Systemic Lupus Erythematosus (SLE): Understanding the Disease

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease where the immune system attacks healthy tissues, causing inflammation and damage to joints, skin, kidneys, lungs, heart, brain, and blood vessels.

Epidemiology

• Predominantly affects women of childbearing age (9:1 female:male).
• Higher prevalence and severity in African American, Hispanic, Asian, Native American women.

Causes

Unknown; likely genetic susceptibility + environmental triggers (UV light, infections, hormones, drugs).

Common Symptoms

• Fatigue, fever
• Joint pain/swelling (arthralgia/arthritis)
• Malar (butterfly) rash, photosensitivity
• Renal (lupus nephritis)
• Cardiovascular (pericarditis, accelerated atherosclerosis)
• Neuropsychiatric (seizures, psychosis, cognitive dysfunction)
• Hematologic (anemia, leukopenia, thrombocytopenia)

Diagnosis

Clinical criteria (EULAR/ACR 2019) + positive ANA + specific autoantibodies (anti-dsDNA, anti-Sm).

Treatment

• NSAIDs (mild joint/pleural pain)
• Antimalarials (hydroxychloroquine) – cornerstone for all patients
• Corticosteroids (flares, severe disease)
• Immunosuppressants (methotrexate, azathioprine, mycophenolate, cyclophosphamide)
• Biologics (belimumab, anifrolumab, rituximab)

Prognosis

Variable; 10-year survival >90% with modern care. Early diagnosis, adherence, and multidisciplinary management improve outcomes.

No known prevention.