Dr. M.J. Bazos,
What is Systemic Lupus
erythematosus (also called SLE or lupus) causes a variety of problems. It may
cause skin rashes, arthritis, anemia, seizures or psychiatric illness, and often
affects internal organs including the kidneys, lungs and heart. Once a disease
with high mortality, SLE is now considered a chronic disease. In 1954, survival
after 4 years was 50%; today it is more than
is a chronic inflammatory disorder resulting from an abnormality of the immune
system, which normally functions to protect the body against cancers and
invading infections. In SLE, the immune system is over-active and produces too
many abnormal antibodies that react with the patient’s own tissues. The
exact cause of lupus is not known, but heredity, environment and hormonal
changes may be involved.
- Prevalence of SLE is 40 to 50 per 100,000.
- It is more common in certain ethnic groups,
particularly among blacks.
- More than 85 percent of lupus patients are women.
of its wide variety of symptoms, diagnosis is often difficult and requires a
high degree of awareness among physicians. Typical features of SLE include:
- A butterfly-shaped rash over the cheeks
- A skin rash appearing in areas exposed to the sun
- Sores in the mouth and nose
- Arthritis involving one or more joints
- Kidney inflammation
- Nervous system disorders including seizures,
mental disorders and strokes
Fever, weight loss, hair loss,
poor circulation in the fingers and toes, chest pain when taking deep breaths
(pleurisy) and abdominal pain are often seen.
Laboratory studies are crucial to
diagnosing SLE. In particular, the antinuclear antibody (ANA) test is almost
always positive in SLE. A precise diagnosis is often appropriately delayed
because the disease may evolve
for SLE depends on the clinical problems present and whether the disease is
active or not at a given time. Earlier and more accurate diagnosis, better
understanding of the immune abnormalities in SLE, and treatment studies have all
contributed to improved treatment of patients with
SLE.Regular medical evaluation is
important to monitor SLE. Drug treatment must be individualized for each
patient, depending on the particular problems and their severity. For mild
inflammation, nonsterodial anti-inflammatory medications are helpful.
Corticosteroids, the single most important drugs to treat SLE, must be used
judiciously. Bone protection is important when steroids are used. Anti-malarials
such as ydroxychloroquine reduce SLE activity and are helpful for the skin and
joints. More severe SLE requires immunosuppressive drugs such as azathioprine
and cyclophosphamide. The disease often enters quiet periods with little or no
activity (remission), during which medications can be reduced and occasionally