Saturday, May 25, 2013

Systemic lupus erythematosus

Table of Contents

Alternative Names

Disseminated lupus erythematosus; SLE; Lupus; Lupus erythematosus


Symptoms

Symptoms vary from person to person, and may come and go. The condition may affect one organ or body system first. Others may become involved later.

Almost all people with SLE have joint pain and swelling. Some develop arthritis. Frequently affected joints are the fingers, hands, wrists, and knees.

Other common symptoms include:

  • Chest pain when taking a deep breath
  • Fatigue
  • Fever with no other cause
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Hair loss
  • Mouth sores
  • Sensitivity to sunlight
  • Skin rash -- a "butterfly" rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread.
  • Swollen lymph nodes

Other symptoms depend on what part of the body is affected:

  • Brain and nervous system:
    • Headaches
    • Mild cognitive impairment
    • Numbness, tingling, or pain in the arms or legs
    • Personality change
    • Psychosis
    • Risk of stroke
    • Seizures
    • Vision problems
  • Digestive tract: abdominal pain, nausea, and vomiting
  • Heart: abnormal heart rhythms (arrhythmias)
  • Kidney: blood in the urine
  • Lung: coughing up blood and difficulty breathing
  • Skin: patchy skin color, fingers that change color when cold (Raynaud's phenomenon)

Signs and tests

The diagnosis of SLE is based upon the presence of at least 4 out of 11 typical characteristics of the disease. The doctor will listen to your chest with a stethoscope. A sound called a heart friction rub or pleural friction rub may be heard. A neurological exam will also be performed.

Tests used to diagnose SLE may include:

  • Antibody tests, including:
    • Antinuclear antibody (ANA) panel
    • Anti-double strand (ds) DNA
    • Antiphospholipid antibodies
    • Anti-Smith antibodies
  • CBC to show low white blood cells, hemoglobin, or platelets
  • Chest x-ray showing pleuritis or pericarditis
  • Kidney biopsy
  • Urinalysis to show blood, casts, or protein in the urine

This disease may also alter the results of the following tests:

  • Anti-SSA or -SSB antibodies
  • Antithyroglobulin antibody
  • Antithyroid microsomal antibody
  • Complement components (C3 and C4)
  • Coombs' test - direct
  • Cryoglobulins
  • ESR
  • Rheumatoid factor
  • RPR - a test for syphilis
  • Serum globulin electrophoresis
  • Serum protein electrophoresis

Review Date: 02/07/2010
Reviewed By: Mark James Borigini, MD, Rheumatologist in the Washington, DC Metro area. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)