Subacute
What is lupus?
Lupus is a chronic (long-lasting) type of autoimmune disease.Autoimmune diseases happen when your immune system attacks healthy cells and tissues by mistake. This attack causes inflammation. It can also damage many parts of the body, including the joints, skin, kidneys, heart, lungs, and brain.
There are several types of lupus:
- Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
- Cutaneous lupus affects the skin. It causes a rash or sores, usually after your skin is exposed to sunlight. The two major types of cutaneous lupus are discoid lupus and subacute cutaneous lupus.
- Drug-induced lupus is caused by a reaction to some medicines. The symptoms may start 3 to 6 months after starting the medicine. The symptoms usually go away when you stop taking the medicine.
- Neonatal lupus, which is rare, affects newborns. It is caused by certain antibodies that are passed from the pregnant parent to the baby.
The cause of lupus is unknown. Researchers are studying what might cause or trigger the disease, such as:
- Genetics
- Environmental factors, such as viral infections, sunlight, certain medicines, and smoking
- Problems with the immune system
Anyone can get lupus, but women get it much more often than men.
Lupus is more common in African Americans than in White people. It is also more common in people of American Indian and Asian descent. African American and Hispanic women are more likely to have severe forms of lupus.
What are the symptoms of lupus?Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are:
- Arthritis, causing painful and swollen joints and morning stiffness
- Fever
- Fatigue or feeling tired often
- Red rashes, most often on the face (also called the "butterfly rash")
- Chest pain when taking a deep breath
- Hair loss
- Pale or purple fingers or toes, from cold and stress (Raynaud's disease)
- Sensitivity to the sun
- Swelling in legs or around eyes
- Mouth ulcers
- Swollen glands
- Headache and dizziness
- Confusion and memory problems
Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time.
What other problems can lupus cause?Lupus causes inflammation throughout your body. This can cause problems in your organs, including:
- Kidney damage (lupus nephritis).
- Heart problems, including inflammation in the heart (myocarditis), heart valves, or lining of the heart muscle (pericarditis).
- Inflammation of blood vessels (vasculitis).
- Blood clots
- Inflammation of the tissue that surrounds the lungs (pleurisy). This can make it painful to breathe.
Some people with lupus may be more likely to develop other conditions, such as coronary artery disease (CAD) and atherosclerosis.
How is lupus diagnosed?There is no specific test for lupus, and it's often mistaken for other diseases that cause similar symptoms. So it may take a while to get a diagnosis. To find out if you have lupus, your health care provider:
- Will ask about your symptoms, medical history, and family health history
- Will do a complete physical exam
- May order blood tests, such as ANA (antinuclear antibody), antibodies, complete blood count, and complement tests
- May order other tests, such as urine tests
- May do biopsies:
- Skin biopsy (looking at skin samples under a microscope)
- Kidney biopsy (looking at tissue from your kidney under a microscope)
There is no cure for lupus, but medicines and lifestyle changes can help control it.
People with lupus often need to see different providers. You will most likely have a primary care provider and a rheumatologist (a doctor who specializes in diseases of the joints and muscles). Which other specialists you will depend on how lupus affects your body. For example, if lupus is damaging your heart or blood vessels, you would see a cardiologist (a doctor who specializes in heart diseases).
Your primary care provider should coordinate care between all of your other providers and treat other problems as they come up. You and your primary care provider will develop a treatment plan to fit your needs. You will both review the plan often to make sure that it is working. You should report new symptoms to your provider right away so that your treatment plan can be changed, if needed.
The goals of a treatment plan are to:
- Prevent flares
- Treat flares when they occur
- Reduce organ damage and other problems
- Improve your quality of life
Treatments may include drugs to:
- Reduce fever, swelling, and pain
- Reduce inflammation in your body
- Prevent or reduce flares
- Reduce or prevent damage to joints
- Suppress (lower) the activity of your immune system
Besides taking medicines for lupus, you may need to take medicines for problems that are related to lupus such as high cholesterol, high blood pressure, or infection.
Alternative and complementary therapies are therapies that are not part of standard treatments. Some people try alternative and complementary therapies to improve their lupus symptoms. But research has not clearly shown whether these treatments may help or treat lupus. Talk to your provider before trying any new treatments.
How can I cope with lupus?It is important to take an active role in your treatment. It helps to learn more about lupus - being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.
