What is Systemic Lupus Erythematosus?
Systemic Lupus Erythematosus (SLE, commonly referred to as lupus) is an autoimmune disorder characterised by immune system dysfunction, resulting in the production of excessive antibodies that attack the body's own tissues. Typical symptoms include arthritis, rashes (such as the butterfly-shaped rash across the cheeks), and photosensitivity. In severe cases, it may impair the kidneys, lungs, or nervous system, leading to life-threatening complications such as renal failure or stroke. The condition predominantly affects young women, with a male-to-female ratio of about 1:9. Genetic predisposition or hormonal medications may trigger the disease, though its precise ethology remains incompletely understood.
Diagnostic Challenges
The diagnosis of lupus adheres to international standards, integrating clinical manifestations with laboratory tests, including antinuclear antibody (ANA) and other specific autoantibody assessments. Dr Yeung Wan-yin, Consultant in Rheumatology at Gleneagles Hospital Hong Kong, points out that due to symptomatic overlap with conditions like rosacea or eczema, misdiagnosis is common, often requiring referrals to dermatology, nephrology, or other specialties before confirmation by a rheumatologist, resulting in treatment delays. Fortunately, advancements in diagnostic technology and heightened public awareness have notably reduced such delays.
Treatment Advances: Leveraging Modern Technology to Minimise Side Effects
Currently, there is no cure for lupus, with treatment focused on symptom management and prevention of organ damage. Historically, corticosteroids were the mainstay for mild symptoms, but prolonged use may lead to side effects such as osteoporosis or diabetes. Contemporary approaches combine low-dose corticosteroids, immunosuppressive drugs, and novel biologic therapies, which target specific immune pathways, reducing reliance on high-dose corticosteroids and mitigating side effects and infection risks. Dr Yeung underscores the critical role of physician-patient communication, emphasising personalised treatment plans and psychological support to empower patients to lead fulfilling lives despite the disease's challenges. 🔎Click here to listen to Dr Yeung Wan-yin (in Cantonese only) discussion on systemic lupus erythematosus for a comprehensive exploration of the latest treatment strategies.
什麼是紅斑狼瘡？
系統性紅斑狼瘡（SLE，俗稱紅斑狼瘡）是一種自身免疫疾病，因免疫系統失調，產生過量抗體攻擊自身組織，導致全身性炎症反應。常見症狀包括關節炎、皮疹（如臉頰上的蝴蝶斑）及光敏感。嚴重者可能會出現腎臟、肺部或神經系統病變，甚至導致腎衰竭或中風等致命的併發症。此病好發於年輕女性，男女比率約為一比九。遺傳及荷爾蒙藥物等風險因素皆可能誘發此症，但確切病因尚未完全明確。
診斷與挑戰
紅斑狼瘡的診斷依據國際標準，結合臨床症狀、血液檢查以及抗核抗體（ANA）和其他特定抗體檢測。港怡醫院風濕病科顧問醫生楊韻姸指出，由於部分症狀與玫瑰痤瘡或濕疹等疾病相似，導致誤診時有發生。患者可能需經皮膚科、腎科等多科轉介，最終才確診為風濕科疾病，導致治療延誤。幸而，隨著公眾認知的提升及診斷技術的進步，延誤情況已有所改善。
治療進展：結合現代技術降低治療副作用
目前醫學尚無根治紅斑狼瘡的方法，治療目標為控制症狀及預防器官損傷。過去主要依賴皮質類固醇，對輕症有效，但長期使用可能導致骨質疏鬆或糖尿病等副作用。現代治療結合低劑量類固醇、免疫抑制劑及新型生物製劑，後者針對特定免疫途徑，可減少對高劑量類固醇的依賴，降低副作用及感染風險。楊醫生強調醫患溝通至關重要，透過個人化治療及心理支援，幫助患者克服疾病挑戰，維持充實的生活。 🔎請按此收聽楊韻姸醫生講述有關於系統性紅斑狼瘡的討論，深入了解最新治療策略。 | 
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