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Lupus Erythematosus, Systemic (SLE)

Katherine M. Tromp, PharmD and Hershey S. Bell, MD, MS, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Systemic lupus erythematosus (SLE) is a multisystem autoimmune inflammatory disease characterized by a chronic relapsing/remitting course; can be mild to severe and may be life-threa...

DIAGNOSIS

Consider SLE in multisystem disease including fever, fatigue, and signs of inflammation. 

HISTORY

  • Fever, fatigue, malaise, weight loss, headache

  • Rash (discoid [LR+] = 18, malar [LR+] = 14), pho...

TREATMENT

GENERAL MEASURES

  • Education, counseling, and support

  • Influenza/pneumococcal vaccines are safe; weigh risk versus benefit for live vaccines in immunocompromised patients

  • Low-estrogen oral contrac...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Clinical evaluation for signs and symptoms

    • Weekly to monthly for active disease

    • Every 3 to 6 months for mild/inactive disease

  • Measures of disease...

REFERENCES

1
Bertsias G, Ioannidis JP, Boletis J, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for Internation...

ADDITIONAL READING

  • Lam NV, Ghetu MV, Bieniek ML. Systemic lupus erythematosus: Primary care approach to diagnosis and management. Am Fam Physician.  2016;94(4):284–294.

  • Lisnevskaia L, Murphy G, Is...

SEE ALSO

Antiphospholipid Antibody Syndrome 

CODES

ICD10

  • M32.9 Systemic lupus erythematosus, unspecified

  • M32.10 Systemic lupus erythematosus, organ or system involv unsp

  • M32.14 Glomerular disease in systemic lupus erythematosus

  • M32.19 Oth organ or s...

CLINICAL PEARLS

  • Aggressiveness of therapy should reflect intensity of disease.

  • Most important diagnostic test is the UA: if abnormal, order kidney biopsy; serum and urine lab values often do not reveal...

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