Systemic Lupus Erythematosus (SLE)

Overview

• Chronic inflammatory disorder of connective tissue causing widespread inflammation and tissue damage.
• Different from discoid lupus which primarily affects the skin.
• Autoimmune disorder resulting in production of antinuclear antibodies (ANA).
• Affects skin, lungs, kidneys, and heart with periods of exacerbations and remissions.

Risk Factors

• More common in women.
• Onset typically between ages 20 and 40.
• Higher risk in African Americans, Asians, and Native Americans.

Signs and Symptoms

• Fatigue and joint pain.
• Fever.
• Butterfly rash across the face (hallmark symptom).
• Raynaud’s phenomenon: vasospasms leading to pale, numb, and cold fingers.
• Anemia and pericarditis (inflammation of heart membrane).
• Lymphadenopathy (enlarged lymph nodes).

Diagnosis

• Positive ANA titer.
• Decreased serum complement (C3 and C4).
• Decreased red blood cells, white blood cells, and platelet counts.
• Increased BUN and creatinine if kidneys are involved.

Treatment

• NSAIDs for pain and inflammation.
• Immunosuppressants like prednisone and methotrexate.
• Hydroxychloroquine, also used for malaria, is effective.
• Topical steroid cream for facial rash.

Nursing Care

• Monitor for complications like renal failure.
• Essential teaching points:
  • Avoid UV and sun exposure to prevent skin damage.
  • Prevent infection by avoiding sick people and taking protective measures.
  • Take frequent rest periods to manage fatigue.

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