Symptoms of SLE
What are the clinical manifestations of SLE? How commonly do they occur?
SLE is characterized by multiple autoantibodies and multisystem involvement. An easy way to remember the complex array of systemic manifestations of SLE is to think from head to toe
Systemic Manifestations of Systemic Lupus Erythematosus
|General (90%)||Malaise, weight loss, fever|
|Skin (55%–70%)||Butterfly rash, discoid lupus, vasculitic skin lesions, alopecia, photosensitivity|
|Brain (25%)||Headache, blurred vision, psychosis, chorea, seizures, neuropathies, cerebrovascular accident, transverse myelitis|
|Eye (3%–30%)||Cotton-wool spots, retinitis, episcleritis, iritis (rarely)|
|Mouth (20%–50%)||Oral ulcers (hard palate, typically painless)|
|Chest (15%–20%)||Pleuritis, basilar pneumonitis, pulmonary hemorrhage, shrinking lung syndrome|
|Heart (15%–20%)||Pericarditis, myocarditis, Libman–Sacks endocarditis|
|Digestive system (25%–40%)||Hepatosplenomegaly, mesenteric arteritis, colitis, hepatitis, pancreatitis|
|Kidneys (>50%)||Glomerulonephritis, nephrotic syndrome, hypertension|
|Extremities (60%–80%)||Arthralgia or arthritis, myalgia or myositis, Raynaud phenomenon, thrombophlebitis, aseptic necrosis (6%–10% of patients, often associated with corticosteroids)|
Pearl: A child with SLE who develops psychosis while on prednisone is much more likely to have neuropsychiatric lupus than steroid psychosis, which is very rare in childhood. Avascular necrosis as a result of steroid usage rarely occurs in children aged <14 years.
Pearl: Discoid lesions in children and adolescents are rarely isolated discoid lupus and are most often accompanied by additional manifestations of SLE.