Systemic Lupus Erythematosus
(Lupus; SLE; Lupus, Systemic)
- Other connective tissue and organs
- Genetic factors
Environmental factors, which may include:
- Sunlight (UV rays)
- Viral or other type of infection
- Drug-induced (methyldopa, procainamide, hydralazine, isoniazid, chlorpromazine, TNF-blocking drugs)
- Sex: female to male ratio: 10:1
- Age: childbearing age (20-45 years)
- Race: African American, Native American, Asian, and Hispanic
- Swollen and/or painful joints
- Skin rashes over areas exposed to sunlight (especially on the nose and cheeks)
- Extreme fatigue
|Common Lupus Rash Sites|
|Facial butterfly rash is hallmark of Lupus.|
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- Hair loss
- Chest pain, coughing up blood, shortness of breath, difficulty breathing
- Kidney inflammation
- High blood pressure
- Anemia or other blood disorders
- Sensitivity to sunlight
- Raynaud phenomenon
- Ulcers in nose or mouth
- Swollen glands
- Inflamed heart, heart vessels, or membrane surrounding the heart
- Blood clots
- Butterfly facial rash
- Rash (or red patches) on sun-exposed areas
- Skin photosensitivity (easily burned by the sun)
- Ulcers in the mouth or near the throat
- Arthritis in at least two joints
- Inflammation of the lining of the heart or lungs (called serositis)
- Kidney problems (identified by kidney function tests)
- Seizures or psychosis that are not caused by another condition
- Abnormally low number of blood cells
- Antinuclear antibodies—these are immune chemicals produced by your body that attack the nuclei in your cells. These antinuclear antibodies may contribute to the cause of lupus.
- Immune dysfunction—in people with lupus, several other antibodies have been found. These antibodies can be detected with lab tests.
- Blood tests, such as complete blood count, antinuclear antibody (ANA) test
- Urine test to check kidney functioning
- Imaging tests (such as MRI scan) if you have neurological symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs)—to relieve joint pain
- Antimalarial drugs (such as hydroxychloroquine, chloroquine)—to relieve joint pain, fatigue, and rashes
- Corticosteroids—to reduce inflammation
- Drugs to suppress the immune system (such as azathioprine, mycophenolate, methotrexate)—to help with symptom relief if the other medicines are not working
- Prescription steroid cream for rashes (such as fluocinonide cream)
- Hormonal medicine (dehydroepiandrosterone [DHEA])—to reduce symptoms
- B-cell therapy (such as rituximab)—experimental medicine to reduce the number of white blood cells
- Oral and intravenous corticosteroids to control and limit inflammation in kidney, brain, lung, and heart, as well as in cases of severe anemia
- Immunosuppressive drugs to suppress the body's autoimmune system
- Mycophenolate, azathioprine, and cyclophosphamide for kidney disease or other life- or organ-threatening conditions
- Rituximab for refractory disease
Other Treatment Options
- Eat a healthy diet. Adding omega-3 fatty acids, found in certain types of fish, may help with symptoms.
- Exercise regularly. Your doctor can give you advice as to which exercises are safe for you to do.
- Protect your skin from the sun. Wear sunscreen with an SPF of at least 30 whenever you go out in the sun.
- Work with a therapist. Counseling may help you to build skills to cope with your condition.
- Schedule regular check-ups.
- Treat all infections quickly and vigorously.
- Avoid sun exposure and wear sunscreen and protective clothing when outdoors .
- Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
- Limit emotional stress.
- Get adequate rest.
- Exercise moderately (as much as your condition allows) with your doctor's permission.
- Call your doctor if you think you will have a flare-up.
- Avoid oral contraceptives, especially if you have had a blood clot.
Lupus Foundation of America, Inc. http://www.lupus.org
Lupus Research Institute http://www.lupusresearchinstitute.org
Lupus Canada http://www.lupuscanada.org
Lupus Foundation of Ontario http://vaxxine.com/lupus
Beers MH, Fletcher AJ. The Merck Manual of Medical Information. New York, NY: Simon and Schuster, Inc; 1999.
Contreas G, Pardo V, Leclercq B, et al. Sequential therapies for proliferative lupus nephritis. N Engl J Med . 2004;350;971-980.
Dehydroepiandrosterone (DHEA). EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated September 2009. Accessed December 4, 2009.
Dorner T, Lipsky PE. Immunoglobulin variable-region gene usage in systemic autoimmune diseases. Arthritis Rheum . 2001;44:2715-2727.
DynaMed Editorial Team. Systemic lupus erythematosus (SLE). EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 19, 2010. Accessed July 13, 2010.
Gescuk BD, Davis JC Jr. Novel therapeutic agents for systemic lupus erythematosus. Curr Opin Rheumatol. 2002;14:515.
Hejaili F, Moist LM, Clark WF. Treatment of lupus nephritis. Drugs. 2003;63:257-274.
Lupus. National Institute of Arthritis and Muskuloskeletal and Skin Diseases, National Institutes of Health website. Available at: http://www.niams.nih.gov/Health%5FInfo/Lupus/default.asp. Published September 1997. Updated August 2003. Accessed June 26, 2008.
Lupus Foundation of America. Treatments for lupus. Lupus Foundation of America website. Available at: http://www.lupus.org/webmodules/webarticlesnet/templates/new%5Flearntreating.aspx?articleid=2245&zoneid=525. Accessed August 31, 2010.
Mayo Clinic. ANA test. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/ana-test/MY00787/DSECTION=how-you-prepare. Updated July 8, 2010. Accessed August 31, 2010.
Mayo Clinic. Lifestyle and home remedies. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/lupus/DS00115/DSECTION=lifestyle-and-home-remedies. Updated July 8, 2010. Accessed August 31, 2010.
Mayo Clinic. Treatments and drugs. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/lupus/DS00115/DSECTION=treatments-and-drugs. Updated July 8, 2010. Accessed August 31, 2010.
Polsdorfer R. Lifestyle changes to manage systemic lupus erythematosus. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 30, 2010. Accessed August 31, 2010.
Polsdorfer R. Medications for systemic lupus erythematosus. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 4, 2009. Accessed August 31, 2010.
Sherer Y, Gorstein A, Fritzler MJ, Shoenfeld Y. Auto-antibody explosion in systemic lupus erythematosus: more than 100 different antibodies found in SLE patients. Semin Arthritis Rheum . 2004;34:501-537.
Smolen JS. Therapy of systemic lupus erythematosus: a look into the future. Arthritis Res. 2002;4(suppl)3:S25.
Symptoms. Lupus Foundation of America website. Available at: http://www.lupus.org/webmodules/webarticlesnet/templates/new%5Flearnunderstanding.aspx?articleid=2235&zoneid=523 . Accessed June 26, 2008.
12/4/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Hartkamp A, Geenen R, Godaert GL, Bijl M, Bijlsma JW, Derksen RH. Effects of dehydroepiandrosterone on fatigue and well-being in women with quiescent systemic lupus erythematosus. A randomized controlled trial. Ann Rheum Dis. 2009 Oct 22. [Epub ahead of print]
5/6/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Smyth A, Oliveira GH, Lahr BD, Bailey KR, Norby SM, Garovic VD. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol. 2010;5(11):2060-2068.
- Reviewer: Rosalyn Carson-DeWitt, MD
- Update Date: 09/01/2011