Living With Lupus – An Introduction to Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE) is an autoimmune condition that affects multiple organ systems. Its pathology is related to the release of antibodies that bind to normal nuclear components. For unknown reasons, in systemic lupus erythematosus, the body forms auto-antibodies against these normal molecules.

The damage in SLE occurs when these auto-antibodies bind to proteins. When this occurs, immune complexes form. These complexes get lodged in small blood vessels throughout the body wreaking havoc on whatever organ system is involved.

Systemic lupus erythematosus is a diagnosis based on clinical findings and laboratory data. Like many rheumatological and autoimmune conditions there is no single test that can rule in, or rule out the disease. A patient is likely to have SLE if at least 4 of 11 clinical and laboratory criteria are met.

Since systemic lupus erythematosus involves multiple organ systems the clinical presentation is highly variable. Many patients present with the classic lupus rash (aka: malar or butterfly rash seen on the cheeks). If kidney disease is present patients may present with swelling of the lower extremities or red tinged urine. If the lungs are involved, shortness of breath may be a presenting symptom. Seizures and neuro-psychiatric symptoms (depression, hallucinations, etc.) can also occur. An enlarged spleen and liver can sometimes be felt on physical exam. If patients have positive antiphospholipid antibodies they may be prone to forming blood clots; these antibodies can also cause recurrent abortions in women of childbearing years. Ultimately, the clinical signs and symptoms are highly variable and depend on the specific organ system(s) affected.

Treatment is based on medications that dampen the immune system. Steroids and non-steroidal anti-inflammatory medications are commonly used. Other immunosuppressive medications may also be used in certain patients.

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