Systemic Lupus Erythematosus Disease Summary

Overview

Systemic lupus erythematosus (SLE) is a chronic, multisystem, inflammatory, autoimmune disorder. It is further described in the Introduction section.

SLE frequently occurs in Asians, Africans and Hispanics. Information about the regional and worldwide incidence and prevalence of this disease can be found in the Epidemiology section.

The Pathophysiology section describes the interplay between genetic and environmental factors that alter the patient’s immunity that can cause the development of SLE.

Categories of disease activity in SLE are described in detail in the Classification section.

History and Physical Examination

Most patients with SLE present with arthralgia of the hand. But systemic signs and symptoms vary, and these are enumerated in the Clinical Presentation section.

Diagnosis

The European League Against Rheumatism (EULAR) or American College of Rheumatology (ACR) provides the criteria for the diagnosis of SLE, and these are enumerated and discussed in the Diagnosis or Diagnostic Criteria section. Disease activity indices that can be used in assessing disease activity of SLE are also in this section.

Complete blood count (CBC) and antinuclear antibodies (ANAs) may be performed to help with the diagnosis of SLE. The Laboratory Tests and Ancillaries section states the other tests that may be performed for the confirmation of the diagnosis of systemic lupus erythematosus and some of its specific manifestations like lupus nephritis and neuropsychiatric SLE.

The Differential Diagnosis section has enumerated conditions that can mimic systemic lupus erythematosus, and they should be identified and ruled out.

Management

The Evaluation section mentions the importance of multidisciplinary team approach in managing patients with systemic lupus erythematosus thus proper specialist referral should be done. This section also discusses the comorbidities of systemic lupus erythematosus.

The Principles of Therapy section enumerates the goals of therapy and the individualized approach in managing patients with systemic lupus erythematosus.

Therapeutic agents for systemic lupus erythematosus such as anti-inflammatory agents, disease modifying anti-rheumatic drugs (DMARDs), immunosuppressants, biologic agents, intravenous immunoglobulin and nonsteroidal anti-inflammatory drugs (NSAIDs) are enumerated and discussed in detail in the Pharmacological Therapy section. Drug options for specific manifestations of SLE and comorbidities are also in this section.

Patient education is discussed in detail in the Nonpharmacological section. In this section also there is a discussion on plasma exchange or plasmapheresis.

Lifetime Monitoring is essential in patients with systemic lupus erythematosus and this section mentions that the frequency of visits depends on the disease activity, severity and extent, response to treatment, type of treatment, and monitoring of toxicity. Parameters to assess during these visits are also enumerated in this section.

Patients in long-term treatment with SLE drugs may have Complications and these are enumerated and discussed in this section.