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    SLE vs MS

    Systemic lupus erythematosus

    Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder that may affect the skin, joints, kidneys, brain, and other organs.

    Causes, incidence, and risk factors

    Systemic lupus erythematosus (SLE) is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. This leads to long-term (chronic) inflammation.

    The underlying cause of autoimmune diseases is not fully known.

    SLE is much more common in women than men. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races.

    Symptoms

    Symptoms vary from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling. Some develop arthritis. Frequently affected joints are the fingers, hands, wrists, and knees.

    Other common symptoms include:

    Chest pain when taking a deep breath

    Fatigue

    Fever with no other cause

    General discomfort, uneasiness, or ill feeling (malaise)

    Hair loss

    Mouth sores

    Sensitivity to sunlight

    Skin rash -- a "butterfly" rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread.

    Swollen lymph nodes

    Other symptoms depend on what part of the body is affected:

    Brain and nervous system: headaches, numbness, tingling, seizures, vision problems, personality changes

    Digestive tract: abdominal pain, nausea, and vomiting

    Heart: abnormal heart rhythms (arrhythmias)

    Lung: coughing up blood and difficulty breathing

    Skin: patchy skin color, fingers that change color when cold (Raynaud's phenomenon)

    Some patients only have skin symptoms. This is called discoid lupus.
    __________________________________________________
    NEUROLOGICAL MANIFESTATIONS OF SLE

    White matter lesions on MRI similar to MS
    Mental status changes
    Short-term memory problems
    Confusion
    Seizures
    Cranial nerve involvement
    Optic neuritis
    Stroke
    Numbness/tingling face and extremities
    Weakness
    Transverse myelitis
    Fatigue

    As a general rule neurologic syndromes are often present at SLE presentation, and SLE should be considered in the following individuals:

    1. Young patients with new-onset confusional or psychiatric states, stroke, or parkinsonism.

    2. Patients presenting with a multifocal process affecting the CNS, especially if both CNS (eg, patients carrying the presumptive diagnosis of multiple sclerosis) and peripheral nervous systems (PNS) are affected.

    3. Patients with cranial neuropathies.

    4. Patients with noncompressive myelopathies.

    5. Patients with chorea, unexplained ataxia, myopathy, or polyneuropathy.
    __________________________________________________
    Signs and tests

    To be diagnosed with lupus, you must have 4 out of 11 typical signs of the disease.

    Your doctor will perform a physical exam and listen to your chest with a stethoscope. An abnormal sound called a heart friction rub or pleural friction rub may be heard. A nervous system exam will also be done.

    Tests used to diagnose SLE may include:

    Antibody tests, including antinuclear antibody (ANA) panel

    CBC

    Chest x-ray

    Kidney biopsy

    Urinalysis
    __________________________________________________
    Treatment

    There is no cure for SLE. The goal of treatment is to control symptoms.

    Mild disease may be treated with:
    Nonsteroidal anti-inflammatory medications (NSAIDs) treat arthritis and pleurisy

    Corticosteroid creams to treat skin rashes

    An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms

    You should wear protective clothing, sunglasses, and sunscreen when in the sun.

    Severe or life-threatening symptoms (such as hemolytic anemia, extensive heart or lung involvement, kidney disease, or central nervous system involvement) often require more aggressive treatment by doctor specialists.

    Treatment for more severe lupus may include:

    High-dose corticosteroids or medications to decrease the immune system response

    Cytotoxic drugs (drugs that block cell growth) if you do not get better with corticosteroids, or whose symptoms get worse when the stop taking them. These medicine have serious, severe side effects. You should be closely monitored by your doctor.

    If you have lupus, it is also important to have:

    Preventive heart care

    Up-to-date immunizations

    Tests to screen for thinning of the bones (osteoporosis)

    Talk therapy and support groups may help relieve depression and mood changes that may occur in patients with this disease.

