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Lupus Factsheet

 

What is systemic lupus erythematosus (SLE)?

Systemic lupus erythematosus (SLE or lupus) is an autoimmune disease in which the immune system attacks cells and tissue in the body, resulting in inflammation and tissue damage. Lupus can affect any part of the body and result in the destruction of vital organs.1

How is it caused?

The cause of lupus is unknown, but is thought to be multifactorial, with genetic, hormonal and environmental factors all playing a role.2 There are three major types of lupus:1

  • Discoid (cutaneous)
  • Systemic
  • Drug-induced

How common is lupus?

It is estimated that 50,000 people live with lupus in the UK.2 Women are seven times more likely to develop the disease than men and lupus can develop at any point in life.3

What are the symptoms?

The course of lupus varies by individual and symptoms come (flares) and go (remission).3

  • butterfly-shaped rash across cheeks and nose
  • hair loss
  • painful or swollen joints
  • Inflammation of the kidneys
  • blood clotting
  • anaemia
  • migraines
  • dizziness
  • abdominal pain caused by effects on the gut, pancreas, liver or spleen

swelling of the lymph glands

  • painful red eye or changes in eyesight


How is lupus diagnosed?

Diagnosis of SLE is difficult as the condition may present symptoms similar to those of other diseases. Diagnosis is based on a combination of physical symptoms and laboratory results.4

The American College of Rheumatology (ACR) has developed a classification system to help identify patients with lupus. The criteria include: malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, serositis (pleuritis or pericarditis), renal disorder, neurological disorder (seizures or psychosis), hematological disorder, immunologic disorder and antinuclear antibodies.5 To be diagnosed with lupus, at least 4 out of the 11 typical signs of the disease must be present.6

Is lupus treatable?

There is no cure for lupus but treatments exist to help manage patients’ symptoms by suppressing the overactive immune system and reducing inflammation.6

  • In more mild forms of lupus the following treatments can be administered to help manage symptoms:6
  • Nonsteroidal anti-inflammatory medications (NSAIDs) which also treat arthritis and pleurisy6
  • Corticosteroid creams to treat skin rashes6
  • An antimalarial drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms6
  • Immunosuppressants such as azathioprine, methotrexate and Cytoxan are used to suppress the immune system1
  • Cytotoxic drugs which block cell growth are used when lupus cannot be controlled by corticosteroids.6
  • Biologic drugs such as belimumab, which is is indicated for treatment of SLE8

Prognosis

The prognosis of living with lupus has improved in recent years due to earlier detection, diagnosis, advances in treatment, patient management and increased awareness of the disease. In the middle of the last century, only 50% of patients could expect to live for five years after diagnosis; today, 90% of patients with lupus survived for more than five years.7

References

1. The Lupus site. What is Lupus?. http://www.thelupussite.com/lupus1.html (accessed August 2012)

2. Lupus UK. http://www.lupusuk.org.uk/what-is-lupus/the-triggers (accessed August 2012)

3. Arthritis Research UK http://www.arthritisresearchuk.org (accessed August 2012)

4. Lupus Foundation of America. What are the Symptoms of Lupus? http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding.aspx?articleid=2235&zoneid=523 (accessed June 2012).

5. ACR. 1997 update of the 1982 American College of Rheumatology revised criteria for classification of systemic lupus erythematosus. 1997. Available online at: http://is.gd/kicno (accessed June 2012)

6. Makover ME. MedlinePlus Medical Encyclopedia: Systemic lupus erythematosus. http:// www.nlm.nih.gov/medlineplus/ency/article/000435.htm Last updated February 2011 (accessed June 2012)

7. Pons-Estel GJ, Alarcon GS, Scofield L, et al. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum 2010;39:257-68

8. Scott LJ et al. Belimumab: A Guide to Its Use in Systemic Lupus Erythematosus. Biodrugs 2012; 26 (3): 195-199

Oct 2012 - UK/12CI0090