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Autoimmune Disease SLE – Causes, Symptoms and Treatment

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which the immune system attacks healthy tissues, causing inflammation in multiple organs throughout the body.

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Things worth knowing about "Autoimmune Disease SLE"

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which the immune system attacks healthy tissues, causing inflammation in multiple organs throughout the body.

What is Systemic Lupus Erythematosus (SLE)?

Systemic lupus erythematosus (SLE) is a chronic, inflammatory autoimmune disease in which the immune system mistakenly attacks the body's own tissues and organs. The term systemic indicates that virtually any organ system can be affected, including the skin, joints, kidneys, heart, lungs, and nervous system. SLE belongs to the group of connective tissue diseases and is one of the most common autoimmune conditions worldwide.

Causes and Risk Factors

The exact cause of SLE has not yet been fully established. It is believed to result from a combination of several contributing factors:

Genetic predisposition: Certain gene variants increase the risk of developing SLE. First-degree relatives of affected individuals have a higher risk.
Hormonal influences: SLE is significantly more common in women of childbearing age, suggesting a role for oestrogens.
Environmental factors: UV radiation, certain medications (drug-induced lupus), infections, and smoking can trigger or worsen the disease.
Immunological dysregulation: A dysregulated immune response leads to the production of autoantibodies, particularly antinuclear antibodies (ANA) and anti-dsDNA antibodies, which damage body tissues.

Symptoms

SLE presents with a highly variable clinical picture. Symptoms can occur in flares and vary in intensity. Common manifestations include:

Butterfly rash (malar rash): A characteristic butterfly-shaped rash across the nose and cheeks.
Joint pain and swelling (arthritis), often symmetrical
Fatigue and exhaustion, often severe and debilitating
Photosensitivity: Skin sensitivity to sunlight
Hair loss (alopecia)
Kidney involvement (lupus nephritis) with protein in the urine
Serositis: Inflammation of the lining around the heart or lungs (pericarditis, pleuritis)
Neurological symptoms: Headaches, seizures, cognitive impairment
Blood count abnormalities: Anaemia, low white blood cell or platelet counts
General symptoms such as fever and weight loss

Diagnosis

The diagnosis of SLE is based on clinical criteria and laboratory findings. Internationally recognised classification criteria include the SLICC criteria (2012) and the EULAR/ACR criteria (2019).

Key Diagnostic Measures

Blood tests: Detection of ANA, anti-dsDNA antibodies, anti-Sm antibodies, complement levels (C3, C4), full blood count, kidney function markers
Urine analysis: Protein or blood in urine as indicators of lupus nephritis
Imaging: X-ray, echocardiography, or MRI in cases of organ involvement
Kidney biopsy: For suspected lupus nephritis to enable precise classification
Skin biopsy: To confirm diagnosis in cases of unclear skin changes

Treatment

There is currently no cure for SLE. The goals of therapy are to control disease activity, prevent organ damage, and improve quality of life. Treatment is individually tailored and depends on the severity of the disease.

Pharmacological Treatment

Hydroxychloroquine (HCQ): An antimalarial drug used in nearly all SLE patients. It reduces disease flares and has beneficial effects on skin, joints, and long-term prognosis.
Nonsteroidal anti-inflammatory drugs (NSAIDs): To relieve joint and muscle pain.
Corticosteroids (e.g. prednisolone): Used during acute flares for rapid anti-inflammatory effect.
Immunosuppressants: For severe organ involvement, including azathioprine, mycophenolate mofetil, or cyclophosphamide.
Biologics: Belimumab (anti-BLyS) and anifrolumab (anti-interferon receptor) are approved biologics for SLE.

Non-Pharmacological Measures

Consistent UV protection (sunscreen, protective clothing)
Regular medical follow-up appointments
Adapted physical activity and stress management
Vaccinations against infections (in consultation with a physician)
Dietary adjustments and smoking cessation

Prognosis

The prognosis for SLE has improved significantly in recent decades thanks to advances in treatment. With appropriate management, most patients can lead largely normal lives. However, severe organ complications, particularly lupus nephritis, can impact the long-term outlook. Regular monitoring is therefore essential.

References

Fanouriakis A et al. - 2019 Update of the EULAR Recommendations for the Management of Systemic Lupus Erythematosus. Annals of the Rheumatic Diseases, 2019; 78(6): 736-745.
Petri M et al. - Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis and Rheumatism, 2012; 64(8): 2677-2686.
Aringer M et al. - 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis and Rheumatology, 2019; 71(9): 1400-1412.

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