It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Felter's Materia Medica on Subacute
The dried flower-heads of Arnica montana, Linné (Nat. Ord. Compositae). A perennial of Siberia and the cooler parts of Europe; also found in... / ...ore normal warmth, re-establish restrained secretion, and thus relieve pain. In painful, bruised or subacute inflammatory disorders arising from injury, with marked lowering of nerve tone, muscular ac...1
The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A climbing perennial, the Kalumb of the Southeast coast of Africa.... / ...ulence and constipation are present. Calumba and the allied bitters should not be given in acute or subacute inflammatory conditions of the stomach, nor during acute fevers, nor when digestion is mere... / ...local action, and indirectly, by favoring better digestion, the quality of the blood is improved, hence its value in anemia during convalescence.1
The ripe fruit, dried, of Capsicum frutescens, Linné (Nat. Ord. Solanaceae). Tropical America; also cultivated in most tropical countries. Dose,... / ... no agent is superior nor safer than capsicum. It has, therefore, wide usefulness in disease-acute, subacute, or chronic. For chronic gastric catarrh it may be used occasionally, but should not be lon...1
The root, root-bark, and leaves of Ceanothus americanus, Marshall (Nat. Ord. Rhamnaceae.) A small shrub indigenous to the United States,... / ...ypertrophy, with expressionless countenance and sallow, doughy skin; also in splenic congestion and subacute splenitis, the pain of which is not much aggravated by pressure. Other indications for cean... / ...During the American Civil War the decoction was used by the soldiers for ague cake or malarial splenitis.1
The whole plant of Chelidonium majus, Linné (Nat. Ord. Papaveraceae). Europe naturalized in waste places in the United States. Dose, 1 to 60... / ...g from hepatic congestion and for jaundice occasioned by swelling of the bile ducts, as a result of subacute inflammation. The best guide to its use is the tenderness and tensive or throbbing pain of ... / ...they are proportionately relieved by the action of chelidonium upon the latter. The greatest drawback to chelidonium is its horribly nasty taste.1
The dried (I) root and (II) seed of Colchicum autumnale, Linné (Nat. Ord. Liliaceae.) England and other parts of Europe. Dose, Corm, 1 to 5... / ...ollen joints, with or without effusion, and attended by tearing, muscular pain, aggravated by heat. Subacute and chronic sciatica are asserted to have been relieved by colchicum when the pain is sharp...1
The fresh root and plant of Collinsonia canadensis, Linné (Nat. Ord. Labiatae.) Damp and rich soils of woods from Canada to Florida. Common... / ...us much relief as can be obtained from any safe medicine. Collinsonia relieves, to a lesser extent, subacute proctitis, the tenesmus of mild types of dysentery and diarrhoea and rectal pain following ... / ...disorder collinsonia is helpful, there is always a sense of weight and constriction, venous engorgement, dilated capillaries, and muscular atony.1
The rhizome of Corallorhiza odontorhiza, Nuttall. (Nat. Ord. Orchidaceae.) Rich woods in eastern half of the United States. Dose, 1 drachm. Common... / ...eart depressing qualities of jaborandi. It was once largely used in fevers. Its principal use is in subacute inflammatory disorders of the respiratory tract, being especially valuable in the declining... / ...agent is too expensive to use for these purposes. It is to be regretted that its extreme scarcity makes corallorhiza an almost unobtainable drug.1
The unripe, full-grown fruits of Piper Cubeba, Linné, fil. (Nat. Ord. Piperaceae.) Java, Borneo, Sumatra, Prince of Wales Island, and other isles... / ...orrhea after discharges have almost ceased; enfeebled conditions of the large intestine and rectum; subacute inflammation of the urinary passages; urethral burning and scalding of urine in women; debi... / ...and hay fever. Care must be had not to blister the roof of the mouth, an untoward effect that is produced by the oil in a good quality of cubeba.1
The feculence of the juice of the fruit of Ecballium Elaterium (Linné), A. Richard. (Nat. Ord. Cucurbitaceae.) A trailing vine of southern... / ... associated with general pelvic dragging and tenderness, and the urine is characteristic of chronic subacute inflammation-ropy with mucus or mucopus. The dose should be small enough not to provoke eme... / ...is preferred by some physicians, though elaterium, notwithstanding its impurities, seems to be more generally efficient than its derivative.1
