Systemic Lupus Erythematosus

Inflammation of the body’s connective tissues, causing damage to the skin, joints, and internal organs

  • Most common between the ages of 16 and 55
  • Much more common in females
  • Sometimes runs in families; more common in some ethnic groups
  • Stress and sunlight may be risk factors

In systemic lupus erythematosus (SLE), the body produces antibodies that react against its own connective tissues. These tissues, which surround body structures and hold them together, become inflamed and swollen. SLE may affect only a few parts of the body or many, and symptoms may range from mild to severe.

The cause of the abnormal immune reaction that occurs in SLE is not known, but it may be triggered by factors such as a viral infection, stress, or sunlight. Hormonal factors may also be involved because many more women than men are affected. SLE sometimes runs in families and appears to be more common in black and Asian women, which suggests that a genetic factor is involved. Symptoms similar to those of SLE may be caused by certain drugs, such as hydralazine (see Antihypertensive drugs) and chlorpromazine (see Antipsychotic drugs).

What are the symptoms?

In typical cases of SLE, the symptoms flare up intermittently for periods of weeks and then become less severe, sometimes for months or even years, but they rarely disappear completely.

People who have SLE may have widely varying symptoms. For example, some people suffer from mild symptoms that appear gradually, whereas others report a wide range of more severe symptoms that develop far more rapidly.

The most common symptoms are:

  • Aching, swollen joints, which may become increasingly painful.

  • Skin rashes – characteristically a raised, red, butterfly-shaped rash on the nose and cheeks.

  • Increased sensitivity to sunlight.

  • Tiredness and fever.

  • Mild depression.

Additionally, there may be less common symptoms of SLE, which include:

  • Shortness of breath and chest pain if the membrane covering the lungs is inflamed (see Pleurisy).

  • Headaches, seizures, or strokes due to involvement of the nervous system.

  • Constant chest pain if the membrane that covers the heart is inflamed (see Pericarditis).

  • Hair loss.

  • Pale skin.

  • Painless mouth ulcers.

Women who have SLE may find that their symptoms become worse while they are taking oral contraceptive pills or during pregnancy, as a result of hormonal changes.

Butterfly-shaped rash in SLE

A common symptom of systemic lupus erythematosus is a red, raised rash that spreads across the nose and the cheeks in a shape that resembles a butterfly.

Are there complications?

SLE may cause damage to the kidneys, which can lead to high blood pressure (see Hypertension) and eventually kidney failure. In severe cases, problems with painful, swollen joints may cause deformity. SLE may occur in association with polymyositis and dermatomyositis.

Although many women with SLE have successful pregnancies, the risk of having an early miscarriage is increased. If you have SLE and are planning a pregnancy, you ask your doctor for advice.

What might be done?

Since the symptoms of SLE are so varied, they often mimic those of other disorders. However, if your doctor suspects that you may have SLE, he or she may arrange for blood tests to look for antibodies associated with the condition. You may also need to have certain specific tests to determine whether the function of particular organs has been affected by the disorder.

There is no cure for SLE; treatment is aimed at relieving the symptoms and slowing the progression of the condition. However, if you have SLE-like symptoms that are triggered by a particular drug, your doctor will prescribe an alternative treatment if possible, and your symptoms should gradually disappear within a few weeks or months.

If your joints are painful, your doctor may recommend a nonsteroidal anti-inflammatory drug. You may also be given the drug hydroxychloroquine (see Antimalarial drugs), which is often used to control the symptoms of SLE. A corticosteroid may be given to suppress severe inflammation. If the condition fails to respond to corticosteroids, an immunosuppressant drug may be prescribed. Physiotherapy may be suggested for joint problems. Your doctor may also advise you to avoid direct exposure to the sun and to ensure that infections are treated without delay.

Most people with SLE can lead an active life. However, in more severe cases, life expectancy may be shortened.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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