Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus (SLE), also known as lupus, is a serious, life-changing chronic autoimmune disease that occurs when the body’s immune system attacks its own healthy tissues and organs 1,2,3.

Inflammation caused by SLE can affect many different body systems, including the skin, joints, kidneys, blood cells, brain, heart and lungs 1,2. While symptoms are varied, the most distinctive sign of SLE (occurring in most but not all patients) is a facial rash that resembles the wings of a butterfly unfolding across both cheeks 2.

SLE is also characterized by episodes known as flares, when signs and symptoms worsen, and remissions, when the symptoms of the disease improve again or even disappear 1,4.

Fast Facts

SLE is a chronic autoimmune disease 1

There is no cure for SLE 3

The goals of treatment are to suppress the overactive immune system, reduce inflammation, control symptoms, prevent flares and minimize damage to organs 5

The majority of people with SLE are female of childbearing age 1

The cause of SLE is not known 3

SLE is a disease of flares and remissions 1

Who gets lupus?

The majority of people with SLE are women of childbearing age between the ages of 15 and 44 years. Men, children and teenagers can also be affected 1,3. People of all races and ethnic groups can develop SLE 1.

The course of lupus varies by individual and symptoms come (flares) and go (remission). There is no way to predict when a flare will happen, how bad it will be, or how long it will last.

Diagnosis is difficult and time-consuming, as there is no single test that can determine whether a person has or will develop lupus, and the diagnosis is based on a combination of physical symptoms and laboratory results.

Signs & Symptoms

Symptoms may include 4,7 
 

Extreme fatigue

Joint pain, stiffness and swelling

Haematologic disorders, such as anaemia

Shortness of breath

Facial or other rashes

Skin lesions that appear or worsen with sun exposure

Dry eyes

Oral or nasopharyngeal ulcers

Pleurisy

Kidney disease

Headaches, confusion, memory loss

Hair loss

Fever

Miscarriage (especially regarding Hughes Syndrome)

Weight loss

Chest pain

Neurologic disorders, such as depression

Vasculitis

Myocarditis

Approximately 5 million people throughout
the world have a form of SLE 1

Patients and families

Lupus has a major impact on the lives of patients, as well as on their families and their wider communities.

The debilitating fatigue and physical symptoms that come with lupus can significantly affect the social functioning of people with the condition.

For example, a typical middle-aged female patient of child-bearing age could find her family life significantly curtailed because her fatigue keeps her from interacting with her children or because she faces diminished family planning and fertility options. She may miss work and face repeated hospitalisation due to illness. She may limit her social and civic activities due to chronic illness. She may face loss of productivity, either through reduced working hours or enforced permanent unemployment.  

The symptoms of lupus make it difficult for people with moderate to severe disease to hold down a job 8.

Controlling lupus

Although there are medications to help reduce the signs and symptoms, there is no cure for SLE 2,3,6. The goals of treatment are to improve quality of life by suppressing the overactive immune system, reducing inflammation and gaining control over symptoms, prevent flares, and minimise damage to organs 5.

SLE is treated by a rheumatologist; however, if damage has been caused to a particular organ, other specialists will be consulted 5. As signs and symptoms flare and subside, treatment may need to be altered or doses adjusted 6.

References
  1. Lupus Foundation of America. What is lupus? Accessed May, 14, 2015 from http://www.lupus.org/answers/entry/what-is-lupus
  2. Mayo Clinic. Definition of Lupus. Accessed May, 14, 2015 from http://www.mayoclinic.org/diseases-conditions/lupus/basics/definition/con-20019676
  3. Lupus Europe. Accessed May, 14, 2015 from http://www.lupus-europe.org/lupus
  4. Mayo Clinic. Symptoms. Accessed May, 18, 2015 from http://www.mayoclinic.org/diseases-conditions/lupus/basics/symptoms/con-20019676
  5. Lupus Foundation of America. How is lupus treated? Accessed May, 14, 2015 from http://www.lupus.org/answers/entry/how-is-lupus-treated
  6. Mayo Clinic. Treatment. Accessed May, 14, 2015 from http://www.mayoclinic.org/diseases-conditions/lupus/basics/treatment/con-20019676
  7. Lupus The Essential Clinican's Guide 2nd Edition (Oxford Press 2014) Daniel J Wallace, MD, FACP, FACR page: 23-49
  8. Utset TO, Baskaran A, Segal BM, et al. Work disability, lost productivity and associated risk factors in patients diagnosed with systemic lupus erythematosus. Lupus Science & Medicine 2015;2:e000058. doi:10.1136/lupus-2014-000058.