Lupus

This article is about the most common type of lupus. For the broader group of diseases, see Lupus erythematosus. For other uses, see Lupus (disambiguation).

Lupus
Other namesSystemic lupus erythematosus (SLE)
Young woman with the distinctive butterfly rash that many individuals with lupus experience
Pronunciation
  • /sɪˈstɛmɪk ˈluːpəs ˌɛrɪθiːməˈtoʊsəs/ ⓘ sist-EM-ik LOO-pəs ERR-ith-ee-mə-TOH-səs
SpecialtyRheumatology
SymptomsPainful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, red rash[1]
Usual onset15–45 years of age[1][2]
DurationLong term[1]
CausesUnclear[1]
Diagnostic methodBased on symptoms and blood tests[1]
MedicationNSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, methotrexate[1]
Prognosis15 year survival ~80%[3]
Frequency2–7 per 10,000[2]

Lupus, formally called systemic lupus erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body.[1] Symptoms vary among people and may be mild to severe.[1] Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face.[1] Often there are periods of illness, called flares, and periods of remission during which there are few symptoms.[1] Children up to 18 years old develop a more severe form of SLE termed childhood-onset systemic lupus erythematosus.[4]

The cause of SLE is not clear.[1] It is thought to involve a combination of genetics and environmental factors.[5] Among identical twins, if one is affected there is a 24% chance the other one will also develop the disease.[1] Female sex hormones, sunlight, smoking, vitamin D deficiency, and certain infections are also believed to increase a person's risk.[5] The mechanism involves an immune response by autoantibodies against a person's own tissues.[1] These are most commonly anti-nuclear antibodies and they result in inflammation.[1] Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests.[1] There are a number of other kinds of lupus erythematosus including discoid lupus erythematosus, neonatal lupus, and subacute cutaneous lupus erythematosus.[1]

There is no cure for SLE,[1] but there are experimental and symptomatic treatments.[6] Treatments may include NSAIDs, corticosteroids, immunosuppressants, hydroxychloroquine, and methotrexate.[1] Although corticosteroids are rapidly effective, long-term use results in side effects.[7] Alternative medicine has not been shown to affect the disease.[1] Men have higher mortality.[8] SLE significantly increases the risk of cardiovascular disease, with this being the most common cause of death.[5] While women with lupus have higher-risk pregnancies, most are successful.[1]

Rate of SLE varies between countries from 20 to 70 per 100,000.[2] Women of childbearing age are affected about nine times more often than men.[5] While it most commonly begins between the ages of 15 and 45, a wide range of ages can be affected.[1][2] Those of African, Caribbean, and Chinese descent are at higher risk than those of European descent.[5][2] Rates of disease in the developing world are unclear.[9] Lupus is Latin for 'wolf': the disease was so-named in the 13th century as the rash was thought to appear like a wolf's bite.[10]

  1. ^ a b c d e f g h i j k l m n o p q r s t u "Handout on Health: Systemic Lupus Erythematosus". www.niams.nih.gov. February 2015. Archived from the original on 17 June 2016. Retrieved 12 June 2016.
  2. ^ a b c d e Danchenko N, Satia JA, Anthony MS (2006). "Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden". Lupus. 15 (5): 308–318. doi:10.1191/0961203306lu2305xx. PMID 16761508. S2CID 6465663.
  3. ^ The Cleveland Clinic Intensive Review of Internal Medicine (5 ed.). Lippincott Williams & Wilkins. 2012. p. 969. ISBN 978-1-4511-5330-9. Retrieved 13 June 2016.
  4. ^ Sura A, Failing C, Co DO, Syverson G (June 2024). "Childhood-Onset Systemic Lupus Erythematosus". Pediatrics in Review. 45 (6): 316–328. doi:10.1542/pir.2023-006011. PMID 38821900.
  5. ^ a b c d e Lisnevskaia L, Murphy G, Isenberg D (November 2014). "Systemic lupus erythematosus". The Lancet. 384 (9957): 1878–1888. CiteSeerX 10.1.1.1008.5428. doi:10.1016/s0140-6736(14)60128-8. PMID 24881804. S2CID 28905456.
  6. ^ "Five lupus patients enter long-lasting remission after immunotherapy". New Atlas. 2022-09-15. Retrieved 2022-09-17.
  7. ^ Davis LS, Reimold AM (April 2017). "Research and therapeutics-traditional and emerging therapies in systemic lupus erythematosus". Rheumatology. 56 (suppl_1): i100 – i113. doi:10.1093/rheumatology/kew417. PMC 5850311. PMID 28375452.
  8. ^ Murphy G, Isenberg D (December 2013). "Effect of gender on clinical presentation in systemic lupus erythematosus". Rheumatology. 52 (12): 2108–2115. doi:10.1093/rheumatology/ket160. PMID 23641038.
  9. ^ Tiffin N, Adeyemo A, Okpechi I (January 2013). "A diverse array of genetic factors contribute to the pathogenesis of systemic lupus erythematosus". Orphanet Journal of Rare Diseases. 8: 2. doi:10.1186/1750-1172-8-2. PMC 3551738. PMID 23289717.
  10. ^ Chabner DE (2013). The Language of Medicine. Elsevier Health Sciences. p. 610. ISBN 978-1-4557-2846-6.
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