E-ISSN:2456-3110

Review Article

A Case Report

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 12 December
Publisherwww.maharshicharaka.in

Ayurvedic approach in the functional improvement of Systemic Lupus Erythematosus (SLE) - A Case Report

Anjana S1*, Lohith BA2, Muralidhar PP3, Ashvini KM4
DOI:10.21760/jaims.8.12.40

1* Sujith Anjana, Post Graduate Scholar, Department of Panchakarma, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

2 B A Lohith, Associate Professor, Department of Panchakarma, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

3 P Pujar Muralidhar, Professor, Department of Panchakarma, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

4 Kumar M Ashvini, Professor, Department of Panchakarma, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

Systemic lupus erythematosus (SLE) is an auto immune disease in which organs and cells undergo damage mediated by tissue-binding autoantibodies and immune complex.[1]. 90% of patients are women of child-bearing years are affected with this disease. According to Ayurveda, the signs and symptoms can be included under the purview of Vataraktha. Case summary: A 43-year-old female patient approached with chief complaints of pain over bilateral elbow joints, shoulder joints and low back pain, burning sensation over toes for 8 years associated with febrile attacks, coated tongue, mouth ulcer, dryness of mouth aggravated since 2 months. The Ayurvedic diagnosis was made as Vataraktha on the basis of signs and symptoms. The patient was given Sadyovirechana (Purgation therapy), Basti therapy (enema) along with other external procedures and internal medications. Significant improvement was observed after the treatment in terms of VAS Score and other subjective parameters. This case study shows that Ayurvedic treatment is helpful in the functional improvement of SLE and helps in improving the quality of life.

Keywords: SLE, Systemic lupus erythematosus, Vataraktha, Basti, Case report.

Corresponding Author How to Cite this Article To Browse
Sujith Anjana, Post Graduate Scholar, Department of Panchakarma, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.
Email: 		Anjana S, Lohith BA, Muralidhar PP, Ashvini KM, Ayurvedic approach in the functional improvement of Systemic Lupus Erythematosus (SLE) - A Case Report. J Ayu Int Med Sci. 2023;8(12):265-268.
Available From
https://jaims.in/jaims/article/view/2805

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-10-11 2023-10-25 2023-11-01 2023-11-09 2023-11-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared. Nil. yes. 13.65 none

© 2023by Anjana S, Lohith BA, Muralidhar PP, Ashvini KMand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Anjana S et al. Ayurvedic approach in functional improvement of Lupus Erythematosus

Introduction

Systemic lupus erythematosus affects multisystem that are influenced by multiple factors such as genetic factors, immunological, environmental factors etc.

symptoms can vary widely from person to person and can change over time. Common symptoms include fatigue, joint pain and swelling, rashes etc.

There is no cure for SLE, but treatment aims to manage symptoms, prevent flares minimize organ damage and improving the quality of life.

Vataraktha is the condition in which both Vata and Raktha are afflicted by distinct etiological factors having symptoms such as Daha (burning sensation),

Ruja (pain), Toda (pricking pain), Sphurana (throbbing sensation), Shyava Twak (cyanosis of skin), Raktha Twak (reddish discoloration), Bheda (splitting type of pain), Gourava (heaviness).[2]

According to Ayurveda among the Panchakarma, Basti Karma is considered as the best line of treatment for Vataraktha. After Roga and Rogi Pariksha, Avasthanusara Chikitsa was planned.

Patient Information

A 43-year-old female patient visited Panchakarma Outpatient Department of SDM Hospital, Hassan on 14/7/2022 with complaints of pain over both elbow joints, shoulder joints and low back region, burning sensation over toes since 8 years associated with febrile attacks.

Complaining of coated tongue, mouth ulcer, dryness of mouth aggravated since 2 months.

Associated Complaints

She had disturbed sleep, tiredness and headache.

Past history

No h/o Diabetics mellitus, hypertension, other major medical and surgical history.

Personal history

Appetite of the patient was reduced. Bowel evacuation and micturition was normal, sleep was disturbed.

Consumption of more spicy food and daily intake of curd.

Family history

No relevant family history.

Clinical findings

Patient was having Madhyama Sara (moderate body tissue),

Madhyama Samhanana (moderate body built),

Madhyama Vyayama Shakthi (moderate capacity to carry on physical activities),

Madhyama Ahara Shakthi (medium capacity of food intake) and Madhyama Jarana Shakthi (medium digestive power).

VAS score was 9 before treatment.

Laboratory parameters

Hb - 10.6 gm%, ESR - 26mm/hr (14/7/22), ANA - positive.

Timeline

Table 1: Timeline

DateRelevant medical history
December 2014c/o coated tongue, mouth ulcer, recurrent fever (once in every month).
July 2015c/o pain over both elbow joints, shoulder joints and low back region, burning sensation over toes
February 2016Biopsy report showed subacute cutaneous lupus erythematosus. - underwent medications - tab HCQ 400MG 1OD, Tab Omnacortil 2.5mg 1 OD
February 2016ANA by IFA - weak positive
May 2018Pain, signs and symptoms aggravated, Tab Azapure 50mg was advised.
23/05/2022Desmoglein III Antibody-positive
1/7/2022First consultation in panchakarma OPD and advised for admission

Diagnostic assessment

With these complaints, patient took treatment from allopathic hospital where she was diagnosed with

SLE with relevant investigations like study of anti-nuclear antibody confirming the diagnosis.

