Federal University of Maranhão, Medical School, Brazil.
Lupus. 2020 Jun;29(7):721-726. doi: 10.1177/0961203320919872. Epub 2020 Apr 23.
Systemic lupus erythematosus is an autoimmune disease that promotes chronic inflammation, with periods of activation and remission. Pain is commonly one of the first symptoms reported by patients with lupus. It interferes with patients' quality of life, leading to a decrease in strength and difficulty in performing daily activities. Given the chronic nature of the disease, the high prevalence of pain and its negative impact on the quality of life of patients with lupus, the present literature review study aims to explain the pathophysiology of pain in systemic lupus erythematosus and the implications of the chronic process and contributing factors. During periods of systemic lupus erythematosus activity, pain is a significant symptom. Despite this, several studies show that severe pain can occur in patients with in mild to moderate disease activity. Also, in the early stages of the disease, the pain may be accentuated by the greater activity of the disease. However, even when advanced disease is under control, there can be comorbidities and accumulated damage that can also cause high levels of pain. This sensitivity is due to the overlap of primary, secondary, and tertiary pain pathologies, which feedback and make this symptom one of the main concerns of patients with lupus. Understanding the pathophysiology of pain in systemic lupus erythematosus, as well as its chronification and contribution factors, is essential to identify effective therapeutic alternatives in these patients at each stage of pain pathology (primary, secondary, and tertiary).
系统性红斑狼疮是一种自身免疫性疾病,会导致慢性炎症,出现活动期和缓解期。疼痛通常是狼疮患者最先报告的症状之一。它会干扰患者的生活质量,导致力量下降,日常活动困难。鉴于疾病的慢性性质、疼痛的高患病率及其对狼疮患者生活质量的负面影响,本文献综述研究旨在解释系统性红斑狼疮疼痛的病理生理学,以及慢性过程和促成因素的影响。在系统性红斑狼疮活动期,疼痛是一个重要症状。尽管如此,几项研究表明,即使疾病活动处于轻度至中度,严重疼痛也可能发生在患者身上。此外,在疾病的早期,疾病的更大活动可能会加重疼痛。然而,即使晚期疾病得到控制,也可能存在共病和累积损伤,这也可能导致高水平的疼痛。这种敏感性是由于原发性、继发性和三级疼痛病理学的重叠,这些病理学相互反馈,使这种症状成为狼疮患者的主要关注点之一。了解系统性红斑狼疮疼痛的病理生理学,以及其慢性化和促成因素,对于在疼痛病理的每个阶段(原发性、继发性和三级)识别这些患者的有效治疗选择至关重要。