Systemic lupus erythematosus (SLE) and possibilities of a spa treatment

23-Aug-2011

SLE is an inflammatory rheumatic disease affecting mostly women between 20 and 50 years of age. It affects various tissues and organs and its course is chronic. Characteristic diagnosis is via a cytology examination – LE tests and confirmation of LE cell phenomenon, with test positivity in case of SLE ranging between 80% and 100%.

The cause of the disease is not known, most probably it is due to several factors such as hereditary predisposition, inadequate immune reaction to elements of one’s own tissues, certain virus infections, increased concentration of venereal hormones and long-term administration of certain medications (e.g. Hydralazine, Procainamide, Hydantoin derivatives).

Clinical course of the disease: the disease usually begins in grades and slowly, it often starts with slightly higher temperatures or irregular waves of fever, overall weakness, fatigue and losing of weight. Symptoms vary greatly; frequent are in particular skin symptoms (the acute phase of disease is typical for localised butterfly-shaped exanthema, possibly an erythema on the whole body), as well as joint pains (pain in several joints, episodic inflammations of one or several joints). These, together with morning stiffness of joints are the most frequent initial signs of SLE. An acute joint inflammation may affect any joint, but most often and typically it affects small joints of hands, wrists and knees. In approximately three quarters of patients the disease develops into a chronic, long-term joint inflammation (poly-arthritis). The disease may affect lungs (pneumonitis, pleuritis), heart (pericarditis, endocarditis), digestive system (inflammations of intestines, pancreas, liver), kidneys (lupus nephritis), spleen that is usually enlarged, lymphatic system (enlarged lymphatic nodes usually in the armpit area and under the jaws) as well as the central nervous system, including psychoses and depressions. Organs may be affected individually or in combination, and the disease is characteristic by having a chronic and long-term course during which acute attacks vary with repeated spontaneous remissions. Therefore, any treatment has to include treatment of acute phases as well as treatment of chronic and mostly progressing disease.

In the recent years we have seen significant progress in SLE treatment, which involves not only treatments by non-steroid antirheumatics and corticoids, but also administration of substances to suppress immune functions, which have successful impacts on the disease.

Spa treatment as such is contraindicated, but in case of certain less serious and stabilised patients we allow for the so-called modified treatment. It needs to be emphasised that in all cases any stimulating treatment procedure that would burden the overall regulation is contraindicated, as well as mud packs and all forms of photo-therapy. In such cases Health Spa Piešťany prescribes an isometric bath maximally 2 times per week and movement treatments to maintain flexibility of affected joints. However, the procedure needs to be more careful compared to other inflammatory rheumatic diseases. In case of a greater muscle weakness, isometric traction is used with submaximal force. Electroanalgesis is used to influence pain.