The leaves of Eucalyptus Globulus, Labillardiere. Collected from the older parts of the tree. (Nat. Ord. Myrtaceae.) A native tree of Australia;... / ...seful as throat and pulmonary antiseptics and stimulants. Eucalyptol is especially much employed in subacute inflammations and chronic diseases of the bronchopulmonic tract, with fetor, relaxation and... / ...Used according to indications as given above, eucalyptus is a very satisfactory and pleasant medicine. It is best given in syrup or glycerin.1
The root of Eupatorium purpureum, Linné (Nat. Ord. Compositae). Low meadows and woods of the United States. Dose, 5 to 60 grains. Common Names:... / ...It especially relieves the deep-seated pelvic perineal aching common to sufferers from cystitis and subacute prostatitis, For passive hematuria it is one of the best drugs we possess. When hydragogues... / ...acts well with the special sedatives, and if fever is present or the skin is hot, dry, and constricted it may be given with aconite or gelsemium.1
The leaves of Gaultheria procumbens, Linné (Nat. Ord. Ericaceae). Damp woods and sandy soils of eastern third of the United States. Common... / ...ater, 16 fluidounces), has a specific action upon the urino-genital tract, relieving irritation and subacute inflammation. This action is especially exerted upon the neck of the bladder and in the pro... / ...of infants. Gaultheria is an agent of special value as a flavoring agent and preservative for water-dispensed medicines in the summer season. Fo1
The dried rhizome and roots of Gentiana lutea, Linné (Nat. Ord. Gentianaceae.) Common in the mountainous regions of southern and central Europe.... / ...onvalescence. Gentian is especially useful in anorexia, in the dyspepsia of malarial origin, and in subacute gastritis and intestinal catarrh. The infusion and the compound tincture of gentian may be ...1
The rhizome of Geranium maculatum, Linné (Nat. Ord. Geraniaceae). Common in the rich soils of woods and low grounds in the United States. Dose, 5... / ...equiring such an action it is preferable to many other constringing drugs. Geranium is indicated in subacute and chronic bowel disorders when the evacuations are abundant and debilitating. It is espec... / ...correct excessive acidity, check hemorrhage, and relieve pain; sometimes healing appears to progress rapidly under their influence.1
Physician's Materia Medica on Subacute
The leaves of BAROsMA BETULIN.-l, (Thunb.) Bart. & Wend. and of B. CRENULATA, (L.) Hook. Tonic, stimulant diuretic, antiseptic. A valuable remedy in all subacute and chronic inflammations of the urinary tract.2
The leaves of EUCALYPTUS GLOBULUS, Labili. Stimulant tonic, antiseptic, antiperiodic, stomachic. Valuable in treatment of chronic catarrhal affections of the genito-urinary tract and of the air passages. Locally applied as a disinfectant and vulnerary in treat ing foul ulcers, etc. The oflicial volatile oil is the chief active consti tuent, and of this Euealyptol is the valuable portion. Both are used. especially in spray or by inhalation, in subacute and chronic bronchitis; also internally in d2
Iodine and its compounds generally act as powerful alteratives, promoting absorption and so of service in glandular hypertrophies (e. g. goitre), enlargements of the joints, etc. P11-scribed (generally in the form of the potassium salt), in chronic syphilitic and scrofulous atfections, in subacute and chronic rheumatism, in glan dular cnlargements and to promote absorption of serous exudates. a. iodine. In addition to the properties above stated, free iodine is distinctly antiperiodic. It is too2
Physician's Therapeutics Memoranda on Subacute
In Acute Cystitis, aconite and spirit of nitrous ether, supposi tories (or hot rectal... / ..., Glyceroplasma over bladder. Avoid highly seasoned foods and remedies which may irritate the bladder. If urine becomes purulent, salol is useful. In Subacute Cystitis, Ze-an (which is also ad misible even in acute attacks as a lenitive diuretic), buchu, uva ursi, Elixir Saw Palmetto and Sandalwood....2
Acute attacks call for aconite as a cardiac sedative with one of the following antiarthritic... / ...nilid or antipyrin (some prescribe phena cetin or salol). Acetanilid is best prescribedjn the form of Acetanilid Compound, Special (see p. 8). In the subacute stage, Potassium iodide is the leading remedy, potassium bicarbonate being an alter. native. Vegetable remedies of importance are black cohos... / ...colchicum and cod liver oil. Locally, stimulating liniments are to be applied with friction.2
References
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.