Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a long-term autoimmune disorder that may affect the skin, joints, kidneys, brain and other organs. The underlying cause of autoimmune diseases is not fully known.

SLE is much more common in women than 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 medications.

Symptoms

Symptoms vary from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling. Some develop arthritis. Frequently affected joints are the fingers, hands, wrists and knees.

Other common symptoms include:

  • Chest pain when taking a deep breath
  • Fatigue
  • Fever with no other cause
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Hair loss
  • Mouth sores
  • Sensitivity to sunlight
  • Skin rash – a “butterfly” rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread.
  • Swollen lymph nodes

Other symptoms depend on what part of the body is affected:

  • Brain and nervous system: Headaches, numbness, tingling, seizures, vision problems, personality changes.
  • Digestive tract: Abdominal pain, nausea, vomiting.
  • Heart: Abnormal heart rhythms (arrhythmias).
  • Lung: Coughing up blood and difficulty breathing.
  • Skin: Patchy skin color, fingers that change color when cold (Raynaud’s phenomenon). Some patients only have skin symptoms. This is called discoid lupus.

Signs and tests

To be diagnosed with lupus, you must have 4 out of 11 typical signs of the disease.

Your doctor will perform a physical exam and listen to your chest with a stethoscope. An abnormal sound called a heart friction rub or pleural friction rub may be heard. A nervous system exam will also be done.

Tests used to diagnose SLE may include: Antibody tests, including antinuclear antibody (ANA) panel, complete blood count (CBC), Chest x-ray, kidney biopsy and urinalysis.

Treatment

There is no cure for SLE. The goal of treatment is to control symptoms.

Mild disease may be treated with:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat arthritis and pleurisy.
  • Corticosteroid creams to treat skin rashes.
  • An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms.
  • Protection from the sun. You should wear protective clothing, sunglasses, and sunscreen when in the sun.

More severe lupus may be treated with:

  • High-dose corticosteroids or medications to decrease the immune system response.
  • Cytotoxic drugs (drugs that block cell growth) if you do not get better with corticosteroids, or for those whose symptoms get worse when they stop taking them. These medicines have serious, severe side effects. You should be closely monitored by your doctor.

Severe or life-threatening symptoms can include hemolytic anemia, extensive heart or lung involvement, kidney disease, or central nervous system involvement, and often require more aggressive treatment by specialists.

Your care

If you have lupus, it is also important to have preventive heart care, up-to-date immunizations and screening for osteoporosis.

Many patients find support groups help relieve depression and mood changes that may occur in patients with this disease.

For more information

Visit the U.S. National Library of Medicine’s PubMed Lupus page.