Understanding Systemic Lupus Erythematosus (SLE)

Among the different types of lupus, Systemic Lupus Erythematosus (SLE) is the most common form. It is an autoimmune condition in which the immune system attacks the body’s own tissues, causing inflammation and damage to various organs. SLE can affect the skin, joint, blood vessels, kidneys, lungs, and brain.

Symptoms of SLE

SLE symptoms may include rashes across cheeks (butterfly rash), arthritis, photosensitivity (sensitivity to light), painless sores in the mouth and nose, swollen glands, hair loss, Raynaud’s phenomenon (fingers and toes become white/pale or blue-purplish), fatigue, fever, and seizure.

Some adults may experience SLE flares, which are the recurring periods of symptoms. They can occur sporadically with years in between and may ease during periods of remission. However, others may face more frequent flares throughout their lifetime.

Risk factors

Gender	Women have a much higher chance to develop lupus in comparison with men, with up to 9 to 10 times as likely.
Environmental factors	Viral infections, specific medications, smoking, and sunlight might trigger lupus in individuals that are susceptible to SLE.
Genetics	Those who have relatives with lupus are at a greater risk of developing lupus.

Diagnosis of SLE

Diagnosing SLE can be difficult, as its symptoms often resemble those of other illnesses and can differ greatly between individuals. Typically, diagnosis involves a combination of clinical signs and laboratory tests.

Antinuclear Antibody (ANA) test	The most common initial test for lupus. A positive test result suggests that the immune system is producing antibodies that target the body’s own tissues. However, this alone does not confirm lupus, as it can also be present in other autoimmune diseases or even in healthy individuals.
Specific autoantibody tests	Anti-double-stranded DNA (anti-dsDNA) and anti-Smith (anti-Sm) antibodies.
Complement protein level test	Signs of lupus may include reduced levels of complement proteins (C3, C4) in the blood, as these proteins are frequently depleted during immune responses.
Blood count and urinalysis	Complete blood count (CBC) reveals possible anaemia, low white blood cell count, and low platelet count. While urinalysis is able to detect blood or protein in the urine which is an indicator of kidney involvement (lupus nephritis).

Relying solely on blood tests to diagnose for SLE might be risky as it could lead to a misdiagnosis. Given the complexity of diagnosing the condition, it is important to consult a rheumatologist for an accurate diagnosis. Rheumatologists sometimes employ specific criteria to classify SLE for research purposes.

Treatment for SLE

While currently there is no cure for SLE, it can be effectively managed through personalised treatment plans. These plans aim to control symptoms, prevent flare-ups, and minimise organ damage Since lupus can affect various parts of the body, each patient’s treatment plan is carefully tailored to their specific symptoms and needs.

Nonsteroidal anti-inflammatory drugs (NSAIDs)	To treat lupus-related fever, pain, and swelling.
Corticosteroids	Anti-inflammatory drugs that can lower immunological response and inflammation. During severe flare-ups, they are frequently prescribed at higher doses, which are then tapered down as symptoms subside.
Immunosuppressants	Medications that are able to suppress the immune system. Prescribed to people with severe lupus that affects the kidney, nervous system, or other organs, or if corticosteroids do not help or if stopping them makes the symptoms worse.

Potential complications of SLE

Typical complications associated with SLE include:

Skin scarring
Anaemia
Blood clots
Severely low platelet count
Lupus nephritis
Joint deformities
Damage to lung tissue
Inflammation of the intestines
Inflammation of blood vessels
Inflammation of the heart
Stroke
Pregnancy complications

Prevention methods of SLE flare

Sun protection	Use sunscreen and avoid direct exposure of sunlight if possible because exposure to ultraviolet (UV) light may cause or worsen symptoms of lupus.
Diet and nutrition	A diet low in fat, rich in fruits, vegetables, and whole grains, with moderate portions of meat, poultry, and fish. Consult a doctor to assess whether any dietary modifications are necessary.
Exercise	Gentle movement in small amounts that can benefit your health are generally recommended. Walking, swimming, yoga, tai chi, Pilates, and low-impact aerobics are all excellent examples of low-impact exercises that build and strengthen muscles.
Avoid smoking	Cigarette smoking has been linked to flare-ups in lupus symptoms. Consult a doctor to provide support for smoking cessation.
Watch out for possible medication allergy	People with lupus are more prone to antibiotic allergies, particularly to those containing sulfonamide. Inform any doctor treating you of your lupus, so they can prescribe suitable medications.

Book an appointment at Gleneagles Hospitals

If you or someone you care about has SLE, taking the initiative to manage the condition is essential. Keep in mind, you are not alone in this journey.

We at Gleneagles Hospitals have a dedicated team of expert rheumatologists that is available for you to consult regarding the condition. If you have any questions or concerns about it, you can schedule an appointment as well. We are committed to providing personalised care, tailored to your individual needs.

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