Systemic Lupus Erythematosus Overview

Systemic Lupus Erythematosus (SLE) Overview

• SLE is a chronic, inflammatory autoimmune disorder impacting connective tissue.
• More prevalent in women than men, particularly in age groups 16 to 55.
• Commonly affects individuals of Asian, Black, and Hispanic descent compared to White populations.
• Gender differences include higher incidence of renal disease and hypertension in men, while women more commonly experience Raynaud phenomenon.
• Genetic predisposition involves susceptibility genes and lack of protective genes, exacerbated by epigenetic factors.
• Hormonal influences, like estrogen and progesterone, contribute to immune system activation in women.

Pathophysiology

• Activation of B cells leads to the production of autoantibodies, notably antinuclear antibodies.
• Formation of immune complexes due to these autoantibodies targets the body's own tissues, including nucleic acids and blood cells.
• A hyperactive helper T cell environment with subdued suppressor T cells supports excessive B cell production.

Diagnosis of SLE

• Clinical diagnosis based on accumulation of criteria; four or more criteria suggest diagnosis.
• Some patients may not meet criteria despite presenting symptoms, leading to delayed diagnosis.
• Common criteria include vague symptoms such as fatigue and fever, alongside more specific manifestations.

Clinical Manifestations

• Skin Symptoms:
  • Malar rash ("butterfly" rash) across the face and photosensitivity.
  • Discoid lupus characterized by rough, scaly, raised red circular lesions.
• Oral Symptoms:
  • Oral ulcers resembling aphthous ulcers, can also appear in the nasal cavity.
• Hair Loss:
  • Patchy alopecia.
• Joint Symptoms:
  • Synovitis, resulting in pain and swelling in two or more symmetric joints, often migratory.
• Serositis:
  • Inflammation of serous membranes in the lungs (pleura), heart (pericardium), and abdomen (peritoneum).
• Hematological Manifestations:
  • Conditions such as hemolytic anemia and leukopenia.