Overview of the clinical manifestations of systemic lupus erythematosus in adults
- Dafna D Gladman, MD, FRCPC
Dafna D Gladman, MD, FRCPC
- Professor of Medicine
- University of Toronto
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect virtually every organ. Immunologic abnormalities, particularly the production of a number of antinuclear antibodies, are another prominent feature of the disease. Women are affected more frequently than men.
SLE has protean clinical manifestations that can affect virtually every organ, and can vary dramatically from patient to patient. The most common pattern is a mixture of constitutional complaints with skin, musculoskeletal, mild hematologic, and serologic involvement (table 1). However, some patients have predominately hematologic, renal, or central nervous system manifestations. The pattern that dominates during the first few years of illness tends to prevail throughout the disease course. The clinical course of SLE is highly variable among patients and may be characterized by periods of remissions and of chronic or acute relapses.
The clinical manifestations of SLE in adults are presented here. The diagnosis, differential diagnosis, and management of SLE in adults are discussed elsewhere (see "Diagnosis and differential diagnosis of systemic lupus erythematosus in adults" and "Overview of the management and prognosis of systemic lupus erythematosus in adults"). The clinical manifestations of SLE in children are also presented separately. (See "Systemic lupus erythematosus (SLE) in children: Clinical manifestations and diagnosis".)
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with a wide range of clinical and serological manifestations that can affect any organ (table 1). The disease course is marked by remissions and relapses and may vary from mild to severe.
The clinical manifestations of SLE are presented below. Most of these manifestations have been included as part of classification criteria for SLE, as a means of categorizing patients for study purposes (table 2). The criteria can be useful for helping clinicians recognize and document some of the key disease manifestations of SLE. The classification criteria are discussed in detail separately. (See "Diagnosis and differential diagnosis of systemic lupus erythematosus in adults", section on 'Classification criteria'.)
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- CLINICAL MANIFESTATIONS
- Constitutional symptoms
- Arthritis and arthralgias
- Skin and mucous membrane involvement
- Vascular disease
- - Raynaud phenomenon
- - Vasculitis
- - Thromboembolic disease
- Renal involvement
- Gastrointestinal involvement
- Pulmonary involvement
- Cardiac disease
- Neuropsychiatric involvement
- Ophthalmologic involvement
- Hematologic abnormalities
- Lymphadenopathy and splenomegaly
- OTHER ASSOCIATED CONDITIONS AND COMPLICATIONS
- Antiphospholipid syndrome
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS