Systemic lupus erythematosus

KIDNEYS

Some people with SLE have deposits of antibodies within the cells (glomeruli) of the kidneys. However, less than 50% have lupus nephritis as defined by persistent inflammation (irritation and swelling) in the kidney. These patients may eventually develop kidney failure and require dialysis or kidney transplantation.

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NERVOUS SYSTEM

Nerve disorders can affect up to 25% of those with SLE. Mild mental problems are the most common symptom, but any area of the brain, spinal cord, or nervous system can be affected. Seizures, psychosis, organic brain syndrome, and headaches are some of the nervous system disorders that can occur.

BLOOD

Blood disorders can affect up to 85% of those with SLE. Venous or arterial blood clots can form and are associated with strokes and pulmonary embolism, or pregnancy loss. Predisposition to blood clots, or less commonly bleeding, occurs due to antibodies against lipids involved in blood clotting and is referred to as anti-phospholipid antibody syndrome (APS). (See Lupus anticoagulant.) Often platelets are decreased which may cause bleeding or clotting problems. Anemia of chronic disease often develops at some point in the course SLE.

HEART

Inflammation of various parts of the heart may occur as pericarditis, endocarditis, or myocarditis. Chest pain and arrhythmias may result from these conditions.

LUNGS

Pleurisy, an inflammation of the lining of the lung, and pleural effusions, a fluid collection between the lung and its lining, can occur as a result of SLE. Chest pain and shortness of breath are frequently results of these disorders.

African Americans and Asians are affected more often than people from other races.

References:

Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005.

Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.