Patients with lupus may develop Raynauds phenomenon - a tendency for the fingers to go dead white then bluish on exposure to cold.
After the confusion created by the many different diseases once called lupus, nowadays, in practice, the term is reserved for two types, both related.
Inflammation of veins - "thrombophlebitis" is an occasional complication of lupus, though of course, it is a common enough medical problem on its own. There is still uncertainty as to how frequently the brain is affected in SLE ( Systemic Lupus Erythematosus) .
It is almost certain that as milder (and earlier) cases of lupus are diagnosed, this figure will fall.
Lupus may strike aggressively as an acute and severe illness, or grumble on undiagnosed for many years.
This phenomenon, which may precede the diagnosis of lupus by many years, is, of course, not unique to SLE and is also seen in otherwise healthy individuals.


Systemic lupus, which is so called because it affects internal organs, generally produces a mild rash or flush on the face. It differs from the other organs involved in lupus in that it has limited powers of healing. Discoid lupus on the other hand, usually causes a much more pronounced, and sometimes scarring rash on the face, and may also result in severe hair loss and scarring of the scalp. It is very difficult to be sure clinically, for example whether an attack of depression in lupus is simply the natural reaction to a bad disease and its treatment, or whether it represents the (albeit mild) effects of inflammation in brain tissues. Despite the severity of the skin rash, discoid lupus paradoxically produces little or no internal disease. The brain (as is the case with other organs) has only a limited number of ways of reacting to "insults" such as inflammation - there can be disturbances of the normal thought processes (eg depression, hallucinations, odd behaviour), or there can be more marked abnormalities such as an attack of epilepsy, or the development of severe migraines.It is evident that mild episodes of brain involvement during active lupus are extremely common.
While joint pains or a rash may quickly bring the patient to the doctor, a "smouldering" inflammation in the kidney may go undetected until irreversible damage is done.It is for this reason that lupus nephritis has the bad reputation it does.


This tendency of the inflammation of tendons waxes and wanes as do so many of the features of lupus. It is tempting to think that these symptoms are related - possibly that the lupus had been present all along. Obviously this will influence the choice of how much treatment is needed.Traditionally, textbooks have tended to quote a figure of 40-50% for "significant" kidney involvement in lupus. While such a patient may well never have another attack in her life, at the present time there are no medical tests sufficiently clear-cut to convince the powers of the law that lupus patients can be treated more compassionately.



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