Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus (SLE) is a prototypic autoimmune disease characterized by the production of antibodies to components of the cell nucleus in association with a diverse array of clinical manifestations. As SLE is a disease of unknown etiology, classification criteria have been devised:

Revised Classification Criteria (1982) for Systemic Lupus Erythematosus

  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Oral ulcers
  • Arthritis (nondeforming polyarthritis)
  • Serositis (pleuritis and/or pericarditis)
  • Renal disorder (proteinurial >0.5 g/day or cellular casts)
  • Neurologic disorder (psychosis and/or seizures)
  • Hematologic disorder (leukopenia or lymphopenia/hemolytic anemia/thrombocytopenia)
  • Immunologic disorder (anti-DNA/anti-Sm/LE cell/false-positive STS)
  • Antinuclear antibody
  • Diagnosis: four of eleven criteria should be fulfilled at the same time or in succession.

Virtually all organ systems are involved, and the disease is sufficiently complex so that two patients might share no clinical findings and yet both satisfy criteria for the diagnosis of SLE. Individual patients tend to have a consistent clinical picture and generally over time "accumulate" more findings. Joints, skin and blood are affected in 80-100% of patients, kidneys, CNS and cardiopulmonary system in over 50%.

 

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.