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Systemic lupus erythematosus

Disseminated lupus erythematosus; SLE; Lupus; Lupus erythematosus; Discoid


lupus
Last reviewed: February 14, 211!
Systemic lupus erythematosus "SLE# is a lon$%term autoimmune disorder that may
a&ect the s'in, (oints, 'idneys, brain, and other or$ans!
)auses, incidence, and ris' *actors
Systemic lupus erythematosus "SLE# is an autoimmune disease, which means the
body+s immune system mista'enly attac's healthy tissue! ,his leads to lon$%term
"chronic# in-ammation!
,he underlyin$ cause o* autoimmune diseases is not *ully 'nown!
SLE is much more common in women than men! .t may occur at any a$e, but
appears most o*ten in people between the a$es o* 1 and /! 0*rican 0mericans
and 0sians are a&ected more o*ten than people *rom other races!
SLE may also be caused by certain dru$s! For in*ormation on this cause, see Dru$%
induced lupus erythematosus
Symptoms
Symptoms vary *rom person to person, and may come and $o! 0lmost everyone
with SLE has (oint pain and swellin$! Some develop arthritis! Fre1uently a&ected
(oints are the 2n$ers, hands, wrists, and 'nees!
3ther common symptoms include:
)hest pain when ta'in$ a deep breath
Fati$ue
Fever with no other cause
4eneral discom*ort, uneasiness, or ill *eelin$ "malaise#
5air loss
6outh sores
Sensitivity to sunli$ht
S'in rash %% a 7butter-y7 rash over the chee's and brid$e o* the nose a&ects about
hal* o* people with SLE! ,he rash $ets worse in sunli$ht! ,he rash may also be
widespread!
Swollen lymph nodes
3ther symptoms depend on what part o* the body is a&ected:
8rain and nervous system: headaches, numbness, tin$lin$, sei9ures, vision
problems, personality chan$es
Di$estive tract: abdominal pain, nausea, and vomitin$
5eart: abnormal heart rhythms "arrhythmias#
Lun$: cou$hin$ up blood and di:culty breathin$
S'in: patchy s'in color, 2n$ers that chan$e color when cold ";aynaud+s
phenomenon#
Some patients only have s'in symptoms! ,his is called discoid lupus!
Si$ns and tests
,o be dia$nosed with lupus, you must have 4 out o* 11 typical si$ns o* the disease!
<our doctor will per*orm a physical e=am and listen to your chest with a
stethoscope! 0n abnormal sound called a heart *riction rub or pleural *riction rub
may be heard! 0 nervous system e=am will also be done!
,ests used to dia$nose SLE may include:
0ntibody tests, includin$ antinuclear antibody "0>0# panel
)8)
)hest =%ray
?idney biopsy
@rinalysis
,his disease may also alter the results o* the *ollowin$ tests:
0ntithyro$lobulin antibody
0ntithyroid microsomal antibody
)omplement components ")A and )4#
)oombs+ test % direct
)ryo$lobulins
ES;
?idney *unction blood tests
Liver *unction blood tests
;heumatoid *actor
,his list is not all inclusive!
,reatment
,here is no cure *or SLE! ,he $oal o* treatment is to control symptoms!
6ild disease may be treated with:
>onsteroidal anti%in-ammatory medications ">S0.Ds# treat arthritis and pleurisy
)orticosteroid creams to treat s'in rashes
0n antimalaria dru$ "hydro=ychloro1uine# and low%dose corticosteroids *or s'in and
arthritis symptoms
<ou should wear protective clothin$, sun$lasses, and sunscreen when in the sun!
Severe or li*e%threatenin$ symptoms "such as hemolytic anemia, e=tensive heart or
lun$ involvement, 'idney disease, or central nervous system involvement# o*ten
re1uire more a$$ressive treatment by doctor specialists!
,reatment *or more severe lupus may include:
5i$h%dose corticosteroids or medications to decrease the immune system response
)ytoto=ic dru$s "dru$s that bloc' cell $rowth# i* you do not $et better with
corticosteroids, or whose symptoms $et worse when the stop ta'in$ them! ,hese
medicine have serious, severe side e&ects! <ou should be closely monitored by your
doctor!
.* you have lupus, it is also important to have:
Breventive heart care
@p%to%date immuni9ations
,ests to screen *or thinnin$ o* the bones "osteoporosis#
,al' therapy and support $roups may help relieve depression and mood chan$es
that may occur in patients with this disease!
Support 4roups
See: Lupus resources
E=pectations "pro$nosis#
5ow well a person does depends on the severity o* the disease!
,he outcome *or people with SLE has improved in recent years! 6any people with
SLE have mild symptoms!
Comen with SLE who become pre$nant are o*ten able to carry sa*ely to term and
deliver a healthy in*ant, as lon$ as they do not have severe 'idney or heart disease
and the SLE is bein$ treated appropriately! 5owever, the presence o* SLE antibodies
may increase the ris' o* pre$nancy loss!
)omplications
Some people with SLE have abnormal deposits in the 'idney cells! ,his leads to a
condition called lupus nephritis! Batients with this condition may eventually develop
'idney *ailure and need dialysis or a 'idney transplant!
SLE causes dama$e to many di&erent parts o* the body, includin$:
8lood clots in the le$s "deep vein thrombosis# or lun$s "pulmonary embolism#
Destruction o* red blood cells "hemolytic anemia# or anemia o* chronic disease
Fluid around the heart "pericarditis#, endocarditis, or in-ammation o* the heart
"myocarditis#
Fluid around the lun$s "pleural e&usions# and dama$e to lun$ tissue
Bre$nancy complications, includin$ miscarria$e
Stro'e
Severely low blood platelets "thrombocytopenia#
.n-ammation o* the blood vessels
)allin$ your health care provider
)all your health care provider i* you have symptoms o* SLE! 0lso, call i* you have
this disease and your symptoms $et worse or a new one occurs!
;e*erences
;ui9%.rastor9a 4, ;amos%)asals 6, 8rito%Deron B, ?hamashta 60! )linical e:cacy
and side e&ects o* antimalarials in systemic lupus erythematosus: a systematic
review! 0nn ;heum Dis! 21;EF:2%2G! HBub6edI
5ahn 85, ,sao 8B! Batho$enesis o* systemic lupus erythematosus! .n: Firestein 4S,
8udd ;), 5arris ED Jr!, et al!, eds! ?elley+s ,e=tboo' o* ;heumatolo$y! Gth ed!
Bhiladelphia, Ba: Saunders Elsevier; 2G:chap K4!
;eview Date: 2L14L211!
;eviewed by: 6ichael E! 6a'over, 6D is a pro*essor and attendin$ in rheumatolo$y
at the >ew <or' @niversity 6edical )enter, >ew <or', ><! ;eview provided by
Meri6ed 5ealthcare >etwor'! 0lso reviewed by David Dieve, 6D, 650, 6edical
Director, 0!D!0!6!, .nc!