Overview
Systemic lupus erythematosus (SLE) is a chronic,
multisystem, inflammatory, autoimmune disorder. It is further described in the Introduction section.
Systemic lupus erythematosus 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 systemic lupus erythematosus.
Categories of disease activity in systemic lupus erythematosus are described
in detail in the Classification
section.
History and Physical Examination
Most patients with systemic lupus erythematosus 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 systemic lupus erythematosus, 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 systemic lupus erythematosus are also in this section.
Complete blood count (CBC) and antinuclear antibodies (ANAs)
may be performed to help with the diagnosis of systemic lupus erythematosus. 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 systemic lupus erythematosus (NPSLE).
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 systemic lupus erythematosus 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 systemic lupus erythematosus drugs
may have Complications and
these are enumerated and discussed in this section.
