a detailed description about Systemic Lupus Eeythematosus.

1. SYSTEMIC LUPUS ERYTHEMATOSUS
Presented by,
RIYA ANTONY
PHARM.D INTERN
Pushpagiri college of pharmacy

2. INTRODUCTION
Systemic lupus erythematosus (SLE) is a severe, relapsing, remitting
multisystem autoimmune disease. The name systemic lupus implies that
almost any organ or system within the body might be affected. It is a
chronic disease of variable severity with significant morbidity that can be
fatal if not treated early in some patients. Onset can occur at any age
however it most typically presents in young adult females at a female to
male ratio of 9:1.

3. ETIOLOGY

4. PATHOPHYSIOLOG
Y

5. PATHOPHYSIOLOG
Y

6. Clinical
Presentation

7. DIAGNOSIS

8. TREATMENT
The type of medication is determined by the clinical manifestations and
severity of symptoms.
 Anti-inflammatory agents are used for mild disease and painful
symptoms joints, muscle pain, pleurisy, headaches, etc. Non-steroidal
anti-inflammatories should be avoided in patients with kidney disease.
 Hydroxychloroquine is a useful first line treatment in mild to moderate
disease and can often control joint symptoms, pleurisy and skin
involvement. Benefit usually occurs gradually over several months.
 Steroids - Generally reserved for organ threatening manifestations of
the disease . It is sometimes necessary to use steroids for non-organ
threatening manifestations such as arthritis, pleurisy, but side effects
are common and doses are kept as low as possible and taken for as
short a time as possible.

9. TREATMENT
 Immunosuppressive drugs - These are reserved for moderate to
severe disease either not responsive to first line treatments or
requiring prolonged use of unacceptably high doses of steroids.
Regular careful monitoring by the General Practitioner is required to
identify any side effects early before they become dangerous.
 Biological agents –Rituximab and belimumab are newer therapies
used to treat moderate to severe disease. Rituximab works by
targeting and depleting cells which play a role in autoantibody
production. Belimumab works by inhibiting B-Lymphocyte stimulator
(BLyS) which stimulates antibody production.

10. TREATMENT

11. TREATMENT (renal)

12. Patient counselling
About Disease
Systemic Lupus Erythematosus is a long term disease that causes systemic inflammation
which affects multiple organs. It is commonly known as “Lupus”.
In this disease the body’s immune system becomes hyperactive, forming antibodies that
attack normal tissues and organs, including skin, joints, kidneys, brain , heart, lungs and
blood.
Lupus is characterized by periods of illness (flares) and periods of wellness (remission).
Lupus is a highly variable disease, affected by the interaction of genetics, environment and
hormonal factors. Genetic susceptibility being the major trigger.
Since it can affect many organs , the symptoms are mostly not specific to the disease. Some
of the symptoms are fever, gastric problems, rashes, arthritis, kidney problem, lung or heart
inflammation , brain related manifestations and abnormal blood investigations. The
frequency and duration of the symptoms are important.
Appropriate treatment for Lupus can help people live normal lives. Treatment is aimed at
suppressing the overactive immune system and to help to prevent any organ damage

13. Patient counselling
Life Style Modifications
A good Doctor-patient relationship and good support from family and friends is essential to
cope with the disease.
Regular gentle exercises can help to keep joints flexible and can also improve fatigue and
reduce stress.
Avoid provoking factors- minimize sun exposure and treat any infections early.
When outdoors on a sunny day wear protective clothing (long sleeves and big-brimmed hat)
and use lots of sunscreen.
Non-live vaccines are safe during lupus , however use them only when the disease is
inactive.
Use of live vaccines can be dangerous.
Be aware of the symptoms of flare-up , so that it can help in informing the physician and
obtaining treatment at the earliest.
Follow a balanced diet.

14. REFERENCE
REFERENCE
• www.lupusuk.org
• www.micromedexsolutions.com
• Putterman, C., Caricchio, R., Davidson, A. and Perlman, H. (2012).
Systemic Lupus Erythematosus. Clinical and Developmental
Immunology, 2012, pp.1-2.
• Fritzler, M., Naden, R. and Johnson, S et al. (2019). 2019 European
League Against Rheumatism/American College of Rheumatology
Classification Criteria for Systemic Lupus Erythematosus. Arthritis &
Rheumatology, 71(9), pp.1400-1412.
• A short guide to Lupus and visiting doctor , lupus uk, 2015 edition.
• Nurses drug handbook.
• www.ACRPatientInfo.org