Systemic Lupus Erythematosus (SLE): Symptoms, Diagnosis, and Treatment

Study Notes

Symptoms

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various parts of the body
Common symptoms:
- Joint pain or swelling (arthritis)
- Fatigue
- Fever
- Skin rashes (especially on the face, neck, and hands)
- Hair loss
- Mouth sores
- Swollen lymph nodes
- Weight loss
- Headaches
- Confusion or memory loss
Symptoms can be mild or severe and can come and go
Some people may experience periods of remission

Diagnosis

Diagnosis is based on:
- Medical history
- Physical examination
- Laboratory tests (e.g., complete blood count, erythrocyte sedimentation rate, anti-nuclear antibody test)
- Imaging studies (e.g., X-rays, CT scans)
American College of Rheumatology (ACR) classification criteria:
- 4 out of 11 criteria must be met:
  - Malar rash
  - Discoid rash
  - Photosensitivity
  - Oral ulcers
  - Arthritis
  - Serositis
  - Renal disorder
  - Neurological disorder
  - Hemolytic anemia
  - Leukopenia
  - Antinuclear antibody

Treatment Options

Goals of treatment:
- Control symptoms
- Prevent flares
- Reduce disease activity
- Minimize damage to organs
Treatment plans are individualized and may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids
- Immunosuppressive drugs (e.g., azathioprine, cyclophosphamide)
- Antimalarials (e.g., hydroxychloroquine)
- Biologics (e.g., belimumab)
- Lifestyle modifications (e.g., stress management, exercise, sun protection)

Lupus Nephritis

Lupus nephritis is a common complication of SLE, affecting up to 60% of patients
Characterized by inflammation of the kidneys (glomerulonephritis)
Symptoms:
- Hematuria (blood in the urine)
- Proteinuria (excess protein in the urine)
- Edema (swelling)
- Hypertension
Diagnosis:
- Urine tests (e.g., urinalysis, protein-to-creatinine ratio)
- Kidney biopsy
Treatment:
- Immunosuppressive drugs (e.g., cyclophosphamide, mycophenolate mofetil)
- Corticosteroids
- Blood pressure management
- Dialysis (in severe cases)

Lupus Myocarditis

Lupus myocarditis is a rare but potentially life-threatening complication of SLE
Characterized by inflammation of the heart muscle (myocardium)
Symptoms:
- Chest pain
- Shortness of breath
- Fatigue
- Palpitations
Diagnosis:
- Electrocardiogram (ECG)
- Echocardiogram
- Cardiac MRI
- Blood tests (e.g., troponin, creatine kinase)
Treatment:
- Corticosteroids
- Immunosuppressive drugs (e.g., azathioprine, cyclophosphamide)
- Cardiovascular medications (e.g., beta blockers, ACE inhibitors)

Description

This quiz covers the symptoms, diagnosis, treatment options, and complications of Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease that can affect various parts of the body. Test your knowledge of this complex condition and its management.