• multifactorial autoimmune disease that mostly affects young women

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

• 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%

• 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

References include
abdo pain in lupus
review of diagnosis and Mx 2016