Systemic lupus erythematosus (SLE)


Systemic lupus erythematosus (SLE) is an autoimmune disease in which organs and cells undergo damage initially mediated by tissue-binding autoantibodies and immune complexes.


  • Tobacco smoking
  • Drinking alcohol
  • Exposure to crystalline silica e.g., inhalation of soap powder dust
  • Soil in farming activities due use of pesticides, artificial fertilizer
  • Genetic susceptibility
  • Autoimmunity-inducing activation of innate immunity
  • T and B cell hyperactivity(adaptive immunity)
  • Persistence of immune complexes
  • Environmental and gene interaction
  • Mutation in TREX1 (encoding a DNAase) on the X chromosome
  • Allopathy drugs. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. SLE may be induced by drugs – procainamide, hydralazine, isoniazid, chlorpromazine, methyldopa, minocycline, anti-TNF agents.


  1. 90% of pts are women, usually of child-bearing age
  2. Constitutional—fatigue, fever, malaise, weight loss
  3. Cutaneous—rashes (especially malar “butterfly” rash), photosensitivity, vasculitis, alopecia, oral ulcers. Skin lesions that appear or worsen with sun exposure (photosensitivity)
  4. Arthritis—inflammatory, symmetric, nonerosive . Hematologic—anemia (may be hemolytic), neutropenia, thrombocytopenia, lymphadenopathy, splenomegaly, venous or arterial thrombosis
  5. Cardiopulmonary—pleuritis, pericarditis, myocarditis, endocarditis. Pts are also at increased risk of myocardial infarction usually due to accelerated atherosclerosis.
  6. GI—peritonitis, vasculitis
  7. Neurologic—organic brain syndromes, seizures, psychosis, cerebritis
  8. Raynaud’s phenomenon -Fingers and toes that turn white or blue when exposed to cold or during stressful periods
  9. Nephritis:
  • Blood in your urine
  • Foamy urine (due to excess protein in urine)
  • High blood pressure
  • Swelling in your hands, ankles or feet
  • High levels of a waste product called creatinine in your blood


  • Complete blood count.
  • Kidney and liver assessment.
  • Urinanalysis
  • Antinuclear antibody (ANA) test.
  • Chest X-ray.
  • Echocardiogram
  • Biopsy

Preventive and control

  • Diet changes. Limiting the amount of protein and salt in your diet can improve kidney function.
  • Avoid using artificial fertilizer
  • Avoid using pesticides
  • Reduce sun exposure
  • Wear protective clothing — such as a hat, long-sleeved shirt and long pants
  • Get regular exercise. Exercise can help keep your bones strong, reduce your risk of heart attack and promote general well-being.
  • Don’t smoke.
  • Eat a healthy diet. A healthy diet emphasizes fruits, vegetables and whole grains.




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