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Systemic Lupus Erythematosus

Rheumatology Referral

Mrs. Evan sees Dr. Blue, a rheumatologist, the following month. Dr. Blue reviews the records from Dr. Smith as well as the temperature log Mrs. Evan has been keeping. The temperature log shows daily temperatures ranging from 99.0°F to 99.8°F. Mrs. Evan's symptoms remain unchanged since her visit with Dr. Smith. She has noted some relief from pain and the swelling in her hands and knee is somewhat less than it was before she started the medication. Her physical exam remains unchanged from her visit with Dr. Smith.

Dr. Blue agrees that the signs and symptoms point to a rheumatic disease. Dr. Blue states that further diagnostic tests are needed to determine the specific disease and that she suspects systemic lupus erythematosus. A blood test for antinuclear antibodies has been ordered as well as repeat CBC, chemistry profile and UA.

Systemic Lupus Erythematosus (SLE)

SLE or lupus, is one of three types of lupus. The second type is discoid lupus which is limited to the skin. The third type is drug-induced lupus. Drug-induced lupus often occurs when certain prescribed medications bring about the signs and symptoms of lupus.

SLE is a systemic, chronic inflammatory auto-immune disease that can affect the skin, joints, blood, kidneys, and cardiovascular system. SLE can range from mild disease only affecting a few organs to severe, even life-threatening problems. It is estimated that 1.5 million people have some form of lupus in the United States. Lupus affects women 10 to 15 times more frequently than men, and African American, American Indian, and Asian ethnic origins are affected more often than Caucasian. Each case of SLE is unique as the symptoms and progression will vary. As SLE progresses there will be periods when very few symptoms are noted (remissions) and other times when the disease is very active (flares).

The cause of SLE is unknown. Scientists currently believe that there is a genetic predisposition to the disease with environmental factors playing a triggering role in the symptoms being expressed. Some environmental factors that have been studied include antibiotics, infections, ultraviolet light, extreme stress, and hormones. There are ongoing studies about the relationship of hormones in women from puberty to menopause and the incidence of SLE.

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Last Update: Oct 19 2012