{"id":3605,"date":"2019-12-05T11:12:58","date_gmt":"2019-12-05T11:12:58","guid":{"rendered":"http:\/\/edren.org\/ren\/education\/textbook\/sle\/"},"modified":"2020-08-12T11:38:01","modified_gmt":"2020-08-12T11:38:01","slug":"sle","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/education\/textbook\/conditions-that-affect-the-kidney\/sle\/","title":{"rendered":"SLE"},"content":{"rendered":"
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Systemic lupus erythematosus (SLE)<\/span><\/strong><\/h3>\n<\/div>\n
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A multi-system autoimmune disease predominantly affecting young women.\u00a0 Typically presents with joint pains and malaise, quite often with fever, and a characteristic erythematous facial ‘butterfly’ rash. Pleurisy is another common early symptom.\u00a0 However the range of possible manifestations is very large.\u00a0 Antinuclear antibodies and antibodies to double-stranded DNA are typical.\u00a0 Serum complement levels may be low.<\/p>\n

Renal involvement may occur in 50% but is often minor.\u00a0 Major renal disease indicates serious disease. Patients typically present with the inflammatory signs of haematuria, proteinuria, high blood pressure. Nephrotic syndrome is also a very common presentation.\u00a0 SLE is an important cause of serious renal disease in young women.\u00a0 It is more common in black and particularly some East Asian races.<\/p>\n

The most common histological pattern is an inflammatory, diffusely proliferative glomerulonephritis.\u00a0 Appearances are highly variable but prognostically important.<\/p>\n

Corticosteroids are required for most types of lupus affecting the kidneys, though some regimens are now minimising this.\u00a0 For aggressive disease, treatment with cyclophosphamide (usually in regular pulses) reduces the risk of progression to ESRF, but less toxic alternatives are increasingly the first choice.\u00a0 Mycophenolate mofetil (MMF) is effective for many.\u00a0 Cyclophosphamide is usually stepped down to azathioprine or other cytotoxic agent after a variable period. Anti-B cell antibodies (Rituzimab) may also be effective.<\/p>\n

If ESRF<\/a> is reached despite treatment, SLE tends to become relatively quiescent. Dialysis and transplantation are successful.<\/p>\n

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Further info<\/span><\/strong><\/h3>\n