Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, kidneys, brain, and other organs.

Definition and Prevalence

SLE is characterized by periods of flares and remission, with the immune system producing antibodies against the body's own tissues, leading to inflammation and tissue damage. According to the Lupus Foundation of America, approximately 1.5 million people in the United States have lupus, with women being nine times more likely to develop the disease than men.

Causes and Risk Factors

The exact cause of SLE is unknown, but it is believed to involve a combination of genetic, environmental, and hormonal factors. Risk factors for developing SLE include:

• Family history: Having a first-degree relative with lupus increases the risk of developing the disease.
• Sex: Women are more likely to develop lupus than men.
• Age: Lupus can occur at any age, but it is most common in women between the ages of 15 and 44.
• Ethnicity: African American, Hispanic, Asian, and Native American women are more likely to develop lupus than Caucasian women.

Symptoms

The symptoms of SLE can vary widely from person to person, but common symptoms include:

• Joint pain and swelling
• Skin rashes, including the characteristic "butterfly" rash on the face
• Fever
• Fatigue
• Weight loss
• Hair loss
• Photosensitivity (sensitivity to sunlight)
• Kidney problems, including nephritis and kidney failure
• Neurological problems, including seizures, psychosis, and cognitive impairment

Diagnosis

Diagnosing SLE can be challenging, as the symptoms are often nonspecific and can be similar to those of other diseases. A diagnosis of SLE is typically made based on a combination of:

• Medical history and physical examination
• Laboratory tests, including:
• Complete blood count (CBC)
• Erythrocyte sedimentation rate (ESR)
• C-reactive protein (CRP) level
• Antinuclear antibody (ANA) test
• Anti-double-stranded DNA (anti-dsDNA) antibody test
• Imaging studies, such as X-rays and ultrasound

Treatment

Treatment for SLE typically involves a combination of medications to manage symptoms, prevent flares, and reduce the risk of organ damage. Commonly used medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
• Corticosteroids to reduce inflammation and suppress the immune system
• Immunosuppressive medications, such as cyclophosphamide and azathioprine, to reduce the risk of organ damage
• Antimalarial medications, such as hydroxychloroquine, to reduce the risk of flares and improve symptoms
• Biological agents, such as belimumab, to reduce the risk of flares and improve symptoms

Complications

SLE can increase the risk of several complications, including:

• Kidney damage and failure
• Neurological problems, including seizures and psychosis
• Cardiovascular disease, including heart attacks and strokes
• Osteoporosis and increased risk of fractures
• Pregnancy complications, including miscarriage and premature birth

Prognosis

The prognosis for SLE varies widely depending on the severity of the disease and the effectiveness of treatment. With proper treatment, many people with SLE can lead active and normal lives. However, some people may experience persistent symptoms and increased risk of complications.