperea herb. HerbalGram, 1994, 30:48.

Bodinet, C. et al: Host resistance increasing activity of root extracts from Echinacea species. Planta Med. 1993, 59(Supp): A672.

Bukovsk? M et al., [Immunomodulating activity of ethanol-water extracts of the roots of Echinacea gloriosa L., Echinacea angustifolia DC. and Rudbeckia speciosa Wenderoth tested on the immune system in C57BL6 inbred mice] Cesk Farm, 1993 Aug, 42:4, 184-7.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide, William Morrow and Company Inc., Pub. 594 pp.

Das, U.N. et al: Free Radicals, Lipid Peroxidation, and Essential Fatty Acids in Patients With Pneumonia, Septicemia, and Collagen Vascular Diseases. Journal of Nutritional Medicine, 1992;3:117-127.

DeSmet, P. et al. (Eds.), Adverse Effects of herbal Drugs 2. Springer Verlag, Berlin, 1994.

Formiga F et al., Loss of bone mineral density in premenopausal women with systemic lupus erythematosus. Ann Rheum Dis, 1995 Apr, 54:4, 274-6.

Formiga F et al., Bone mineral density and hormonal status in men with systemic lupus erythematosus. Lupus, 1996 Dec, 5:6, 623-6.

Formiga F et al., The association of dehydroepiandrosterone sulphate levels with bone mineral density in systemic lupus erythematosus. Clin Exp Rheumatol, 1997 Jul-Aug, 15:4, 387-92.

Guyton, A.C. 1976. Textbook Of Medical Physiology 5th ed. Saunders Pub Co., Philadelphia. 1194 pp.

Hamilton, H. K. ed. 1982. Professional Guide To Diseases Intermed Communications Inc. Pub, Springfield, Massachusetts. 1323 pp.

Hearth-Holmes M et al., Dietary treatment of hyperlipidemia in patients with systemic lupus erythematosus. J Rheumatol, 1995 Mar, 22:3, 450-4.

Horrobin, D. Clinical Uses Of Essential Fatty Acids. Montreal, Canada: Eden Press, 1972.

Ilowite NT et al., Effects of dietary modification and fish oil supplementation on dyslipoproteinemia in pediatric systemic lupus erythematosus. J Rheumatol, 1995 Jul, 22:7, 1347-51.

Isenberg, D.A. & M.L. Snaith. Variation in Circulating Immune Complexes Levels with Diet. Annals Of Rheumatic Diseases, 40. 1981.

Karlson EW et al., The relationship of socioeconomic status, race, and modifiable risk factors to outcomes in patients with systemic lupus erythematosus. Arthritis Rheum, 1997 Jan, 40:1, 47-56.

Kremer, J.M. Effects of Manipulation of Dietary Fatty Acids on Clinical Manifestations of Rheumatoid Arthritis. Lancet. January 26, 1985.

Lersch C et al., Nonspecific immunostimulation with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea extracts (echinacin) in patients with far advanced colorectal cancers: preliminary results. Cancer Invest, 1992, 10:5, 343-8.

Luettig B et al., Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst, 1989 May 3, 81:9, 669-75.

Matsukawa Y et al., Ectopic calcinosis possibly due to 1 alpha (OH) vitamin D3 in a patient with systemic lupus erythematosus. Clin Exp Rheumatol, 1995 Jan-Feb, 13:1, 91-4.

Mengs U et al., Toxicity of Echinacea purpurea. Acute, subacute and genotoxicity studies. Arzneimittelforschung, 1991 Oct, 41:10, 1076-81.

Molad, Y. et al: Serum Cobalamin and Transcobalamin Levels in Systemic Lupus Erythematosus. The American Journal of Medicine, February 1990;88:141-144.

Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York.

Pisetsky DS et al., Systemic lupus erythematosus. Diagnosis and treatment. Med Clin North Am, 1997 Jan, 81:1, 113-28.

Rider JR et al., Human cytomegalovirus infection and systemic lupus erythematosus. Clin Exp Rheumatol, 1997 Jul-Aug, 15:4, 405-9.

Schroeder JO & Euler HH: Recognition and management of systemic lupus erythematosus. Drugs, 1997 Sep, 54:3, 422-34.

See DM et al., In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients.

Strand V: Approaches to the management of systemic lupus erythematosus. Curr Opin Rheumatol, 1997 Sep, 9:5, 410-20.

Thorner, A. et al: Beneficial Effects of Reduced Intake of Polyunsaturated Fatty Acids in the Diet For One Year in Patients With Systemic Lupus Erythematosus. Annals of Rheumatic Diseases, February 1990; 49(2):134.

Van Vollenhoven RF & McGuire JL: Studies of dehydroepiandrosterone (DHEA) as a therapeutic agent in systemic lupus erythematosus. Ann Med Interne (Paris), 1996, 147:4, 290-6.

Wallace DJ et al., Use of hyperbaric oxygen in rheumatic diseases: case report and critical analysis [see comments]. Lupus, 1995 Jun, 4:3, 172-5.

Wichtl, M. Herbal Drugs & Phytopharmaceuticals. CRC, Boca Raton, 1994.

Yell, J. A. et al: Vitamin E and Discoid Lupus Erythematosus. Lupus, 1992;1:303-305.

Yell JA et al., Cutaneous manifestations of systemic lupus erythematosus. Br J Dermatol, 1996 Sep, 135:3, 355-62.