According to Ayurveda it can be included under the purview of Vataraktha in which disease manifest as a result of Marga-Avarodha of Vata by Rakta.

Diagnosis - Vataraktha


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Table 2: Therapeutic intervention

InterventionDuration
Sarvanga Udwartana f/b Parisheka with Dashamoola Kwatha14/7/2022 - 16/7/2022 for 3 days
Sadyovirechana with Trivrit Lehya (80gm) + Triphala Kashaya (100ml)16/7/2022
Sarvanga Abhyanga with Pinda Thaila f/b Parisheka with Dashamoola Kwatha.
Basti as per schedule.		17/7/2022 - 20/7/2022
Sarvanga Abhayanga with Ksheerabala Thaila f/b Patra Pinda Sveda Basti as per scheduled21/7/2022 - 23/7/2022
Sarvanga Abhyanga with Ksheera Bala Taila f/b Shasthika Shali Pinda Sveda Basti as per scheduled24/7/22-25/7/2022
Yasthimadhu Churna (100gm) + Shankha Bashma (100gm) + Pravala Bashma (20 gm) = ½ tsp BD with butter milk before food.Internally from 1/7/2022
Nimbadi Kashaya Basti
Honey - 80gm
Saindhava -10gm
Sneha - Dadimadi Gritha + Sukumara Gritha (40ml each)
Kalka - Musta, Devadaru, Manjitsa, Amalaka, Guduchi (10 gm each)
Kashaya - Nimbadi Kashaya -300ml		17/718/719/7/20/7
ANAN
21/722/723/7/24/7
ANAA
A - Anuvasana Basti
N - Niruha Basti

Outcomes

Patient responded well to the treatment, symptoms like pain in the joints, febrile episode started to reduce gradually, changes in the mouth ulcer was also noted. On the 4th day of treatment, it was observed that VAS score has reduced to 7. After the treatment VAS score was 3.

Fig.1: Picture showing changes in mouth ulcer before and after treatment

Fig. 2: Picture showing changes in coating of tongue before and after treatment.

Discussion

Present case was already a diagnosed case of SLE, an autoimmune disease. Patient took allopathic treatment but no much relief was seen. Ayurvedic management was found to be effective in the functional improvement of SLE, correlating the symptoms with Vataraktha. Initially for Rukshana and Ama Pachana, Udwarthana Chikitsa followed by Parisheka was carried out. For Kostha Shodhana, Sadyovirechana was given with Trivrit Lehya and Triphala Kashaya. Later on Sarvanga Abhyanga with Pinda Thaila f/b Parisheka with Dashamoola Kwatha was done as Snehana helps in the proper Gati of Vata, brings Gaatra Mardavata and removes the Srothorodha. Later on, Shasthika Shali Pinda Sveda was done after attaining Nirama Avasta in order to control the aggravated Vata Dosha and for producing Brimhana therapy. Internally Yasthimadhu Churna (100gm) + Shankha Bashma (100gm) + Pravala Bhasma (20 gm) = ½ tsp BD with butter milk before food was given as all the drugs are Madhura in nature and Madhura Rasa is helpful in reduction of Pitta Dosha, which is connected to Rakta according to Ashrya Aashrayi Bhava. Madhura is also helpful in reduction of Vata. Basti Karma is the best treatment modality for Vataraktha.[3] Nimbadi Kashaya Basti helps in correcting the vitiated Vata and Pitta along with Rakthaprasadaka and Rasayana drugs. Drugs having Thikta Pradhana Rasa, Madhura Vipaka, Ushna Veerya was used.


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Conclusion

SLE is an auto immune disorder, which is progressive in nature, ayurvedic line of approach helps in the functional improvement of the condition and hence improves the quality of life of the individuals. Present observation and approach definitely boost up the new research scholars to manage these conditions and do further studies.

Patient Perspective

Patient was satisfied with the treatment in terms of reduction in pain, burning sensation and mouth ulcer and improved sleep.

Patient Consent

Written permission for the publication of this case study has been obtained from the patient.

References

1. Fauci A, Braunwald E, Kasper D, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's Manual of Medicine, 17th Edition. McGraw-Hill Professional; 2009; p. 2075.

2. Charaka Samhitha with Ayurveda-Dipika Commentary. Edited by Vaidya Jadavji Trikamji Acharya. Chaukhambha Krishnadas Academy, Varanasi; Reprint: 2006. Chikitsa Sthana; 29:20, p. 628.

3. Charaka Samhitha with Ayurveda-Dipika Commentary. Edited by Vaidya Jadavji Trikamji Acharya. Chaukhambha Krishnadas Academy, Varanasi; Reprint: 2006. Chikitsa Sthana; 29:88, p. 631.


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