    Resources: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001471/

    http://emedicine.medscape.com/articl...view#aw2aab6b5
    Disabled RN with MS for 14 years
    SPMS EDSS 7.5 Wheelchair (but a racing one)
    Tysabri

    #2
    I was recently diagnosed with SLE (within the last 2 weeks) and would love to hear from other MS'er who have been thru this. It has thrown me into a horrible depression. I was just about weened off my cymbalta but went back to the full dose and it has helped a lil but this is very hard to deal with. My adoptive grandmother died 3 years after recieving this diagnosis. I know times have changed and people can live longer with the newer medicines we have now but I am scared to death.

    Comment


      #3
      Originally posted by mommyto3angels View Post
      I was recently diagnosed with SLE (within the last 2 weeks) and would love to hear from other MS'er who have been thru this. It has thrown me into a horrible depression. I was just about weened off my cymbalta but went back to the full dose and it has helped a lil but this is very hard to deal with. My adoptive grandmother died 3 years after recieving this diagnosis. I know times have changed and people can live longer with the newer medicines we have now but I am scared to death.
      Wow! You have all 3! How horrible for you! I am so sorry!
      I hope someone will join in with some experience with lupus. I had a good friend with it who did quite well although he had a lot of pain in his joints with it, but that is all he had.

      Take care
      Lisa
      Disabled RN with MS for 14 years
      SPMS EDSS 7.5 Wheelchair (but a racing one)
      Tysabri

      Comment


        #4
        I was diagnosed with RA first ,then MS and two months later SLE. Spent the last 2 years testing and retesting to convince myself how in the world can you have all 3 diseases together. Talk to many doctors and most of them said that same thing ...Its rare to see them in this combination but they are all autoimmune diseases and once you get one AI disease you may get another.

        Now my SLE does not show in my brain (no sle lesion ,just ms lesion in my brain and spine ) . The sle showed up in the blood work and mild symptoms. In my case my skin shows the signs (malar rash, discoid spots) . If it weren't for those things it would be hard for me to tell the symptoms apart from some of my MS and RA symptoms. Know I still have my doubts and think that I always will. But the SLE scares me more than the MS. Mainly because it can attack then heart and lungs ect... but then again so might the RA and MS. I'm not afraid that it may shorten my life as they have come a long way with dmd's. Maybe I should say I feel more uneasy about have SLE than with the MS .
        dx.SPMS (baclofen,gabapenin,norco)
        started tecfidera 7/10/2013
        rituxan 11/13/2012 stopped due to side effect &it didn't help me (for RA and MS)
        copaxone started 4/2012 but stopped due to bad allergic reaction
        Matt.19;26 “With man this is impossible, but with God all things are possible.”

        Comment


          #5
          Originally posted by wheeliegirl View Post
          I was diagnosed with RA first ,then MS and two months later SLE. Spent the last 2 years testing and retesting to convince myself how in the world can you have all 3 diseases together. Talk to many doctors and most of them said that same thing ...Its rare to see them in this combination but they are all autoimmune diseases and once you get one AI disease you may get another.

          Now my SLE does not show in my brain (no sle lesion ,just ms lesion in my brain and spine ) . The sle showed up in the blood work and mild symptoms. In my case my skin shows the signs (malar rash, discoid spots) . If it weren't for those things it would be hard for me to tell the symptoms apart from some of my MS and RA symptoms. Know I still have my doubts and think that I always will. But the SLE scares me more than the MS. Mainly because it can attack then heart and lungs ect... but then again so might the RA and MS. I'm not afraid that it may shorten my life as they have come a long way with dmd's. Maybe I should say I feel more uneasy about have SLE than with the MS .


          I'm so glad someone with experience answered. I have so many questions but don't even know which ones to ask. How do tell the differance between each problem and which dr to call? How do you know if it's going to start to attack your organs, is there anything you can do to prevent it? I know you have to take the meds but I wanna do something more. I've read about diets but there are so many confusing ones and I also read having sle put us at a higher risk for cancer yet the diets say to cut out tomatoes which help fight cancer. Idk it's all just so confusing, and I don't go back to the rumutologist for another 6 weeks

          Comment


            #6
            Hi Mommyto3angels and wheeliegirl!

