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This version of SharkBytes has been archived as of February 28, 2019. To search through archived articles, visit nova.edu/search. To access the new version of SharkBytes, visit sharkbytes.nova.edu.
What is Systemic Lupus Erythematosus (SLE or lupus)?
Source: Centers for Disease Control and Prevention
Systemic Lupus Erythematosus is an autoimmune disease in which the immune system produces antibodies to cells within the body leading to widespread inflammation and tissue damage. The causes of SLE are unknown but are believed to be linked to genetic, environmental, and hormonal factors. SLE may be characterized by periods of illness and remissions. SLE has a variety of clinical manifestations and can affect joints, skin, brain, lungs, kidneys, and blood vessels. People with SLE may experience fatigue, pain or swelling in joints, skin rashes, and fevers. A team approach in treating lupus is often warranted due to the number of organ systems involved.
I. Background
- This report is on systemic lupus erythematosus (for shorthand, SLE or lupus), and not on 2 other types of lupus: discoid lupus (skin only), and drug-induced lupus (temporary).
- Lupus is a prototypical autoimmune disease with a wide array of clinical manifestations (rash, photosensitivity, oral ulcers, arthritis, pleuritis, pericarditis, kidney problems, seizures and psychosis, blood cell abnormalities). It is characterized by the production of antibodies to components of the cell nucleus.
- Primarily a disease of young women.
- Occurs from infancy to old age, with peak occurrence between ages 15 and 40.
- Females are affected far more than males.
- Blacks (and possibly Hispanics, Asians, and Native Americans) are affected more than whites.
- Although there is a strong familial aggregation, the disease is relatively uncommon and most cases are sporadic.
- May occur with other autoimmune conditions (e.g., thyroiditis, hemolytic anemia, idiopathic thrombocytopenia purpura).
- Diagnosis can be very difficult. The gold standard is a rheumatologist’s diagnosis. The American College of Rheumatology (ACR) uses a standard classification scheme requiring 4 of 11 criteria for research definition, although this is recognized to miss early and mild cases. Even so, there is
- Underdiagnosis because the presenting symptoms and signs are often not specific.
- Overdiagnosis because doctors mistakenly use a positive blood test (present in 5% of the healthy population) by itself to make a diagnosis.
- Accelerated atherosclerosis among these patients is a newly recognized phenomenon responsible for premature mortality.
- Treatment consists primarily of immunosuppressive drugs (e.g., hydroxychloroquine [Plaquenil] and corticosteroids [prednisone]). (1,2) In 2011 the FDA approved the first new drug for lupus in more than 50 years—belimumab [BENLYSTA®].
- Morbidity and mortality may be related to late diagnosis, problems in access to care, less effective treatments, and poor compliance with therapeutic regimens.
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