What are the symptoms of Systemic Lupus Erythematosus (SLE)?

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From the Guidelines

Lupus symptoms can vary widely, but commonly include fatigue, joint pain, skin rashes, fever, and sensitivity to sunlight, and can be effectively managed with a multidisciplinary approach, considering individual, medical, and societal costs, as recommended by the 2019 EULAR guidelines 1.

Common Symptoms of Lupus

  • Fatigue
  • Joint pain
  • Skin rashes (particularly the butterfly-shaped rash across the cheeks and nose)
  • Fever
  • Sensitivity to sunlight
  • Hair loss
  • Mouth sores
  • Chest pain
  • Dry eyes
  • Headaches
  • Raynaud's phenomenon (fingers turning white or blue in cold temperatures)

Internal Organ Involvement

Internal organ involvement can lead to:

  • Kidney problems
  • Shortness of breath
  • Heart inflammation
  • Neurological symptoms like memory issues or seizures

Blood Abnormalities

Blood abnormalities such as:

  • Anemia
  • Low white blood cell count
  • Low platelet count are common

Diagnosis and Treatment

Diagnosis typically requires a combination of clinical evaluation, blood tests, and sometimes tissue biopsies, and treatment goals include long-term patient survival, prevention of organ damage, and optimization of health-related quality of life, as stated in the 2019 EULAR recommendations 1.

Prognosis

The prognosis of lupus can be determined by several clinical involvement manifestations, laboratory tests, and immunological tests, as outlined in the 2008 EULAR recommendations 1.

Vaccination

Vaccination status should be assessed in the initial workup of patients with autoimmune conditions, including lupus, according to the European League Against Rheumatism (EULAR) 1.

From the Research

Lupus Symptoms

  • The symptoms of lupus vary between patients, but common symptoms include:
    • Unexplained fever
    • Skin rash
    • Swollen or painful joints
    • Fatigue
    • Kidney problems 2
  • People with lupus may experience periods of exacerbation of symptoms, which are termed 'flares', as well as periods of remission 2

Treatment and Management

  • Lupus can be treated effectively, but there is presently no cure for the condition 2
  • Hydroxychloroquine (HCQ) is the backbone therapy for SLE, and a judicious use must be accomplished, using doses that allow a good control of lupus without compromising the safety of treatments very much prolonged over the time 3, 4
  • Glucocorticoids (GCs) should be used more judiciously, with methyl-prednisolone pulses as the main therapy for inducing rapid remission and doses ≤5-2.5 mg/day be never exceeded in long-term maintenance treatments 3
  • Lifestyle changes, such as avoidance of ultraviolet light, and prevention of comorbidities, including coronary artery disease, osteoporosis, infections, and drug toxicities, are also important in the management of SLE 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Systemic lupus erythematosus: nurse and patient education.

Nursing standard (Royal College of Nursing (Great Britain) : 1987), 2012

Research

Hydroxychloroquine in systemic lupus erythematosus: overview of current knowledge.

Therapeutic advances in musculoskeletal disease, 2022

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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