Systemic lupus erythematosus (SLE) is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.
The underlying cause of autoimmune diseases is not fully known.
SLE is much more common in women than men. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races.
Symptoms vary from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling. Some develop arthritis. The joints of the fingers, hands, wrists, and knees are often affected.
Other common symptoms include:
Chest pain when taking a deep breath
Fever with no other cause
General discomfort, uneasiness, or ill feeling (malaise)
Sensitivity to sunlight
Skin rash -- a "butterfly" rash in about half people with SLE. The rash is most often seen over the cheeks and bridge of the nose, but can be widespread. It gets worse in sunlight.
There is no cure for SLE. The goal of treatment is to control symptoms. Severe symptoms that involve the heart, lungs, kidneys, and other organs often need treatment from specialists.
Mild forms of the disease may be treated with:
NSAIDs, such as ibuprofen, for joint symptoms and pleurisy
Corticosteroid creams for skin rashes
An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms
Treatments for more severe lupus may include:
High-dose corticosteroids or medications to decrease the immune system response
Cytotoxic drugs (drugs that block cell growth). These medicines are used if you do not get better with corticosteroids, or if your symptoms get worse when the stop taking them. Side effects from these drugs can be severe, so you need to be monitored closely if you take them.
If you have lupus, it is also important to:
Wear protective clothing, sunglasses, and sunscreen when in the sun
Get preventive heart care
Stay up-to-date with immunizations
Have tests to screen for thinning of the bones (osteoporosis)
The outcome for people with SLE has improved in recent years. Many people with SLE have mild symptoms. How well you do depends on how severe the disease is.
The disease tends to be more active:
The first years after diagnosis
People under age 40
Many women with SLE can get pregnant and deliver a healthy baby. A good outcome is more likely for women who receive proper treatment and do not have serious heart or kidney problems. However, the presence of SLE antibodies raises the risk of miscarriage.
Some people with SLE have abnormal deposits in the kidney cells. This leads to a condition called lupus nephritis. Patients with this problem may go on to develop kidney failure and need dialysis or a kidney transplant.
SLE can cause damage in many different parts of the body, including:
Call your health care provider if you have symptoms of SLE. Call your health care provider if you have this disease and your symptoms get worse or a new one occurs.
Ruiz-Irastorza G, Ramos-Casals M, Brito-Zeron P, Khamashta MA. Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review. Ann Rheum Dis. 2010;69:20-28.
Crow MK. Etiology and pathogenesis of systemic lupus erythematosus. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap XX.
Ariel D. Teitel, MD, MBA, Clinical Associate Professor of Medicine, NYU Langone Medical Center. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.