DR. CORA LIM-MEDICAL INSIDER
Systemic Lupus Erythematosus
PART 4
Let us continue with our discussion of Systemic Lupus Erythematosus.
Clinical features
Research says that SLE is notorious for its heterogeneity in presentation and its ability to mimic other diseases.
Common findings are skin lesions, such as malar rash or discoid lesions, photosensitivity, scarring or non-scarring patchy alopecia, mucocutaneous ulcers, polyarticular arthritis, nephritis with secondary hypertension and pedal oedema, and serositis manifesting as pleuropericarditis with pleural and pericardial effusions.
The same studyd shows that although the disease predominantly affects young to middle-aged females, SLE can also present in older age groups, when it often follows a more indolent course. Neuropsychiatric lupus usually occurs in the first 10 years following diagnosis of SLE.
Although the disease is far more common in women than men, the disease can follow a more aggressive course in males, with men demonstrating higher mortality rates than women.
Anti-phospholipid syndrome can occur in association with SLE
and is characterized by arterial and venous thromboses and recurrent pregnancy morbidity.
According to the study, in the development of SLE, there may be a pre-clinical phase in which autoantibodies occur in the serum in the absence of any clinical symptoms.
Such patients do not require any specific treatment until they develop clinical features of disease. Development of multiple autoantibodies is often followed by inflammation in one or more organs.
Recurrent flares of inflammatory disease activity lead to accumulation of damage, which ultimately results in increased morbidity and mortality.
The report continues that in the longer term, comorbidities develop – in particular, accelerated atherosclerosis due to traditional and non-traditional risk factors, osteoporosis, infections and malignancies – which are additional challenges to management.