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KEY CONCEPTS
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Systemic lupus erythematosus (SLE) is considered a disease primarily of young women, but it can occur in anyone. The prevalence and severity vary with sex, race, ethnicity, and socioeconomic factors.
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Understanding the etiology of SLE and environmental factors that can initiate or exacerbate the disease may make it possible to avoid those triggers.
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SLE is an autoimmune disease characterized by the presence of autoantibodies, some of which may play a role in the pathogenesis of the disease. An understanding of disease mechanisms can lead to targeted drug therapy.
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SLE is a multisystem disease that can involve almost any organ and may present in many different ways. Therapy is determined by the manifestations in each patient, which may change and fluctuate in severity over time.
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Lifestyle changes can modify risk factors for SLE flares and complications.
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The overall goals of therapy are to prevent disease flares and involvement of other organs, decrease disease activity and prevent damage, achieve and maintain remission, reduce use of corticosteroids, and improve quality of life, while minimizing adverse effects and costs. Most patients with SLE should receive hydroxychloroquine alone or in combination with other therapy appropriate for the disease manifestations.
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Pregnancy planning is essential for good outcomes. Pregnancy outcomes are best when the disease is controlled before conception. Drugs used to treat SLE may adversely affect fertility and the fetus.
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Antiphospholipid antibodies are associated with arterial and venous thrombosis and obstetric complications.
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Many drugs can induce a lupus-like syndrome. The manifestations and laboratory findings may be different between the traditional drug-induced lupus and that seen with use of tumor necrosis factor-alpha inhibitors.
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Since SLE can present in many different ways, it is difficult to design standard response criteria. Development of appropriate criteria is essential for the approval of new drugs.
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Preclass Engaged Learning Activity
Go to lupus organization Websites that are designed for patients:
World Lupus Federation (https://tinyurl.com/smmwg2k): review the document, “Lupus Knows No Boundaries e-Report” (https://tinyurl.com/tgasjgo)
Lupus Foundation of America (https://tinyurl.com/yyz8etzd): explore the section, Understanding Lupus (https://tinyurl.com/tkjxavy)
Lupus Canada (https://tinyurl.com/r34lghm): review the Living with Lupus Section (https://tinyurl.com/uf2sxmd)
Summarize what you learned about SLE from the Personal Stories section (https://tinyurl.com/r7dxhmo).
What questions would you have if you developed lupus?
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Systemic lupus erythematosus (SLE) is an autoimmune disease associated with autoantibody production. The term “lupus” (Latin for wolf) was first used in the 13th century to describe erosive lesions that looked like skin that had been gnawed by a wolf. In the 1800s, it was recognized that other organs may be affected and we now know that SLE is a multisystem disease. The common finding in SLE is production of autoantibodies.1 This is an exciting time in the management of SLE because a better understanding of disease mechanisms has led to ...