Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that can affect many organ systems, such as the skin, nerves, and serous membranes. The cause of the disease is unclear, but it is widely considered an autoimmune disorder, characterized by the production of antinuclear antibodies, which reflects immunological abnormalities. The incidence of SLE is higher in Black individuals, followed by White individuals, while it is less common among Asians. Women are more frequently affected than men, with a ratio of 5 to 10 times higher. The age of onset ranges from 2 to 90 years, but it most commonly occurs between 20 and 40 years of age. The higher prevalence in women suggests a role for genetic factors. Certain drugs, such as hydralazine, anticonvulsants, and procainamide, can trigger SLE in susceptible individuals or worsen symptoms in those already diagnosed. In SLE, inflammatory changes in various tissues and organs are caused by antinuclear antibodies and immune complexes binding to antigens.

bubble_chart Clinical Manifestations

Most SLE patients experience involvement of the hands, wrists, knees, ankles, and elbow joints. The prominent features of arthritis in this disease include joint redness, swelling, heat, pain, and stiffness, with large joints rarely developing deformities. Osteonecrosis of the femoral head, talus head, and humeral head occasionally occurs, and the incidence of osteonecrosis increases in patients undergoing steroid treatment. X-ray examinations typically show no bony destruction in the joints.

bubble_chart Diagnosis

SLE can be diagnosed by the antinuclear antibody test: most antinuclear antibodies are positive during the active phase of SLE, and if the antinuclear antibody is negative, the possibility of this disease can be ruled out. The antinuclear antibody test is sensitive and can replace the lupus cell test to diagnose the presence of SLE.

Currently, there is no specific treatment for systemic lupus erythematosus (SLE). The primary focus of therapy is to control acute flare-ups and prevent exacerbation. Systemic treatment is effective for SLE-related arthritis. Commonly used medications include prednisone, which exerts anti-inflammatory effects by suppressing or eliminating antinuclear antibody complexes. The dosage is gradually reduced to a maintenance level after symptoms are alleviated or resolved, with the lowest dose used to control clinical symptoms. Antimalarial drugs can also inhibit SLE disease activity, but they carry the risk of severe complications such as irreversible retinitis and must be used with caution. For SLE cases presenting only with arthritis symptoms, aspirin is the most commonly used effective medication. Additionally, physical therapy and exercise are crucial for improving joint function and enhancing muscle strength. In cases of severe joint pain and significant functional impairment where systemic SLE therapy is ineffective, joint arthroplasty may also be considered.