            Just a few days ago an extremely relevant abstract was published which you may want to check out. Find it at http://www.medpagetoday.com/MeetingCoverage/ACR/36003.

            Also, there is one drug, Rituximab, which has had good results in RA, SLE, and in a Phase 2 trial of MS. Google it to develop your knowledge and be sure click this link, also… http://neuroimmunology.wordpress.com...ple-sclerosis/
            Your doctor would probably know Rituximab as Rituxan and would be able to prescribe it if it was appropriate for you. It is very similar to natalizumab (Tysabri) BUT appears to be much safer. The Phase2 trial of Rituximab in MS patients showed its effectiveness very similar to Tysabri.

            Used in RA, 6 patients out of about 120,000 developed PML using Rituxan.

            Used in MS, about 300 patients out of about 100,000 developed PML using Tysabri, a similar drug.

            Used in SLE, some patients have developed PML using Rituxan but I have not researched how many.
            Just Google that question to start your research, if you wish.

            A main point to make is that Rixtuximab does have risk BUT SO DOES MS, RA, and SLE!!!!!!!!!

            Any possible treatment should be thoroughly considered and none more so than one with potential to treat all 3.

            God Bless You Both and very special thanks to Lisa for all your efforts to bring comfort and help to those who need it most. Surely Lisa, you are one of God's favorites. You have our sincere appreciation, too.

            Comment


              #7
              SLE & MS

              I have both MS & SLE. I have had both since 2007.

              I'm still very much alive! Lupus does not shorten the lifespan as it once did.

              For medication I take plaquenil & COPAXONE. Copaxone's side effect list is FILLED with warnings that it is carcinogenic. I worry much more about that risk than I worry about cancer from lupus.

              The best advice for treating symptoms and staying well that I can give is to radically change your diet - it is so worth it. Since I started juicing vegetables daily - about 30 ounces a day of juiced Kale, Cabbage, Carrots, Apples, Collard Greens, squash, zucchini - I feel so much better - less fatigue, more mental clarity, much better mood, less pain. I am avoiding gluten and dairy as well.

              When I was first tested for lupus, my titer was 1:640. After treating with plaquenil, it is 1:80. 1:80 is considered "borderline lupus" and 1:40 is normal. So, in my case, the disease is well controlled with just Plaquenil alone - but symptoms are still there. I hope it will be the same for you.

              You're right, it is near impossible to decipher the MS symptoms from lupus symptoms. I have achey joints, headaches, intolerance to cold or heat, confusion and fatigue, muscle spasms, malaise.


              Lupus symptoms that have gotten worse over 5 years are:

              The joint pain has spread from my hands/wrists, feet/knees to include shoulders, low back, & individual finger joints.

              The fatigue has gotten worse for sure. I was exercising (yoga/walking/eliptical) 5 days a week in 2007-08. In 2009 the fatigue became so overwhelming I had to stop working. Now I can't tell if the lingering fatigue is from illness or from taking DMD copaxone.

              That crappy sick feeling - malaise - I feel that way most of the time - that's the most difficult symptom for me to overcome. Many days I feel "sick" with a slight sore throat, swollen glands, flu-like symptoms. Is it from the DMD? or from a disease? No one knows. Since beginning the juice regimen 2 months ago & making dietary changes, this symptom has improved dramatically.

              Lupus has not affected any of my organs. For me, a prolonged infection is the worst enemy -- lupus making it more difficult to fight the infection & the prolonged infection may trigger an MS relapse.

              My second MS attack followed a UTI that was treated for about a year on and off before it was cured. In the future, I will always check in with my rheumatologist before taking an antibiotic because we often need to take them longer to fight infection - the urologist did not know this.

