Systemic lupus erythematosus (SLE)

An autoimmune disease affecting multiple organ systems

Systemic lupus erythematosus
Butterfly-shaped rash on the face, a common symptom of SLE
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, joint pain, rash, fever
Complications	Kidney failure, heart disease, lung disease
Onset	Usually between 15 and 45 years of age
Duration	Long term
Types	N/A
Causes	Unknown, genetic and environmental factors
Risks	Female sex, age, family history
Diagnosis	Based on symptoms, blood tests, biopsy
Differential diagnosis	N/A
Prevention	N/A
Treatment	Immunosuppressants, corticosteroids, lifestyle changes
Medication	N/A
Prognosis	N/A
Frequency	20 to 70 per 100,000 people
Deaths	N/A

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the body's immune system attacking its own tissues, leading to widespread inflammation and tissue damage in the affected organs. It can affect the skin, joints, kidneys, brain, and other organs. The disease is known for its unpredictable course and a wide range of symptoms, which can vary greatly among individuals.

Pathophysiology

SLE is an autoimmune condition, meaning the immune system mistakenly attacks healthy tissue. The exact cause of SLE is unknown, but it is believed to involve a combination of genetic, hormonal, and environmental factors. Genetic predisposition plays a significant role, as SLE is more common in individuals with a family history of the disease. Environmental triggers such as infections, sunlight, and certain medications can also contribute to the onset of SLE.

The hallmark of SLE is the production of autoantibodies, particularly antinuclear antibodies (ANAs), which target the cell nucleus. These autoantibodies form immune complexes that deposit in tissues, leading to inflammation and damage.

Clinical Manifestations

SLE is often referred to as "the great imitator" because its symptoms mimic those of many other diseases. Common symptoms include:

• Fatigue
• Joint pain and swelling
• Skin rashes, including the characteristic "butterfly rash" across the cheeks and nose
• Fever
• Photosensitivity
• Oral ulcers
• Hair loss

Severe cases of SLE can lead to complications such as lupus nephritis, pericarditis, pleuritis, and central nervous system involvement.

Diagnosis

Diagnosing SLE can be challenging due to its diverse symptoms. The American College of Rheumatology has established criteria to aid in diagnosis, which include clinical and laboratory findings. Blood tests are crucial, with the presence of ANAs being a key indicator. Other tests may include anti-double-stranded DNA, anti-Smith antibodies, and complement levels.

Treatment

There is no cure for SLE, but treatment aims to control symptoms and prevent organ damage. Common treatments include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation
• Corticosteroids to reduce inflammation
• Immunosuppressive drugs such as azathioprine, methotrexate, and mycophenolate mofetil
• Hydroxychloroquine, an antimalarial drug, is often used to manage skin and joint symptoms

Lifestyle modifications, such as sun protection and a healthy diet, are also important in managing SLE.

Prognosis

The prognosis for individuals with SLE has improved significantly with advances in treatment. However, the disease can still lead to significant morbidity and mortality, particularly if vital organs are affected. Regular monitoring and early intervention are crucial to managing the disease effectively.

Epidemiology

SLE is more prevalent in women, particularly those of childbearing age, with a female-to-male ratio of approximately 9:1. It is also more common in certain ethnic groups, including African Americans, Hispanics, and Asians.

Also see

• Autoimmune disease
• Rheumatology
• Lupus nephritis
• Antinuclear antibody

Rheumatologic diseases

Arthritis is often used to refer to any disorder that affects the joints. Rheumatic diseases usually affect joints, tendons, ligaments, bones, and muscles. Rheumatologic diseases usually affect joints, tendons, ligaments, bones, and muscles.

Connective Tissue Diseases

Rheumatology and	Connective Tissue Diseases
Ankylosing spondylitis	Arthritis
Arthritis and Rheumatic diseases	Autoimmune diseases
Autoinflammatory diseases	Behçet’s disease
Bursitis	Giant cell arteritis
Gout	Juvenile arthritis
Knee problems	Lupus
Osteoarthritis	Polymyalgia rheumatica
Psoriatic arthritis	Reactive arthritis
Rheumatoid arthritis	Scleroderma
Sjögren’s syndrome	Systemic lupus erythematosus (Lupus)
Tendinitis	Rheumatologic diseases