Systemic lupus erythematosus (SLE)Systemic lupus erythematosus, or SLE for short, is an
Autoimmune disease. In some cases, SLE is limited to affecting the skin, but more often it also affects internal organs. Probably an interaction of different factors triggers systemic lupus erythematosus.
Systemic lupus erythematosus cases in Germany
5.448 cases in 2019
5.569 cases in 2022 ( prognosis )
What is systemic lupus erythematosus??
Systemic lupus erythematosus (SLE) belongs to the autoimmune diseases. These are diseases in which the body's defense mechanism (lymphocytes, antibodies) is directed against its own organism. These antibodies directed against themselves (auto-antibodies) react primarily with the nuclei of organ cells. They are therefore also called antinuclear antibodies (ANA).
Autoantibodies travel with the blood to all parts of the body and can cause inflammation and damage in virtually all organs. In some cases, SLE is limited to the skin, but more often it affects internal organs (systemic or visceral LE).
What are the causes of systemic lupus erythematosus??
SLE can occur at any age, but strangely, the majority of patients are women – young women between 16 and 40. So at the age when the woman produces the female sex hormones most strongly. Obviously, these hormones facilitate the development of SLE – but they are not its cause!
Ultimately, we do not know what leads to SLE, but it is probably the confluence of several triggering moments that set the disease in motion. Genetic predisposition – without SLE being inherited because of it – and female hormones are considered to be pathogens. Triggers include physical and psychological stress, infectious diseases, sunlight, pregnancy and medications.
What are the symptoms of SLE?
The inflammation in the body leads to general symptoms (fever, feeling dull, fatigued) and to symptoms caused by the attack of specific organs.
Skin: Reddening and burning of the skin, often on the face over the cheeks and nose (butterfly erythema), frequent sun sensitivity of the skin, frequent hair loss
Joints:Joint pain and joint inflammation (arthritis)
Musculature: Muscle pain, rarely muscle inflammation
Kidneys: Mild kidney pain, usually the patient does not feel the kidney inflammation! Urine examination for red blood cells (erythrocytes) and protein is important
Lungs: pleurisy (pain when breathing)
Heart:Cardiac arrhythmias, pericarditis, myocarditis, etc.
Central nervous system (CNS):Migraine, word-finding disorders, depression, aggressiveness up to psychosis, seizures
Blood vessels: Often a sudden paling of the fingers (Raynaud's), less commonly vascular inflammation (vasculitis) usually in the fingers with skin bleeding
Blood: Decrease of white blood cells (leucocytes), red blood cells (erythrocytes) and platelets (thrombocytes). These changes are often not noticed by the patient, but become apparent when the blood count is examined: disturbances in blood clotting with increased thromboses. In some cases, SLE is also associated with inflammation of the salivary and lacrimal glands (Sjogren's syndrome)
Usually, a patient will exhibit only some of these possible signs of disease (z.B. skin and joints).
What is the course of systemic lupus erythematosus (SLE)??
SLE usually progresses in relapses, with one relapse lasting a few weeks to months. Between relapses, some patients are completely symptom-free, while others still have minor signs of the disease, such as decreased performance and joint pain. Only in a few patients is SLE constantly active.
A patient with skin inflammation and joint pain suffers a lot from his illness, but his life is not threatened. Others may not feel as much from their SLE – so z.B. most patients with kidney inflammation. However, the kidney is a vital organ, so that in rare cases SLE can be life-threatening. A patient with SLE naturally asks himself: What will happen to me?. Be my disease in a few years? In most cases you can ame that the SLE will remain in the form in which it has "nested". You can expect that the same organs will be affected if there is another attack. The intensity of the disease decreases over the years, the attacks become less frequent and less severe.
Treatment of systemic lupus erythematosus
In treatment, we have to distinguish between drug therapy, when a relapse has occurred, and prophylaxis (prevention), which is intended to prevent the patient from having another relapse of the disease.
Drug therapy of systemic lupus erythematosus
Drug therapy aims to relieve the patient's symptoms, z.B. with a remedy for joint pain and to have a regulating effect on the disease so that the imbalanced immunological system is brought back into balance.
In very mild cases, treatment with an anti-inflammatory drug is sufficient. However, cortisone must often be used. They are given in higher doses during the relapse and then reduced. If possible, discontinue cortisone altogether at some point. However, it is common to leave it at a lower continuous dose if this has a favorable effect on the patient's well-being.
