Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder that may affect the skin, joints, kidneys, brain, and other organs.
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Causes, incidence, and risk factors
Systemic lupus erythematosus (SLE) is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. This leads to long-term (chronic) inflammation.
The underlying cause of autoimmune diseases is not fully known.
SLE is much more common in women than men. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races.
SLE may also be caused by certain drugs. For information on this cause, see Drug-induced lupus erythematosus
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Symptoms
Symptoms vary from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling. Some develop arthritis. Frequently affected joints are the fingers, hands, wrists, and knees.
Other common symptoms include:
Chest pain when taking a deep breath
Fatigue
Fever with no other cause
General discomfort, uneasiness, or ill feeling (malaise)
Hair loss
Mouth sores
Sensitivity to sunlight
Skin rash -- a "butterfly" rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread.
Swollen lymph nodes
Other symptoms depend on what part of the body is affected:
Brain and nervous system: headaches, numbness, tingling, seizures, vision problems, personality changes
Digestive tract: abdominal pain, nausea, and vomiting
Heart: abnormal heart rhythms (arrhythmias)
Lung: coughing up blood and difficulty breathing
Skin: patchy skin color, fingers that change color when cold (Raynaud's phenomenon)
Some patients only have skin symptoms. This is called discoid lupus.
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Signs and tests
To be diagnosed with lupus, you must have 4 out of 11 typical signs of the disease.
Your doctor will perform a physical exam and listen to your chest with a stethoscope. An abnormal sound called a heart friction rub or pleural friction rub may be heard. A nervous system exam will also be done.
Tests used to diagnose SLE may include:
Antibody tests, including antinuclear antibody (ANA) panel
CBC
Chest x-ray
Kidney biopsy
Urinalysis
This disease may also alter the results of the following tests:
Antithyroglobulin antibody
Antithyroid microsomal antibody
Complement components (C3 and C4)
Coombs' test - direct
Cryoglobulins
ESR
Kidney function blood tests
Liver function blood tests
Rheumatoid factor
This list is not all inclusive.
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Treatment
There is no cure for SLE. The goal of treatment is to control symptoms.
Mild disease may be treated with:
Nonsteroidal anti-inflammatory medications (NSAIDs) treat arthritis and pleurisy
Corticosteroid creams to treat skin rashes
An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms
You should wear protective clothing, sunglasses, and sunscreen when in the sun.
Severe or life-threatening symptoms (such as hemolytic anemia, extensive heart or lung involvement, kidney disease, or central nervous system involvement) often require more aggressive treatment by doctor specialists.
Treatment for more severe lupus may include:
High-dose corticosteroids or medications to decrease the immune system response
Cytotoxic drugs (drugs that block cell growth) if you do not get better with corticosteroids, or whose symptoms get worse when the stop taking them. These medicine have serious, severe side effects. You should be closely monitored by your doctor.
If you have lupus, it is also important to have:
Preventive heart care
Up-to-date immunizations
Tests to screen for thinning of the bones (osteoporosis)
Talk therapy and support groups may help relieve depression and mood changes that may occur in patients with this disease.
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