Arthritis Battle: Lupus and Rheumatoid Arthritis - Similarities, Disparities, and Further Details
Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA) are autoimmune diseases that share some similarities but have distinct characteristics. Both conditions affect the joints, but they differ significantly in their impact on the skin, internal organs, and joint symptoms.
Key Differences Between SLE and RA
Skin Effects
SLE is characterised by a malar (butterfly) rash across the cheeks and nose and various other skin rashes and sores, including discoid lupus with only localised skin symptoms. Photosensitivity is common. On the other hand, RA may cause rheumatoid nodules on the skin but typically does not cause extensive skin rashes like the malar rash of SLE.
Internal Organs
SLE is a systemic disease affecting multiple organ systems, including the kidneys, heart, lungs, brain, blood vessels, and blood cells. These systemic involvements can be life-threatening. In contrast, RA generally affects primarily the joints; although it can have systemic features such as inflammation affecting the lungs, heart, and eyes, internal organ involvement is less common and less diverse compared to SLE.
Joint Pain
Both SLE and RA involve the small joints of the hands and wrists. However, SLE arthritis rarely leads to joint deformities, while RA typically causes joint damage and deformities over time due to chronic inflammation and erosion.
Symptoms and Diagnosis
SLE Symptoms
SLE symptoms are highly variable with systemic flares and remissions, including fever, fatigue, memory problems, hair loss, and mouth ulcers. SLE is more likely to affect internal organs such as the kidneys, lungs, and heart compared to RA.
RA Symptoms
The main symptom of RA is joint pain and stiffness. RA-specific symptoms include pain, stiffness, or swelling in the joints for 6 weeks or more, stiff joints in the morning lasting for 30 minutes or more, multiple joint involvement, symmetrical symptoms in the same joints on both the left and right sides of the body, symptoms occurring in smaller joints first, such as the hands, wrists, and feet, fatigue, and low fever.
Diagnosis
Doctors may carry out blood tests to check for certain indicators of RA, including rheumatoid factor, anti-cyclic citrullinated peptide antibodies, C-reactive protein, and erythrocyte sedimentation rate. For SLE, there is no single test, but blood tests can show antibodies that may indicate SLE, and skin or kidney biopsies may indicate organ involvement.
Treatment
Antimalarial drugs, corticosteroids, immunosuppressants, NSAIDs, and biologics are used to treat SLE symptoms. For RA, NSAIDs, disease-modifying antirheumatic drugs, and corticosteroids are used to treat the condition.
Co-existence of SLE and RA
Rhupus syndrome is a rare occurrence, affecting 0.09% of people, where both SLE and RA co-exist. A doctor may use several criteria to diagnose SLE, including a butterfly-shaped rash on the cheeks and nose, sensitivity to sunlight, joint inflammation, heart or lung inflammation, neurological conditions, kidney disorder, anemia, immunological disorder, and positive antinuclear antibodies in a blood test.
In conclusion, while SLE and RA share some similarities, they are distinct autoimmune diseases with different impacts on the body. Understanding these differences is crucial for accurate diagnosis and effective treatment.
- A person naive to autoimmune disorders may struggle to comprehend the distinct characteristics between Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA), two chronic diseases that primarily affect the joints yet vary significantly in their impact on skin, internal organs, and joint symptoms.
- Science has established that Rheumatoid Arthritis (RA) is less likely to cause extensive skin rashes like the malar rash observed in SLE, although it may invoke rheumatoid nodules on the skin.
- In contrast, Systemic Lupus Erythematosus (SLE) is a systemic disease that can affect multiple organ systems, posing life-threatening risks to the kidneys, heart, lungs, brain, blood vessels, and blood cells, whereas Rheumatoid Arthritis (RA) primarily impacts joints, albeit it could have systemic features impacting the lungs, heart, and eyes.
- In both SLE and Rheumatoid Arthritis (RA), joint pain is a prevalent symptom, but SLE arthritis rarely leads to joint deformities, contrasting with RA, which commonly results in joint damage and deformities due to chronic inflammation and erosion.
- Health-and-wellness professionals utilise various diagnostic methods for SLE and Rheumatoid Arthritis (RA), such as blood tests checking for indicators like Rheumatoid factor, anti-cyclic citrullinated peptide antibodies, and skin or kidney biopsies to determine organ involvement. Treatment for these chronic diseases includes a range of drugs like antimalarial drugs, corticosteroids, immunosuppressants, NSAIDs, biologics, and disease-modifying antirheumatic drugs.
