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Lupus erythematosus and allergyBy Dr Vera Machtelincks, general practitioner |
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For people with allergies, the months April-May-June are difficult months. They are troubled with watery eyes, a running nose and descending infections. What is the situation like for CICTD patients, as they already suffer from an autoimmune disorder? Are they more troubled with allergies and how is it treated? |
| What is allergy? |
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| An allergy is a violent reaction of the body due to hypersensitivity to certain agents of chemical or physical nature. There are three types of allergies:
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| What are the symptoms? |
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People with allergic rhinitis are in spring and summer inconvenienced with an itchy sensation and watery secretion at the height of the nose and eyes, suffer from a stuffed up nose, sneezing fits, a tickle in the throat and a heavy head. 100 persons out of 1000 between the age of 5 and 45 suffer from it, with a higher prevalence between 15 and 24. Four to 12 years after the diagnosis the complaints of allergic rhinitis fade away in 60% of the patients so that medications are no longer necessary. Allergic asthma is a disorder of the pulmonary bronchi and requires a follow-up by a specialist. The bronchoconstriction needs to be removed quickly and additional infections have to be treated immediately and adequately. Symptoms of allergic dermatosis are basically urticaria and Quinckes oedema. Urticaria, also called 'nettle rash', is itching and stinging swellings of the skin due to oedema. Sometimes the oval plaques flow together and become fairly big, but disappear within a few hours. The Quincke's oedema is the same swelling, but occurs in a deeper layer of the skin, mostly in the face.
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| To what substances can one become allergic? |
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The most important inhalation allergens in the open air are pollen (especially the birch tree) and grasses. Indoors, it is dust mite and pets which are important. Sometimes food substances or drugs may also trigger allergies.
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| What is atopy? |
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This is a type of allergy following a reaction between an allergen and the so-called atopic reagines; a specific type of these anti-allergen antibodies which exclusively develop in the organism of persons who are constitutionally susceptible to it. During the reaction between the allergen and the body, histamine is released at the point of contact. This is considered to be the direct cause of the complaints. Atopic allergens can be found in pollen of grasses, many components of plants (radix ipeca-cuanhae, folia sennae) and types of wood, insects, worms, mites, fungi and yeasts.
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| Patients with systemic lupus erythematosus and allergy |
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In Israel a study was performed to determine the incidence of the patients with both an allergy and SLE. They found out that 56 % of the SLE-patients also had an allergy, compared to 10% of the normal population, and 21.6 % had even two allergies. Most common were dermatoses due to food (51.6%) or drugs (31.6%), compared to 11.6% and 5% of the incidence of the control group. In addition, the other allergies were also more prevalent in SLE-patients: conjunctivitis was seen in 26.7% (control group: 9.5%), rhinitis in 34% (control group: 13.6%). Finally, asthma was seen in 47% of the SLE-patients and only in 5.9% of the control group.
Genetical, environmental and immunological factors intervene in the pathogenesis of the two disorders: allergy and systemic lupus erythematosus. Pollen, dust mites, food and drugs may provoke allergy while ultraviolet light and chemical products may provoke SLE. Both disorders may be genetically determined. Individuals with these disorders have many cells that produce antibodies. In conclusion, it can be stated that patients with SLE are frequently bothered with allergies and that both diseases are based on certain similar pathogenic mechanisms.
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| Treatment |
The treatment of SLE-patients does not differ from the treatment of other patients. Firstly they can go to a general practitioner who can relieve the symptoms and refer to an allergologist-pneumonologist or dermatologist, if necessary. The general practitioner's task is to alleviate the symptoms of a running nose, itching eyes and sneezing.
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