              As far as which doctor to ask about which symptom? I tell both of them all my symptoms & they tell me which is which... & that many are related to both MS and Lupus.

              In my case, the neuro treats muscle spasticity, fatigue, cognitive, numbness, muscular pain.

              Rheumatologist treats skin, joints, lungs, heart, kidneys.

              I wish you peace of mind and many brighter days ahead.

              Jade

              Comment


                #8
                Originally posted by Jade Divine View Post
                I have both MS & SLE. I have had both since 2007.

                I'm still very much alive! Lupus does not shorten the lifespan as it once did.

                For medication I take plaquenil & COPAXONE. Copaxone's side effect list is FILLED with warnings that it is carcinogenic. I worry much more about that risk than I worry about cancer from lupus.

                The best advice for treating symptoms and staying well that I can give is to radically change your diet - it is so worth it. Since I started juicing vegetables daily - about 30 ounces a day of juiced Kale, Cabbage, Carrots, Apples, Collard Greens, squash, zucchini - I feel so much better - less fatigue, more mental clarity, much better mood, less pain. I am avoiding gluten and dairy as well.

                When I was first tested for lupus, my titer was 1:640. After treating with plaquenil, it is 1:80. 1:80 is considered "borderline lupus" and 1:40 is normal. So, in my case, the disease is well controlled with just Plaquenil alone - but symptoms are still there. I hope it will be the same for you.

                You're right, it is near impossible to decipher the MS symptoms from lupus symptoms. I have achey joints, headaches, intolerance to cold or heat, confusion and fatigue, muscle spasms, malaise.


                Lupus symptoms that have gotten worse over 5 years are:

                The joint pain has spread from my hands/wrists, feet/knees to include shoulders, low back, & individual finger joints.

                The fatigue has gotten worse for sure. I was exercising (yoga/walking/eliptical) 5 days a week in 2007-08. In 2009 the fatigue became so overwhelming I had to stop working. Now I can't tell if the lingering fatigue is from illness or from taking DMD copaxone.

                That crappy sick feeling - malaise - I feel that way most of the time - that's the most difficult symptom for me to overcome. Many days I feel "sick" with a slight sore throat, swollen glands, flu-like symptoms. Is it from the DMD? or from a disease? No one knows. Since beginning the juice regimen 2 months ago & making dietary changes, this symptom has improved dramatically.

                Lupus has not affected any of my organs. For me, a prolonged infection is the worst enemy -- lupus making it more difficult to fight the infection & the prolonged infection may trigger an MS relapse.

                My second MS attack followed a UTI that was treated for about a year on and off before it was cured. In the future, I will always check in with my rheumatologist before taking an antibiotic because we often need to take them longer to fight infection - the urologist did not know this.

                As far as which doctor to ask about which symptom? I tell both of them all my symptoms & they tell me which is which... & that many are related to both MS and Lupus.

                In my case, the neuro treats muscle spasticity, fatigue, cognitive, numbness, muscular pain.

                Rheumatologist treats skin, joints, lungs, heart, kidneys.

                I wish you peace of mind and many brighter days ahead.

                Jade



                Thanks thats alot of usefull info, you don't know how much it helps to read this right now

                Comment


                  #9
                  I am going through this now as they are still trying to diagnose me. I had all the blood work and ana tests. They only said my levels were high and did not give me a number. I have inflammation somewhere, so they put me on 60 mgs a day of prednisone which is making me have all kinds of side effects. Anyways they are looking at lupus or another autoimmune
                  disease. No MS diagnosis yet either. I have had two mris but only had a couple small lesions. I started with symptoms over a year and a half ago and still trying to find out what is wrong.

                  Comment


                    #10
                    Originally posted by acaverly View Post
                    I am going through this now as they are still trying to diagnose me. I had all the blood work and ana tests. They only said my levels were high and did not give me a number. I have inflammation somewhere, so they put me on 60 mgs a day of prednisone which is making me have all kinds of side effects. Anyways they are looking at lupus or another autoimmune
                    disease. No MS diagnosis yet either. I have had two mris but only had a couple small lesions. I started with symptoms over a year and a half ago and still trying to find out what is wrong.


