Systemic Lupus Erythematosis (SLE)

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Systemic Lupus Erythematosus (SLE), also known as lupus, is a disease of the immune system, which is estimated to affect more than 20,000 people in Australia and New Zealand. Symptoms can be vague and vary between people, and therefore diagnosis can be difficult. However, once diagnosed, a combination of prescribed treatment and lifestyle adjustments enables most people with lupus to enjoy an almost normal life.

What is lupus?

The main role of the immune system is to fight foreign invaders such as bacteria, moulds and viruses.  In autoimmune diseases the immune system produces antibodies that attack the body's own healthy tissue. Lupus is an autoimmune disease, and the antibodies produced by the immune system in lupus cause inflammation, tissue damage and pain.

Who is affected by lupus?

Around 90% of people with lupus are women and the majority develop the condition between 15 and 45 years. When lupus occurs in children it is usually diagnosed during puberty. Lupus is more common and severe in Indigenous Australians, Polynesians and those with descendants from South East Asia. 

There are two main types of lupus

There are two main types of lupus, which differ significantly in the type and severity of symptoms:

Other milder forms of lupus include:

The cause of lupus is unknown

A combination of genetic and environmental factors contribute to the formation of the antibodies that lead to lupus.  Possible triggers of disease flare ups include:

Lupus symptoms may be vague, variable and unpredictable

Lupus can cause many symptoms, including:

Most people with lupus will never experience all the symptoms and no two individuals seem to experience identical symptoms.

The course of lupus is usually unpredictable

For some people, symptoms will subside after treatment of the initial acute attack.

For others, periods of improvement (remission) are punctuated by brief flares of disease.

Early diagnosis is important

The diagnosis of lupus is usually suspected on the basis of clinical symptoms and signs and confirmed by laboratory tests.

Blood tests will usually include an Anti Nuclear Antibody (ANA) test, which measures antibodies to self tissues. Whilst this is a good screening test, not all people with SLE have a positive ANA result and many people with a positive ANA do not have SLE. For example, close relatives of SLE patients may have a positive ANA without developing SLE themselves. Additional blood tests are therefore necessary to confirm the diagnosis and to monitor the activity of SLE.

Effective treatments are available for lupus

The aim of lupus treatments is to reduce inflammation in tissues and improve quality of life. Treatment must be individualised, taking account of the severity of the disease.

There are five main groups of drugs that are used to treat lupus:

Diagnosis, treatment and lifestyle changes are important

The outlook for most people with lupus is good. Early detection, effective treatment and some lifestyle adjustments enable most people with lupus to feel well and live normal lives. It is only a small minority of people who find the condition substantially reduces their quality of life.

Lupus and pregnancy

Women with lupus should talk to their doctor before considering pregnancy. They should be made aware of any potential risk for themselves and the baby. It is preferable for lupus to be in remission, as this reduces the risk of a disease flare occurring during pregnancy. Lupus flares occurring during pregnancy are usually mild and occur in the first three months (trimester). In the first few weeks after birth new mothers may experience lupus flares but this can be controlled with corticosteroids.

It is important to discuss therapy options with your doctor to ensure that any current medication taken will not adversely affect the pregnancy. Women should have no difficulty becoming pregnant as lupus does not usually lower fertility.  However, a small proportion of women with lupus are at increased risk of blood clots and recurrent miscarriages.

Some tips to help people with lupus to lead normal lives

There are currently no cures for lupus, but there are effective medications that will bring the disease under control, and often permanently. As you grow older, it is likely that the disease will improve.

© ASCIA 2019

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Updated May 2019