Symptoms of SLE

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.


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