=====Systemic Lupus Erythematosus (SLE)=====
  *multifactorial autoimmune disease that mostly affects young women
  
===SLE is part of a spectrum===
[{{  :wiki:autoimmune:lupus_syndromes.png?400| //**Lupus Spectrum**//}}]
  *SLE is one component of the lupus spectrum
  *Adult or paediatric patients with nephritis also have SLE, but other lupus syndromes incompletely overlap with SLE itself.
  *Incomplete lupus and cutaneous LE may be subsets that include individuals who will eventually develop SLE.
    *Cutaneous lesions occur in up to 85% of patients with SLE and are the first sign in up to 28%
  *MCTD has distinct elements outside of the usual lupus spectrum, such as erosive arthritis.
  *Anti-phospholipid syndrome may exist as a separate entity or may be part of SLE
===Clinical===
  *Triggers for flares include the following:
    *infections, ultraviolet irradiation,
    *medications such as quinidine, hydralazine and procainamide
    *pregnancy
  *Premature atherosclerosis is an important cause of morbidity and mortality in SLE
  *//**Metabolic syndrome**// - a clustering of cardiovascular risk factors associated with insulin resistance and an increased risk of future type 2 diabetes mellitus and cardiovascular disease
  *Adult SLE patients are at risk of glucocorticoid-induced osteoporosis
  *//**Lupus enteritis**//, including GI vasculitis, is common with or without infarction
    *prevalence of intestinal vasculitis variously reported up to 53%

===Management===
  *antimalarials - in particular hydroxychloroquine
  *pulse therapy with steroids occasionally - often used but evidence is lacking for high dose therapy
  *immuno-suppressants - azathioprine does have steroid sparing effects, cyclophosphamide, Mycophenolate mofetil
  *biologics - Rituximab, Belimumab, Silfalimumab


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**References include**\\ 
[[https://ard.bmj.com/content/61/6/547|abdo pain in lupus]]\\ 
[[https://academic.oup.com/rheumatology/article/56/suppl_1/i3/2738661|review of diagnosis and Mx 2016]]\\