Other medications used are: Antimalarials (z.B. Resochin®), which is used especially for skin and joint inflammations, and immunosuppressants, which are supposed to dampen the wrongly programmed immune system. The best known are Imurek® and Endoxan®: whether to use them depends on the inflammatory activity of SLE and the severity of organ involvement. Gold and Azulfidine®, which are effective in chronic polyarthritis, should not be used in SLE.
Measures to prevent a new SLE disease flare-up
The course of the disease can be influenced favorably by appropriate behaviors.
1. Physical and psychological stress
Patients with SLE have a very unstable immune system that cannot withstand extreme stresses. The result may be that a new disease flare is triggered. Therefore, a moderate lifestyle is paramount. This is valid for physical as well as for psychological strain. Light sporting activity is allowed. Exercise that leads to exhaustion is bad. Avoid unnecessary conflicts. Don't let professional ambition eat away at you. Find the right balance in all things.
The "right measure" applies just as well to the nutrition. Eat as scarce as possible; overweight is quite bad. Avoid all one-sided diets, but eat as varied a diet as possible. Lots of fruit, lots of salad are not good for you, but everything in moderation! Eat little protein, just as much as the body needs. However, there is no special diet that cures the disease.
3. Infectious diseases
Infections by viruses or bacteria are the most common cause for an SLE relapse. The patient should therefore – as far as possible – avoid all circumstances that are associated with an increased risk of infection. Should he still fall ill, he should consult his doctor as soon as possible, so that, if necessary, the burgeoning infection can be fought with antibiotics. Certain antibiotics may not be given (z.B. sulfonamides), as they themselves can trigger an SLE flare-up. If you are on cortisone, do not reduce the cortisone dose under any circumstances during an infectious disease. Rather, it is often appropriate to increase the dose.
Sunlight, more specifically ultraviolet light, can activate SLE – This is especially true in those patients who have already noticed sun sensitivity of their skin. Therefore avoid the sunlight. Protect your skin with special sunscreens. Your doctor can prescribe them for you. Of course, solaria are also. Tanning salons taboo for you!
There is no doubt that SLE often worsens during pregnancy. Miscarriages and premature births also occur more frequently than in healthy women – but malformations are not more frequent! On the other hand, many SLE patients have become mothers without complications. However, pregnancy should not be planned until the disease has been inactive for at least 6 months and the patient needs only a small dose of cortisone at most. In patients who have a severe phase of organ involvement, z.B. of the kidneys have passed, SLE should have tended to become quiescent over 1 to 2 years.
6. Pregnancy prevention
When using the pill, it is important to remember that certain female sex hormones (the estrogens) can adversely affect SLE. Therefore, only a pure progestogen preparation without estrogens should be used as an anti-baby pill (s.g. "mini-pill"). Other contraceptive methods can also be used, but in the case of the IUD it should be borne in mind that inflammation may occur more frequently.
If you are scheduled for surgery, be sure to tell the surgeon about your condition and therapy. He will consult with an internist for advice on drug therapy.
Learn more about our selection process
Quality arance is ensured by the competence network of the Leading Medicine Guide. Each doctor listed on Leading Medicine Guide was contacted by us on the basis of his or her caseload (surgeries, treatments and therapies), among other factors. The case numbers are based on a network of different publicly available sources. After discussions with the selected physicians and medical facility managers, and a subsequent review, inclusion in the Leading Medicine Guide was achieved.
The quality arance of the Leading Medicine Guide is additionally ensured by 8 admission criteria. Each member must meet at least 6 of these:
– At least 10 years of surgical and treatment experience – Proficiency in modern diagnostic and surgical procedures – Outstanding treatment focus within own specialty – Member of a leading national professional society – Senior professional position – Active participation in professional meetings (z.B. lectures) – Active in research and teaching – Evaluated quality management (z.B. Certification)
Your path to the right doctor:
We provide expert support to help you find the right Leading Medicine Guide specialist – free of charge, confidentially, and with the highest medical quality. This is what Leading Medicine Guide stands for with strict inclusion criteria.
Vangerowstrabe 14/1 69115 Heidelberg – Germany
Leading Medicine Guide is certified by afgis. The afgis quality logo is a seal of approval for verified health information.
The projected growth in the number of cases is based on population trend data from the Federal Statistical& State offices. Calculated per age group so that demographic effects are taken into account. Case numbers are based on a network of different publicly available sources. Data analysis procedures are used to process these figures. Made available to our users.