SLE is an autoimmune disease, the cause of which is unknown, may be related to the HLA gene, patients produce anti-DNA antibodies, and may be secondary to some viral infections. Occurs in women of childbearing age; the incidence is higher in African Americans and other people of color than in whites. Common symptoms include extreme fatigue, joint pain or swelling, unexplained fever, skin flushing, mouth ulcers, and kidney problems.
Pathophysiology: SLE has a genetic constitution, which excessively produces type 1 interferon and other cytotoxic cells. SLE is an autoimmune disease that affects various organ systems. It affects kidney function resulting in excessive excretion of protein and often develops renal failure.
Medical management: SLE disease itself and the drugs used (corticosteroids, NSAIDs, immunosuppressants, antimalarials) can affect nutrient metabolism, needs, and excretion. Recent therapies include: rituximab; this drug is also used in cancer chemotherapy which causes a decrease in immune B cells. The decrease in B cells helps to improve the remission of SLE while maintaining normal amounts of IgG and IgM.
SLE of medical nutrition therapy
1. There are currently no special diet guidelines for managing SLE.
2. Because patients often have the same significant symptoms as other autoimmune diseases, it is not easy to propose MNT guidelines for SLE.
3. Diet should meet the needs of individual patients.
4. The pre-treatment of diet treatment includes: managing the sequelae of diseases and the effects of drugs on organ function and nutrient metabolism.
5. Protein, fluid, and sodium requirements will be changed by renal dysfunction and steroid-induced side effects. The energy requirements need to meet the individual patient’s dry wt. Goals, and should achieve and maintain the usual weight.
6. Chronic cases may require enteral nutritional support