The clinical features of SLE may vary markedly from relatively mild symptoms through to life-threatening multi-organ disease (1).
Non specific features of SLE include:
- fever - unexplained fever is common and characteristic for SLE
- malaise
- fatigue - occurs in 80% to 100% of patients, but does not always correlate with disease activity (2)
- weight loss
- oral ulcers
- myalgia and myositis - in about one third of patients
- photosensitive skin rashes. The characteristic malar or butterfly rash occurs in 30% to 40% of patients, and may be more common in female patients (3)
- lymphadenopathy - occurs in about half of cases, often in association with hepatomegaly
- pleuritic chest pains
- headache
- paraesthesia
- symptoms of dry eyes and mouth
- Raynaud's phenomenon (2)
In women, disease may be exacerbated by menstruation and pregnancy.
The approximate frequency of systems involvement is given below: (4)
- haematological 95%
- joints 95%
- cutaneous 80%
- pulmonary 65%
- nervous system 60%
- renal involvement is present in approximately 50% to 70% of patients, and may be more common in male patients (3)
- gastrointestinal 20%
- ocular 15%
References:
- Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-12.
- Leuchten N, Milke B, Winkler-Rohlfing B, et al. Early symptoms of systemic lupus erythematosus (SLE) recalled by 339 SLE patients. Lupus. 2018 Aug;27(9):1431-6.
- Boodhoo KD, Liu S, Zuo X. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Medicine (Baltimore). 2016 Jul;95(29):e4272.
- D'Cruz DP. Systemic lupus erythematosus. BMJ. 2006;332(7546):890-4.