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Systemic Lupus Erythematosus

  • Chapter
Primer on the Rheumatic Diseases

Abstract

In sharp distinction to organ-specific autoimmune diseases such as thyroiditis, diabetes, or myasthenia gravis, systemic lupus erythematosus (SLE) is a constellation of signs and symptoms classified as one nosologic entity. Indeed, it is the diversity of presentation, accumulation of manifestations over time, and undulating disease course that challenge the most astute of clinicians. With rare exception, the unifying laboratory abnormality is the presence of circulating antinuclear antibodies (ANA). Acknowledging the complexity of this disease, its broad differential diagnosis, and the need to develop better and more specific therapies, the American College of Rheumatology (ACR) has designated 11 diagnostic criteria (presented in Table 15A-1) (1,2). These criteria reflect the major clinical features of the disease (mucocutaneous, articular, serosal, renal, neurologic) and incorporate the associated laboratory findings (hematologic and immunologic). The presence of four or more criteria is required for diagnosis. They need not necessarily present simultaneously: a single criterion such as arthritis or thrombocytopenia may recur over months or years before the diagnosis can be confirmed by the appearance of additional features. While there is incomplete agreement among rheumatologists as to whether these criteria need to be strictly applied in a practice setting, or reserved only for formal academic studies, they do facilitate a methodologic approach to evaluate a patient.

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Authors and Affiliations

  1. Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, USA

    Jill P. Buyon MD (Professor, Director)

  2. Lupus Clinic, New York University Hospital for Joint Diseases, New York, NY, USA

    Jill P. Buyon MD (Professor, Director)

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  1. Jill P. Buyon MD
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Editors and Affiliations

  1. Arthritis Foundation, Atlanta, GA, USA

    John H. Klippel MD (President and CEO) (President and CEO)

  2. Massachusetts General Hospital, Boston, MA, USA

    John H. Stone MD, MPH (Associate Physician, Deputy Editor for Rheumatology) (Associate Physician, Deputy Editor for Rheumatology)

  3. Division of Rheumatology & Women’s Health, University of Kentucky, Lexington, KY, USA

    Leslie J. Crofford MD (Gloria W. Singletary Professor of Internal Medicine, Chief) (Gloria W. Singletary Professor of Internal Medicine, Chief)

  4. Arthritis Foundation, Atlanta, GA, USA

    Patience H. White MD, MA (Chief Public Health Officer) (Chief Public Health Officer)

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Buyon, J.P. (2008). Systemic Lupus Erythematosus. In: Klippel, J.H., Stone, J.H., Crofford, L.J., White, P.H. (eds) Primer on the Rheumatic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68566-3_15

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  • Print ISBN: 978-0-387-35664-8

  • Online ISBN: 978-0-387-68566-3

  • eBook Packages: MedicineMedicine (R0)

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