Lupus - Systemic Lupus Erythematosus

Systemic lupus erythematosus, OR SLE, is an autoimmune disorder that affects many parts of the body. An autoimmune disorder is a condition in which the body creates antibodies against its own tissues.

What is going on in the body?

A person with SLE produces antibodies against many of his or her own tissues. This autoimmune reaction can damage many parts of the body. These include:

What are the causes and risks of the disease?

The exact cause of systemic lupus erythematosus is unknown. It is believed to be an autoimmune disorder. SLE tends to run in families.

New research findings suggest that autoimmune disorders may be triggered by a transfer of cells between the fetus and the mother during pregnancy. The study involved women with scleroderma, an autoimmune disorder involving the skin. These women have more fetal cells in their blood decades after a pregnancy than women who don't have scleroderma. While further research is needed to substantiate these findings, the study does offer an explanation for the much higher incidence of autoimmune disorders in women than in men.

Certain medications have been known to cause systemic lupus erythematosus. These include procainamide, hydralazine, isoniazid, and chlorpromazine. Events that may trigger the disease include infection, stress, exposure to toxins, and sunlight.

Women account for 80% to 90% of cases of SLE. It is more common in black women than in white women. SLE is also more common in Asian, Hispanic, and Native American women.

What are the signs and symptoms of the disease?

Because SLE affects so many different parts of the body, the disease has many signs and symptoms. These are best listed by organ system.

Signs and symptoms that affect the whole body:

Signs and symptoms that affect the skin:

Symptoms and signs that affect the muscles, bones, and joints:

Signs and symptoms of kidney involvement:

Signs and symptoms affecting the nervous system:

Signs and symptoms involving the blood:

Signs and symptoms involving the heart:

Signs and symptoms involving the lungs:

Signs and symptoms affecting the digestive system:

Symptoms and signs affecting the eye:

How is the disease diagnosed?

A complete medical history and physical examination are important tools for diagnosing SLE. Blood tests also play an important role. A blood test called an ANA looks for antibodies that the person has produced against his or her own tissues.

Other tests used to diagnose SLE include the following:

What can be done to prevent the disease?

Most cases of systemic lupus erythematosus cannot be prevented. It may be helpful to avoid medications that cause SLE, but not everyone who takes these medications will develop the disease.

What are the long-term effects of the disease?

SLE is a long-term disease that flares up, then quiets down, then flares up again. Persons with SLE often have a significant decrease in the quality of daily life. Many complications of SLE put the person at risk. Many of the medications used to treat the disease also have significant side effects. SLE can be fatal, often as a result of kidney failure, infections, or heart attack.

What are the risks to others?

There is no evidence that SLE is a contagious disease that can be passed from one person to another. However, it does tend to run in families. Pregnant women with SLE have an increased risk of miscarriages, stillbirths, and premature infants.

What are the treatments for the disease?

Although there is no cure for SLE, certain things can help prevent flare-ups. Persons with SLE should avoid intense sun exposure. Liberal use of sunscreens, long-sleeved shirts, and hats are helpful.

Since infections are common, persons with SLE should seek prompt evaluation of fevers. A yearly flu vaccine is recommended. If the spleen is removed, the person should receive the pneumococcal vaccine. Individuals should also receive antibiotics before any dental procedures.

A number of medications are used to treat SLE, including the following:

Individuals with end-stage kidney disease may benefit from kidney dialysis or a kidney transplant.

What are the side effects of the treatments?

The medications used to treat lupus have significant side effects. Unfortunately, some of these side effects can mimic the symptoms of the disease itself.

NSAIDs can cause stomach irritation, allergic reaction, and decreased kidney function.

Antimalarial medications can cause rash, muscle weakness, and nerve problems.

Corticosteroids have a host of possible side effects. These include weight gain, high blood pressure, osteoporosis, and increased risk of infection.

The cytotoxic medications can cause problems with the bladder and with blood cell production.

What happens after treatment for the disease?

Systemic lupus erythematosus is a chronic disease that fluctuates over time. The best way to manage it is by active collaboration between the individual and his or her healthcare providers.

How is the disease monitored?

Periodic examinations allow the healthcare provider to monitor the activity of the disease and determine possible complications. A variety of blood tests help in the monitoring of the disease. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Minot Cleveland, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:03/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/06/01