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Systemic Lupus Erythematosus

(Lupus; SLE; Lupus, Systemic)

 

Definition

Systemic lupus erythematosus (SLE) is an autoimmune disorder that causes inflammation of joints, tendons, skin, blood vessels and other connective tissue, and organs. SLE causes the immune system to produce antibodies that attack the body's healthy cells and tissue. Of all the forms of lupus, SLE is the most common and most well-known.

 

Causes    TOP

The cause of SLE is unknown. It is likely due to a combination of genetic and environmental factors, such as viral infections or chemicals.

Flares of lupus can be triggered by:

  • ultraviolet rays from the sun or high intensity fluorescent light bulbs
  • Certain drugs
  • Infection or injury
  • Physical or emotional stress
 

Risk Factors    TOP

SLE is more common in women aged 20-45 years old. It is also more common in people of African American, Native American, and Hispanic descent.

Other factors that increase your chance of SLE include:

 

Symptoms    TOP

Symptoms can be mild or very severe. For some people, only part of the body, such as skin, is affected. For others, many parts are affected. Though symptoms can be chronic, they can flare up and get better on and off.

Common symptoms may include:

  • Headaches
  • Extreme fatigue
  • Swollen and/or painful joints
  • Fever without signs of infection
  • Weight loss
  • Skin rashes over areas exposed to sunlight, especially butterfly shaped rash over the nose and cheeks
  • Mouth sores

Common SLE Rash Sites

Lupus rash

Facial butterfly rash is hallmark of SLE.

Copyright © Nucleus Medical Media, Inc.

Other symptoms may depend on the area of the body that is affected:

  • Affected skin may become sensitive to light, have hives or red or purple rashes, or have hair loss
  • Affected muscles may become stiff and weak
  • Affected kidney tissue may cause blood or protein in the urine
  • Affected liver, stomach and intestines may cause nausea, vomiting, or abdominal pain
  • Affected lung or heart tissue may cause trouble breathing and chest pain
  • Affected brain and nerves may lead to psychiatric disorders, such as depression, seizures, and nerve pain and numbness
  • Affected glands may cause swollen nodes or spleen
  • Affected blood may result in anemia, bleeding, or blood clots

SLE may cause complications during pregnancy. There may be a flare-up of symptoms, kidney problems, or pre-eclampsia. There is also an increased risk of premature birth, stillbirth, miscarriage, or growth problems with the baby during pregnancy.

 

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis is based on specific diagnostic criteria related to your signs and symptoms. Your doctor will also rule out other health conditions that have symptoms similar to SLE. It may take some time to gather all the necessary information for a diagnosis.

Some tests include:

  • Blood tests—specific tests may be positive with lupus
  • Urine tests—to look for kidney damage
  • Skin biopsy
  • Kidney biopsy—to diagnose type of kidney disease, if you have kidney damage
  • Imaging is done with an MRI scan—if you have any neurologic or psychiatric symptoms
 

Treatment    TOP

SLE is not curable, but it can be managed with medications and lifestyle changes. You may also need treatment for issues caused by SLE.

Talk with your doctor about the best treatment plan for you. Treatment options depend on the severity and location of your symptoms.

Medication

There are many different kinds of medications that are used to treat SLE. Examples include:

  • Antimalarial drugs—if no major organs are involved
  • Corticosteroids
  • Drugs to suppress the immune system
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)—only if you have no stomach symptoms
  • B-cell therapy
  • Anticoagulants—in patients at risk for blood clots

Your doctor may recommend that you take a combination of medications.

Preventing Flare-ups

Some lifestyle changes can help you prevent flare-ups of SLE. Lower doses of antimalarial drugs, corticosteroids, and drugs to suppress the immune system may also be used to prevent flares. Work with your doctor to create a plan for your symptoms.

  • Learn the signs of a flare-up and contact your doctor as soon as possible
  • Get immediate treatment for any cuts or infections
  • Manage symptoms for other chronic conditions caused by SLE
  • Avoid sun exposure
  • If you smoke, learn how to quit
  • Eat a healthy diet
  • Limit emotional stress
  • Get enough rest
  • Exercise regularly, with your doctor's permission

Chronic Care    TOP

Chronic conditions liks SLE are best managed with strong communication between you and your healthcare team. Make sure to go to all appointments as recommended. Let your doctor know about any changes in your health or care program.

Depression in people with chronic health conditions like SLE is common, emotional support is important. Surround yourself with supportive family and friends. If you are still having problems, consider counseling or joining a support group.

 

Prevention    TOP

There are no current guidelines to prevent SLE since the cause is not known.

RESOURCES:

Lupus Foundation of America
http://www.lupus.org

Lupus Research Institute
http://www.lupusresearchinstitute.org

CANADIAN RESOURCES:

Lupus Canada
http://www.lupuscanada.org

Lupus Foundation of Ontario
http://lupusfoundationofontario.com

REFERENCES:

Handout on health: Systemic lupus erythematosus. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at:
...(Click grey area to select URL)
Updated February 2015. Accessed May 16, 2016.

Systemic lupus erythematosus (SLE). EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated April 29, 2016. Accessed May 16, 2016.

Understanding lupus. Lupus Foundation of America website. Available at:
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Accessed May 16, 2016.

12/4/2009 DynaMed's Systematic Literature Surveillance
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Hartkamp A, Geenen R, Godaert GL, et al. Effects of dehydroepiandrosterone on fatigue and well-being in women with quiescent systemic lupus erythematosus. A randomized controlled trial. Ann Rheum Dis. 2010;69(6):1144-1147.

5/6/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Smyth A, Oliveira GH, Lahr BD, et al. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol. 2010;5(11):2060-2068.

11/25/2013 DynaMed's Systematic Literature Surveillance.
...(Click grey area to select URL)
Ludvigsson JF, Rubio-Tapia A, Chowdhary V, Murray JA, Simard JF. Increased risk of systemic lupus erythematosus in 29,000 patients with biopsy-verified celiac disease. J Rheumatol. 2012;39(10):1964-1970.



Last reviewed May 2016 by Michael Woods, MD
Last Updated: 11/25/2013

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