Lupus Erythematosus, Systemic (SLE)

Lupus Erythematosus, Systemic (SLE) is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or .

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

Description

  • Multisystem autoimmune inflammatory disorder with variable presentation, disease course, and prognosis
  • May manifest in any organ system, especially dermatologic, renal, hematologic, musculoskeletal, cardiovascular, pulmonary, immunologic, and reproductive
  • Synonyms: systemic lupus erythematosus (SLE), lupus

Epidemiology

Incidence
  • Overall incidence in United States is 5 to 7 per 100,000 person-years.
  • Significant variation based on ethnicity: black 16.0, American Indian/Alaska Native 7.4, Hispanic 5.6, Asian/Pacific Islander 4.6, white 3.3 per 100,000 person-years
  • Strong female predominance compared to male: 9.8 versus 0.8 per 100,000 person-years (about 12-fold higher)
  • Peak incidence in females ranges from 3rd to 7th decades of life.
  • Peak incidence in males later, from 5th to 7th decades of life

Prevalence
  • Overall prevalence in United States ranges from 70 to 100 cases per 100,000.
  • Increasing due to better recognition and increased survival
  • Highest prevalence in black women: 498 per 100,000
  • Strong female predominance compared to male: 179 versus 21 cases per 100,000 (about 9-fold higher)

Etiology and Pathophysiology

Complex and multifactorial: Genetic, environmental, immunoregulatory, hormonal, and epigenetic factors all play a role in pathogenesis.

Genetics
  • More than 30 susceptibility loci for SLE in genome-wide association studies
  • Heritability, the proportion of phenotypic variance explained by genetics, between 40% and 70%
  • Previous criteria from American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) still used widely in clinical practice

Risk Factors

  • Ethnicity: highest risk in black populations; intermediate risk in Asian, Hispanic, and American Indian/Alaska Native populations
  • Hormonal: female sex, early menarche, endometriosis, surgical menopause, earlier age at menopause
  • Family history of SLE or other autoimmune disease
  • Environmental: cigarette smoking, crystalline silica exposure, exogenous female hormones, certain medications (drug-induced lupus)

Commonly Associated Conditions

  • Antiphospholipid syndrome
  • Depression
  • Fibromyalgia
  • Thyroid disease
  • Overlap connective tissue disease syndromes: rheumatoid arthritis (RA), Sjögren syndrome, systemic sclerosis, polymyositis, dermatomyositis

-- To view the remaining sections of this topic, please or --

Basics

Description

  • Multisystem autoimmune inflammatory disorder with variable presentation, disease course, and prognosis
  • May manifest in any organ system, especially dermatologic, renal, hematologic, musculoskeletal, cardiovascular, pulmonary, immunologic, and reproductive
  • Synonyms: systemic lupus erythematosus (SLE), lupus

Epidemiology

Incidence
  • Overall incidence in United States is 5 to 7 per 100,000 person-years.
  • Significant variation based on ethnicity: black 16.0, American Indian/Alaska Native 7.4, Hispanic 5.6, Asian/Pacific Islander 4.6, white 3.3 per 100,000 person-years
  • Strong female predominance compared to male: 9.8 versus 0.8 per 100,000 person-years (about 12-fold higher)
  • Peak incidence in females ranges from 3rd to 7th decades of life.
  • Peak incidence in males later, from 5th to 7th decades of life

Prevalence
  • Overall prevalence in United States ranges from 70 to 100 cases per 100,000.
  • Increasing due to better recognition and increased survival
  • Highest prevalence in black women: 498 per 100,000
  • Strong female predominance compared to male: 179 versus 21 cases per 100,000 (about 9-fold higher)

Etiology and Pathophysiology

Complex and multifactorial: Genetic, environmental, immunoregulatory, hormonal, and epigenetic factors all play a role in pathogenesis.

Genetics
  • More than 30 susceptibility loci for SLE in genome-wide association studies
  • Heritability, the proportion of phenotypic variance explained by genetics, between 40% and 70%
  • Previous criteria from American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) still used widely in clinical practice

Risk Factors

  • Ethnicity: highest risk in black populations; intermediate risk in Asian, Hispanic, and American Indian/Alaska Native populations
  • Hormonal: female sex, early menarche, endometriosis, surgical menopause, earlier age at menopause
  • Family history of SLE or other autoimmune disease
  • Environmental: cigarette smoking, crystalline silica exposure, exogenous female hormones, certain medications (drug-induced lupus)

Commonly Associated Conditions

  • Antiphospholipid syndrome
  • Depression
  • Fibromyalgia
  • Thyroid disease
  • Overlap connective tissue disease syndromes: rheumatoid arthritis (RA), Sjögren syndrome, systemic sclerosis, polymyositis, dermatomyositis

There's more to see -- the rest of this entry is available only to subscribers.