Also Known As
Lupus
Disseminated lupus erythematosus
Lupus erythematosus
SLE
LE
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This article waslast modified on 3 December 2017.
What is it?

Lupus (SLE) is a chronic, inflammatory autoimmune disorder that may affect many organ systems including the skin, joints, blood cells and internal organs, especially kidneys, and sometimes the brain. SLE affects women nine times more often than men and it usually occurs between the ages of 20-40 years. There is an increased incidence of lupus in persons of African, and Asian descent.  The cause of lupus is not fully understood.  It is thought to involve both an inherited component and a trigger that may be related to environmental factors and/or to hormones.  Certain drugs may also cause SLE.
Lupus may co-exist with other autoimmune disorders, such as Sjögren’s Syndrome, thyroid disease, and the antiphospholipid syndrome.

Symptoms and signs of lupus are highly variable and include:

  • Arthritis-like pain in one or more joints (but no or little joint damage)
  • A red rash – particularly one resembling a butterfly across the nose and cheeks; sensitivity to ultraviolet light
  • Fever
  • Persistent fatigue
  • Mouth ulcers
  • Muscle pain
  • Hair loss
  • There may also be inflammation and damage to organs and tissues including the kidneys, lungs, heart, lining of the heart, central nervous system, and blood vessels. 
  • Kidney disease is a frequent occurrence in patients with lupus.  Lupus causes glomerulonephritis, a condition that affects the kidney’s ability to filter toxins, which can lead to kidney failure if untreated.  
  • Sometimes involvement of the nervous system may occur and can lead to complications including headaches, seizures, depression, or even psychosis.

Symptoms of SLE come and go, vary over time, and vary from patient to patient.  They may worsen abruptly with flare-ups and then improve.  Flare-ups may be triggered by changes in the patient’s health status, such as physical or emotional stressors and/or by outside stimulants such as exposure to ultraviolet light (many affected persons are sensitive to sunlight), infections, and sometimes exposure to oestrogens such as in the combined oral contraceptive pill. It is important not to stop contraception abruptly, but to discuss with your doctor. Pregnant women may experience flare-ups during pregnancy or shortly after giving birth.

Some patients with lupus may also be affected by the antiphospholipid syndrome, where the blood becomes more prone to clot: this can lead to clots in arteries leading to strokes, and in veins such as deep vein thrombosis in the legs, or pulmonary embolism (blood clot in the lung). The antiphospholipid syndrome also leads to an increased risk of miscarriages. Antiphospholipid syndrome can also occur in the absence of underlying lupus.

 

Accordion Title
About SLE
  • Tests

    Diagnosis is made by, clinical evaluation of patient symptoms and examination findings, as well as the results of investigations. The following laboratory tests may be useful in the diagnosis of SLE:

    Anti-nuclear antibody test (ANA) is positive in almost all patients with SLE
    anti-double stranded DNA antibodies are frequently present, and the level can fluctuate with disease activity
    anti-Sm (specific to lupus, but only seen in 10-30% of cases)
    anti-SSA (Ro) and anti-SSB (La) antibodies may also be positive
    antiphospholipid antibodies

     

  • Treatment

    There is currently no cure for lupus, although many patients may experience remissions of symptoms between flare-ups, often with the help of treatment.  The goals of treatment are to alleviate symptoms, to minimise the occurrence of flare-ups and to minimise and address the development of complications associated with SLE.  To help decrease the number of flare-ups, patients should get sufficient rest, maintain a degree of exercise, and should minimise stress and avoid exposure to ultraviolet light. 

    Patients should work closely with their doctor and with their specialist (often a rheumatologist, a specialist in joint disease) to develop a treatment plan that is effective for them.  This plan is likely to change over time with changes in the patients’ symptoms, their general state of health and as new treatments become available.  Women wanting to become pregnant should talk to their doctor about their health and their medications.  Some treatments are safer than others for the fetus during pregnancy. 

    The types of treatment that are used depend on what symptoms and complications the patient is experiencing at that time and their severity.  Patients may take non-steroidal anti-inflammatory drugs (NSAIDs) to help alleviate pain and inflammation, though caution is needed if there is kidney disease.  Antimalarial drugs such as hydroxychloroquine, and chloroquine may be given to help ease lupus skin and joint symptoms and to help inhibit flare-ups.  For more severe symptoms, corticosteroids (such as prednisone) and immunosuppressants (such as azathioprine, cyclophosphamide, mycophenolate mofetil or methotrexate) may be given  - despite their associated side effects. It is important to discuss and assess the risks and benefits associated with these drugs with your healthcare professional before starting.

     

  • FAQs

    My doctor told me my ANA test is positive but is not sure I have lupus. How can this be?

    The body’s immune system normally produces antibodies  that are designed to fight off diseases and infections. In an autoimmune disease, something goes wrong with this system and the person’s body begins producing antibodies against their own tissues. Antinuclear antibodies (ANA) are antibodies that react with the cell nucleus (the central controlling part of the cell).  

    The ANA test looks at the concentration of antinuclear antibodies in a person’s blood. A positive result means that you have a higher than “normal” concentration of these antibodies. The incidence of a positive ANA in normal people increases with age, and for example, it is quite common to find weak positive ANA in the elderly population, in whom lupus is rare.

    ANA testing is one of the tools in diagnosing lupus as well as several other autoimmune diseases, so a positive result may be related to lupus or another disease. Just having a positive ANA blood test does not equate to a diagnosis of lupus. You may simply have a higher than normal concentration of these antibodies. To make a diagnosis of lupus, there should be suggestive clinical features, and often other abnormal laboratory test results.

    Even among people with lupus, the ANA results can vary widely – one person can be in remission at a certain level of ANA while another can be extremely ill at the same level. Interpreting what these results mean for you is the work of your doctor.

    For more FAQs, see the ‘Lupus A to Z: Q & A Overview’ pages on the Lupus UK website.