diflucan mechanism of action

Lupus & Sjogrens

Q: I have read that sjogrens and lupus are closely related like sisters or cousins
but my doc says they are only related by the fact that they are both autoImmune.
My question is how closely related are they???

A:  Sjogrens(Sjs) and Lupus (SLE) can occur together, in which case one will be designated Secondary Sjs, or each may present alone. They are both immune dysregulation disorders causing autoimmunity (both autoantibodies, termed humoral immunity, and lymphocyte dysregulation, termed cellular immunity). It appears that in SLE, the antigen that is triggering the autoantibodies is in the nucleosome (within nucleus of cells), and in Sjs the antigen is ribonucleic acid (ribosomes with cells in cytoplasm-outside the nucleus). It still is not known what is triggering these normal host antigens to cause autoantibody formation. Viral triggers or pieces of viruses (retroelements) may play a role, as well as dysfunctions that occur in the host/self immune regulatory pathways.

Clinically, Sjs patients do not have dsDNA antibodies (a hallmark for SLE). But SSA and SSB antibodies can occur in either condition.

The main clinical difference to watch for is a serious condition of the kidney (nephritis), which occurs in SLE much more commonly than Sjs. The earliest sign may be protein in the urine. Sjs patients can get nephritis, it's true but this is rare. A condition called renal tubular acidosis can occur in Sjs (but rare), and would be unusual in SLE.

dr c

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1 Comment   »

  • Shani says:

    Hi Doc,

    Recently I've been having tingling sensations of my mouth and now my tongue.
    This is constantly.

    My Neuro has scheduled a Mri scan of my brains just to be safe.
    The last was done a year ago ad was completely normal but I only got diagnosed with Sle and Sjogren etc, lots of other things- since June 2010.

    And I am getting a lot more issues, pain, ...

    My Neuro has mentioned that this could be Neuropathy when I first only had the mouth tingling, but now the tongue aswell so she wants a Mri done.

    Aswell she mentioned hyperventilation but I told her it's not that as I am not very stressed and I haven't had that issue for a long time+
    When I do hyperventilate I get short in breath, heart pounding.

    Never had tingling.
    And when I take very deep and rapid breaths, the tingling does not increase.

    So I'm sure it's not a stress issue or anything.
    They told me ages ago that all of my issues are due to stress etc but then here I am stuck with all my diagnoses such as Sle.

    I also have Polyneuropathy in my feet and hands due to Plaquenil as they think might have caused it+weakness of my muscles.

    I have quit the drug a few weeks now and Neuro said it can take months for the symptoms to go away.
    But I know Sle/Sjs can cause these sensations itself aswell.

    So I was wondering if it's all workin together a bit and might be perm Neuropathy or things like Ms.

    I would like to know you're opinion about this.
    I don't have any allergies or deffiencies etc. So it's not that.

    Thank you in advance.

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