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Systemic Lupus Erythematosus (Internal Medicine)

Multisystem autoimmune disease: 2019 EULAR/ACR classification and treatment principles

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Systemic Lupus Erythematosus (Internal Medicine)?

SLE is the most common systemic autoimmune connective tissue disease, with female:male ratio of 9:1 and onset typically between 15-44 years. Prevalence is 50-150 per 100,000; African and Asian populations have higher disease severity. Genetic, environmental (UV, EBV, smoking), and hormonal factors contribute.

Pathogenesis: B and T cell hyperactivity, abnormal apoptosis-induced autoantigen presentation, type I interferon-driven inflammation, and immune complex deposition cause organ damage. Lupus nephritis (40-60%), neuropsychiatric SLE (20-40%), hematologic involvement (cytopenia), and serositis are most common.

Diagnosis is based on 2019 EULAR/ACR criteria; ANA ≥1:80 is required entry criterion, with ≥10 points across clinical and immunologic domains. Hydroxychloroquine reduces attacks, prevents organ damage, and lowers cardiovascular mortality - a critical disease-modifying therapy.

Symptoms

Malar (butterfly) rash and photosensitivity
Symmetric polyarthritis (small joints)
Fatigue, fever, weight loss
Oral/nasal ulcers (painless)
Raynaud phenomenon, hair loss
Renal involvement (proteinuria, hematuria - lupus nephritis)

Risk Factors

Female gender (9:1 female predominance)
Reproductive age (15-44 years)
African American, Hispanic, Asian ethnicity
Family history (10-fold increased risk)
Estrogen exposure (OCP, pregnancy, hormone therapy)
Cigarette smoking, UV exposure, EBV history

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent fatigue, joint pain, butterfly rash
  • Unexplained kidney findings (proteinuria, hematuria)
  • Recurrent miscarriage (antiphospholipid suspicion)
  • Severe Raynaud's phenomenon
  • Cytopenia (anemia, leukopenia, thrombocytopenia)
  • Sun-induced rash, oral ulcers

Treatment Methods

01
Hydroxychloroquine (5 mg/kg/day) - foundation of therapy in all patients
02
Glucocorticoid (in attack, lowest effective dose)
03
Methotrexate, azathioprine, mycophenolate (steroid-sparing)
04
Belimumab, anifrolumab (biologic therapy - moderate-severe)
05
Cyclophosphamide, rituximab (severe lupus nephritis, neurolupus)
06
Sun protection, smoking cessation, cardiovascular risk management

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.