                    Hopefully you get your answers quickly!

                    Comment


                      #11
                      Sorry that I haven't responded in so long. I just did 2 infusions of rituxan and yes it was for my ms/ra/sle . Its the only treatment that I can take at the moment as I'm either allergic or can't take other treatments due to problems.
                      I

                      I don't remember who asked this question on how can I tell the difference between my MS and SLE.
                      Its hard . The main to things is the malar rash and the small discoidal (sp?) rashes I get . Everything else is just mimicking symptoms.
                      I do not know if the lupus has affected my organs at this point. Again hard to tell as RA can affect the heart,lungs,bowels/bladder and eyes too. Then with the the MS affecting the eyes and bowel/bladder you can see the problem. I also have spinal damage causing problems with my bladder/bowels too.

                      It would be a little easier (no much) if one had just MS and lupus . The other thing is one can have CNS lupus with cause lesions on the brain but in other areas than were the MS lesions show up. CNS lupus is not common .

                      Back to the Rituxan . I've not seen any good changes yet and I've had side effects to deal with . One being I'm one of the few people to see hair thinning by the 3 day after infusion . Now that being said it slowing down some now as I'm on my 9th day after my 2nd infusion. Still may be to soon to see any improvements.

                      If this doesn't help me any I'll not be doing the infusions again.
                      dx.SPMS (baclofen,gabapenin,norco)
                      started tecfidera 7/10/2013
                      rituxan 11/13/2012 stopped due to side effect &it didn't help me (for RA and MS)
                      copaxone started 4/2012 but stopped due to bad allergic reaction
                      Matt.19;26 “With man this is impossible, but with God all things are possible.”

                      Comment


                        #12
                        Hi Wheeliegirl,

                        Rituxan may work for you if you give it time. Certainly your doctor can advise on an appropriate length of time trying it.

                        I saw your scripture that with God all things are possible and offer this one from Proverbs 8:12, “I wisdom dwell with prudence, and find out knowledge of witty inventions”.

                        If you can hang in there Rituxan may be the “witty invention” effective in your health. Do let us know, we learn from each other. Best to Ya!

                        Comment


                          #13
                          Thank you Myoak . I'll let everyone know how it is working soon as it kicks.
                          dx.SPMS (baclofen,gabapenin,norco)
                          started tecfidera 7/10/2013
                          rituxan 11/13/2012 stopped due to side effect &it didn't help me (for RA and MS)
                          copaxone started 4/2012 but stopped due to bad allergic reaction
                          Matt.19;26 “With man this is impossible, but with God all things are possible.”

                          Comment


                            #14
                            just a call in to say hi, i don't have lupus but quite some yrs back before i was diagnosed with MS, i was quite ill for a while and MS was one of the things that was considered.

                            I am an RN and at the time, lots of RN's at the facility i worked at heard on the grape vine and offered support, they were all people who had lupus or who were in lupus limbo- i was quite astounded at how many had more than one auto immune condition including MS -

                            i have often wondered considering the auto immune conditions are supposedly on the less common list, is it really more common in folk like nurses who work shift work or is it just that they pick up on some of the less obvious symptoms and start getting checked out earlier- i guess it could just be the effects of randomness but i do not have a big peer group these days due t my mobility issues but both MS and LUPUS are well represented in that group unfortunately

                            ** Moderator's note - Post broken into paragraphs for easier reading. Many people with MS have visual difficulties that prevent them from reading large blocks of print. **

                            Comment


                              #15
                              I am/was an R.N., have MS, have Psoriatic Arthritis, and doctor was getting suspicious, last summer for SLE, due to a distinct "butterfly-rash". I just roll my eyes some days. AI disorders are cruel.
                              Live simply. Love generously. Care deeply. Speak kindly.

                              Comment

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