Systemic lupus erythematosus

Systemic lupus erythematosus is a chronic autoimmune connective tissue disease affecting multiple systems.

Incidence of SLE is increased in females and especially those of Afro-Caribbean origin.

Diagnosis is by fulfilling 4 of the 11 criteria of the American College of Rheumatology:
  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Oral ulcers
  • Arthritis
  • Serositis – either pleuritis or pericarditis
  • Renal disorder –persistent proteinuria or cellular casts
  • Neurological disorder – seizures or psychosis
  • Haematological disorder – haemolytic anaemia or leukopeania or lymphopenia or thrombocytopenia
  • Immunologic disorder –
    • anti-dsDNA antibody or anti-Sm antibody or positive antiphospholipid antibodies
    • with either abnormal serum anti-cardiolipin antibody levels or positive lupus anticoagulant or false positive serological testing for syphilis
  • Abnormal ANA titre

Anti-dsDNA is positive in 70% of SLE patients (and 0.5% general population)
ANA is positive in 90% of SLE patients (and 30% general population)

Complications/associations of SLE
  • more prone to infections
  • increased risk of non-Hodgkins lymphoma
  • associated with antiphospholipid syndrome, which confers increased risk of thrombosis and miscarriage
  • lupus glomerulonephritis – occurs in 39%

Blood tests in flares of SLE may show:
  • Raised Anti-dsDNA titres
  • Decreased C3/C4 levels
  • Raised ESR

  • sunscreen
  • NSAIDs
  • Corticosteroids
  • Hydroxychloroquine
  • DMARDs (azathioprine, methotrexate)

Small print gem: Libman-Sacks endocarditis is an endocarditis found in SLE patients with non-infective vegetations, most commonly affecting the mitral valve.

author profile image

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book.

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)