Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder. SLE may affect the skin, joints, kidneys, and other organs.
Disseminated lupus erythematosus; SLE; Lupus; Lupus erythematosus
SLE (lupus) is an autoimmune disease. This means there is a problem with the body's normal immune system response.
Normally, the immune system helps protect the body from harmful substances. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. The result is an overactive immune response that attacks otherwise healthy cells and tissue. This leads to long-term (chronic) inflammation.
The underlying cause of autoimmune diseases is not fully known.
SLE may be mild or severe enough to cause death.
SLE affects nine times as many women as men. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races.
SLE may also be caused by certain drugs. For information on this cause of SLE, see drug-induced lupus erythematosus.
Symptoms vary from person to person, and may come and go. The condition may affect one organ or body system first. Others may become involved later.
Other common symptoms include:
Other symptoms depend on what part of the body is affected:
The diagnosis of SLE is based upon the presence of at least 4 out of 11 typical characteristics of the disease. The doctor will listen to your chest with a stethoscope. A sound called a heart friction rub or pleural friction rub may be heard. A neurological exam will also be performed.
Tests used to diagnose SLE may include:
This disease may also alter the results of the following tests:
There is no cure for SLE. Treatment is aimed at controlling symptoms. Your individual symptoms determine your treatment.
Mild disease that involves a rash, headaches, fever, arthritis, pleurisy, and pericarditis does not need much therapy.
You should wear protective clothing, sunglasses, and sunscreen when in the sun.
Severe or life-threatening symptoms (such as hemolytic anemia, extensive heart or lung involvement, kidney disease, or central nervous system involvement) often require treatment by a rheumatologist and other specialists.
For additional information and support, see lupus resources.
The outcome for people with SLE has improved in recent years. Many people with SLE have mild illness. Women with SLE who become pregnant are often able to carry safely to term and deliver a normal infant, as long as they do not have severe kidney or heart disease and the SLE is being treated appropriately.
The presence of antiphospholipid antibodies may increase the possibility of pregnancy loss.
The 10-year survival rate for lupus patients is greater than 85%. People with severe involvement of the brain, lungs, heart, and kidney do worse than others in terms of overall survival and disability.
Some people with SLE have deposits of antibodies in the cells (glomeruli) of the kidneys. This leads to a condition called lupus nephritis. Patients with this condition may eventually develop kidney failure and need dialysis or a kidney transplant.
SLE causes damage to many different parts of the body, including:
Call your health care provider if you develop symptoms of SLE. Also, call if you have SLE and symptoms get worse or if new symptoms develop.
Ruiz-Irastorza G, Ramos-Casals M, Brito-Zeron P, Khamashta MA. Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review. Ann Rheum Dis. 2010;69:20-28.
Hahn BH, Tsao BP. Pathogenesis of systemic lupus erythematosus. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 74.