Systemic Lupus Erythematosus
(SLE)
What is SLE?
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease in which
the body’s immune system mistakenly attacks its own healthy tissues.
In short:
● “Systemic” → affects many organs of the body
● “Lupus” → the disease name
● “Erythematosus” → refers to the red skin rash often seen
The immune system produces autoantibodies (antibodies against self-cells).
These form immune complexes that get deposited in organs and cause:
● inflammation
● tissue damage
● pain
Commonly affected organs:
● Skin
● Joints
● Kidneys
● Heart
● Lungs
● Brain
Common symptoms:
● Butterfly-shaped facial rash
● Fever
● Joint pain
● Fatigue
● Hair loss
Common causes:
Hormones
Mechanism of SLE
Step 1 Step 2 Step 3 Step 4 Step 5
Triggering factors Loss of self- Autoantibody Immune complex Inflammation and
tolerance formation formation & organ damage
Genetic predisposition
+ environmental
deposition
Immune system B cells produce Complement
triggers (UV light, fails to recognize autoantibodies (e.g., Antigen–antibody activation → chronic
infections, hormones) body’s own cells ANA, anti-dsDNA) complexes form and inflammation → tissue
activate immune and starts attacking against nuclear get deposited in injury and multi-organ
system abnormally. self-antigens. components. tissues (kidneys, damage.
skin, joints, vessels).
Zahiri wa batini tabdiliyan
(external and internal pathological changes)
1. Skin
● Red, butterfly-shaped rash over
face
● Thickening and inflammation of
dermis
● Interface dermatitis
(damage at dermo-epidermal
junction)
2. Kidneys (Lupus nephritis)
● Most important organ affected
● Immune complex deposition in
glomeruli
● Thickened capillary walls, “wire-
loop” lesions
● May progress to glomerulonephritis
3. Joints 5. Serosal surfaces
● Non-erosive arthritis (covering of organs)
● Synovial inflammation ● Inflammation of pleura
● No permanent joint destruction and pericardium (heart)
● Pleural effusion or
4. Blood vessels
pericarditis may occur
● Vasculitis (inflamed blood
vessels) due to immune complex
deposition
● Inflammation of vessel walls
Diagnosis (Tashkhis) :
[Link]
NabzExamination
Examination(Pulse)
(Pulse)
1. Clinical Examination (Alamat)
● ● Fast
Fastororirregular
irregularpulse
pulsedue
duetoto
Common findings: inflammatorycondition
inflammatory condition
● Butterfly (malar) rash
● Joint pain
● Fever
3. Mizaj Assessment
● Fatigue
● Photosensitivity ● Usually associated with hot and
abnormal temperament
● Disturbance in body humors (Akhlat)
[Link] Examination
Urine (Urine)
Examination
4. Blood Tests
● Changes in urine color or
● Proteinuria
ANA Test (Antinuclear Antibody) quantity
● Hematuria
● Protein in urine may indicate
● Most sensitive test for SLE ● Indicates lupus nephritis
kidney involvement
● Positive in most patients
Anti-dsDNA Antibody
6. Complete Blood Count
● More specific for SLE (CBC)
● Indicates kidney involvement
May show:
Anti-Smith (Anti-Sm) Antibody
● Anemia
● Highly specific for SLE ● Leukopenia
● Thrombocytopenia