From the Guidelines
Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease that can affect multiple organs and systems, and its signs and symptoms can vary widely from patient to patient.
Common Signs and Symptoms
- Musculoskeletal symptoms: such as arthritis, arthralgia, and myalgia are common in SLE patients 1
- Dermatologic symptoms: such as skin rashes, particularly the characteristic "butterfly" rash on the face, and photosensitivity are also common 1
- Renal symptoms: such as proteinuria and kidney damage, which can lead to lupus nephritis, a potentially life-threatening condition 1
- Neuropsychiatric symptoms: such as seizures, psychosis, and cognitive dysfunction can occur in some patients with SLE 1
- Cardiovascular symptoms: such as pericarditis and myocarditis can also occur in SLE patients 1
- Hematologic symptoms: such as anemia, leukopenia, and thrombocytopenia are common in SLE patients 1
- Gastrointestinal symptoms: such as abdominal pain, nausea, and vomiting can occur in some patients with SLE 1
- Pulmonary symptoms: such as pleuritis and pneumonitis can also occur in SLE patients 1
Diagnosis and Monitoring
The diagnosis of SLE is based on a combination of clinical manifestations, laboratory tests, and classification criteria, such as the EULAR/ACR 2019 criteria 1. The use of anti-dsDNA autoantibodies can be helpful in the diagnosis and follow-up of SLE, particularly in patients with lupus nephritis 1. Regular monitoring of patients with SLE is essential to detect and manage potential organ damage and to adjust treatment as needed 1. A holistic assessment, including clinical, urinary, and laboratory parameters, is important in informing clinical management decisions 1. Kidney biopsies can be useful in confirming the diagnosis and assessing the activity and chronicity of kidney involvement in SLE patients 1.
From the Research
Signs and Symptoms of Systemic Lupus Erythematosus (SLE)
The signs and symptoms of SLE can vary from person to person and may come and go, depending on what part of the body is affected 2. Some common initial symptoms include:
- Arthritis/arthralgia (74.5%) 3
- Rashes (61.8%) 3
- Oral ulcers 3
- Malar rash 3 Other symptoms may include fever, cytopenia, arthritis, and proteinuria, which may be indicative of lupus nephritis 4.
Organ System Involvement
SLE can affect multiple organ systems, including:
- Mucocutaneous system 4
- Musculoskeletal system 4
- Hematologic system 4
- Kidney system 4 Approximately 40% of people with SLE develop lupus nephritis, and an estimated 10% of people with lupus nephritis develop end-stage kidney disease after 10 years 4.
Diagnosis and Treatment
Diagnosis of SLE can be difficult because it mimics many other diseases and requires clinical and serologic criteria 2, 5. Treatment goals include reducing disease exacerbations, hospitalizations, and organ damage due to the disease or treatment toxicity 4. Hydroxychloroquine is standard of care for SLE and has been associated with a significant reduction in mortality 4. Other treatments, such as immunosuppressive agents and biologic therapies, may be used to treat moderate to severe disease 4.