[Source: Changchun Evening News]
A normal question from a doctor
actually brought out the cruel reality of mother-daughter disease
Recently, 51-year-old Ms. Jin (pseudonym) was hospitalized in the hospital for treatment due to dry mouth and a mouth full of rotten teeth. . During this period, her 23-year-old daughter was diagnosed with lupus erythematosus after being reminded by the doctor. Fortunately, it was discovered in time and the condition was under control.
Zhang Jin, chief physician of Li Huili Hospital, Ningbo Medical Center, Zhejiang Province, said that there are many clinical cases of both mother and daughter suffering from lupus erythematosus, and genetic factors play an important role in the pathogenesis of systemic lupus erythematosus.
Mom went to see a doctor and her daughter was also diagnosed?
When she got her daughter's report card, Ms. Jin couldn't help but shed tears of self-blame. Because I suffer from Sjögren's syndrome and lupus erythematosus, I have now passed on lupus erythematosus to my daughter. But thinking about what the doctor said, "Thanks to the timely discovery," her daughter's condition was relatively mild, and she was grateful that her unintentional words had revealed such important information.
Ms. Jin’s situation over the past year can be said to be very painful. At first, her mouth was so dry every day that her mouth and tongue seemed to be stuck, and she always wanted to drink water. During this period, her originally good teeth became black, loose, and even fell out. During the examination, the doctor also found that her white blood cells had been low.
For this reason, she went to the hematology department, dental department and other departments for medical treatment. She had to report to the hospital every week and had a thick stack of registration sheets. However, after seeing so many doctors, the symptoms and indicators did not improve at all, but got worse. Half of the teeth were rotten. At the reminder of a doctor, she came to the rheumatology and immunology department for treatment.
Chief Physician Zhang Jin from the Rheumatology and Immunology Department of Li Huili Hospital highly suspected Sjögren's syndrome after learning about Ms. Jin's medical history in detail. After various indicators and symptoms, Ms. Jin was diagnosed. During the examination, her lupus erythematosus antibody was also positive. This means that she is most likely suffering from two connective tissue diseases at the same time.
After being admitted to the hospital, Dr. Chen Aqiong from the Department of Rheumatology and Immunology asked Ms. Jin further. "Auntie, do you usually get rashes on your face, especially after being in the sun?" Rashes and photosensitivity are one of the typical symptoms of lupus erythematosus.
Ms. Jin shook her head and said: "I don't have this situation, but my daughter has, and it has been five or six years." Ms. Jin's words attracted Chen Aqiong's attention.
Clinical studies have shown that heredity is closely related to the onset of systemic lupus erythematosus. The disease has familial aggregation and genetic predisposition. If a first- or second-degree relative has lupus erythematosus, the prevalence is much higher than Normal people. Moreover, the male to female ratio of the incidence of lupus erythematosus is 1:9, and daughters are more likely to inherit it.
At Chen Aqiong's suggestion, Ms. Jin's daughter Xiaohan (pseudonym) went for an antinuclear antibody spectrum test. Combined with other test reports and symptoms, Xiaohan was diagnosed with systemic lupus erythematosus.
This result dealt a huge blow to the family. Fortunately, due to early detection, Xiaohan's current condition is not serious, and the symptoms she shows are only facial rash caused by photoallergy. After immunomodulatory treatment, the condition was under control.
Is lupus erythematosus a genetic disease?
According to Zhang Jin, systemic lupus erythematosus is a chronic autoimmune disease, and its pathogenesis is related to factors such as genetics, estrogen, environment, and infection.
This disease is more likely to occur in women of childbearing age. It is precisely because estrogen plays a large role in the pathogenesis of lupus erythematosus. Many women are only found to have systemic lupus erythematosus after pregnancy, or the condition of systemic lupus erythematosus is worsened. The culprit is "estrogen levels that continue to rise after pregnancy."
UV rays are the most important environmental factor. Lupus patients are extremely sensitive to ultraviolet rays. Exposure to the sun may not only induce or aggravate skin lesions, but may also directly lead to disease outbreaks.
Therefore, lupus patients should strictly avoid prolonged exposure to the sun in daily life, take physical sun protection measures such as wearing long-sleeved clothing, wide-brimmed hats and sunglasses, and use sunscreen with spf>50 for protection.In addition, other rheumatic patients who also have photoallergic symptoms should also strengthen their awareness of sun protection to reduce unnecessary health risks.
Many studies have shown that systemic lupus erythematosus is related to viral infections, such as Epstein-Barr virus infection, cytomegalovirus infection, etc.
It can be seen that although systemic lupus erythematosus has a genetic predisposition, its onset is the result of the interaction of multiple factors. Heredity here means that the patient carries a genetic susceptibility gene, which does not mean that lupus is a genetic disease.
The clinical manifestations of lupus erythematosus are highly heterogeneous and vary from patient to patient. Including systemic symptoms such as fever and fatigue; symptoms of skin and mucosal damage such as butterfly erythema on the cheek and oral ulcers; musculoskeletal related symptoms such as arthritis and myalgia; multiple serous cavity effusions such as pericardial effusion and pleural effusion; kidney, The lungs, heart, digestive system, nervous system, blood system, etc. are affected.
"Young women who have fever, rash, arthritis, oral ulcers, hair loss and other related symptoms, combined with evidence of autoimmunity (such as positive autoantibodies, reduced complement, etc.), need to be highly vigilant," Zhang Jin reminded.
However, this does not mean that patients with lupus erythematosus cannot conceive and have children.
Can lupus erythematosus be cured? Will it be fatal?
At present, lupus erythematosus is still a serious and difficult disease. With the improvement of treatment concepts and diagnosis and treatment levels in recent years, the 5-year survival rate of this disease exceeds 90%, and the 20-year survival rate can reach more than 60%.
Director Zhang Jin said: Although current medical methods cannot yet cure lupus erythematosus, with standardized treatment, most patients can achieve better clinical remission. As long as you follow your doctor's instructions, take medications and undergo regular check-ups, and keep all indicators basically normal, you don't need to worry too much.
◆Source: Hangzhou Transportation 918
Editor of this issue: Ma Yuhua
Director on duty: Liang Shuang
Third review: Zhu Baoming
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