Systemic Lupus Erythematosus (SLE)
About the disease & condition
Known Symptoms
- Constitutional: Fatigue, fever, weight loss.
- Mucocutaneous: Malar rash (butterfly rash), discoid lesions, photosensitivity. Oral/nasal ulcers, alopecia.
- Musculoskeletal: Arthralgia/arthritis (non-erosive), myositis. Renal: Lupus nephritis (proteinuria, hematuria, casts). Hematologic: Cytopenias (anemia, leukopenia, thrombocytopenia). Neuropsychiatric: Headaches, seizures, psychosis, cognitive dysfunction. Serositis: Pleuritis, pericarditis.
- Red flags: Rapidly progressive glomerulonephritis, CNS lupus, thrombotic events (associated with antiphospholipid antibodies).
Known Causes
- Etiology: Genetic predisposition (e.g., HLA-DR2/DR3, IRF5, STAT4).
Environmental triggers (e.g., UV light, infections, drugs, hormones). Epigenetic factors and immune dysregulation. - Pathophysiology:
- Autoantibodies (e.g., anti-dsDNA, anti-Smith) form immune complexes deposited in tissues, activating complement and causing inflammation.
- Type I interferon pathway activation, B-cell hyperactivity, and defective clearance of apoptotic debris.
Care
- Prevention: Avoid triggers (e.g., UV exposure, sulfa drugs).
Regular monitoring and early treatment to prevent flares. - Follow-up: Frequent assessment of disease activity (e.g., SLEDAI score).
Monitoring for organ involvement (e.g., renal function, urinalysis). Screening for comorbidities (e.g., osteoporosis, cardiovascular risk). Vaccinations (avoid live vaccines on immunosuppressants).
Note: SLE requires lifelong, multidisciplinary management (rheumatology, nephrology, dermatology). Treatment is tailored to disease severity and organ involvement. Patient education on medication adherence, lifestyle modifications, and pregnancy planning (if applicable) is crucial. Prognosis has improved with earlier diagnosis and advanced therapies, but organ damage remains a major cause of morbidity and mortality.
Relevant Specialties
Rheumatology
The Rheumatology & Clinical Immunology team at our diagnoses and treats disorders that arise when the immune system mistakenly attacks the body. These conditions can affect joints, muscles, skin and internal organs. Our specialists diagnose and combine clinical assessment with imaging, blood tests for autoantibodies and, where needed, tissue sampling, so treatment is based on clear evidence. Procdures are multidisciplinary: rheumatologists and clinical immunologists work closely with physiotherapists, pain specialists, surgeons, obstetricians and paediatric teams to create personalised plans for each patient. Treatment options range from conventional and biologic disease-modifying drugs to joint aspiration and targeted injections, alongside physiotherapy, bone-health management and supervised daycare infusions when required.
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