Systemic Lupus Erythematosus

What is Systemic Lupus Erythematosus?

Systemic lupus erythematosus is an inflammatory multi-system disease of unknown etiology. It is recognized worldwide and clearly more prevalent in women, especially in their reproductive years.

This effect of age and sex on incidence and prevalence rates of SLE suggests a role for hormonal factors in its pathogenesis. In the USA, SLE is three times more common among blacks than whites. Genetic factors have long been considered to have a role in the formation of SLE. There are observations of a higher prevalence of SLE among twins.

SLE can affect the skin, joints, kidneys, lungs, nervous system, serous membranes and/or other organs of the body. Immunologic abnormalities, especially the production of a number of antinuclear antibodies, are another prominent feature of the disease. The clinical course may be characterized by periods of remissions and chronic or acute relapses.

Symptoms of Systemic Lupus Erythematosus

Because lupus can affect so many different organs, a wide range of signs and symptoms can occur. These symptoms may come and go, and different symptoms may appear at different times during the course of the disease.

The most common symptoms of lupus (which are the same for men and women) are:

  • Extreme fatigue (tiredness)
  • Headaches
  • Painful or swollen joints
  • Fever
  • Anemia (low numbers of red blood cells or hemoglobin, or low total blood volume)
  • Swelling (edema) in feet, legs, hands, and/or around eyes
  • Pain in chest on deep breathing (pleurisy)
  • Butterfly-shaped rash across cheeks and nose
  • Sun- or light-sensitivity (photosensitivity)
  • Hair loss
  • Abnormal blood clotting
  • Fingers turning white and/or blue when cold (Raynauld's phenomenon)
  • Mouth or nose ulcers

Most patients with SLE have mild to moderate disease with chronic smoldering symptoms, punctuated by gradual or sudden increases in disease activity (flare-ups). The disease course in a smaller percentage of patients is characterized by alternating flare-ups and complete clinical remissions. Rarely, a patient has a single episode of active SLE followed by sustained remission.

Treatment of Systemic Lupus Erythematosus

The management of patients with SLE is decided on an individual basis, guided by the degree and severity of specific symptoms and organ involvement.