The great pretender. Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a multisystem disorder with a multitude of clinical symptoms and a wide variety of presentations.

To outline the variety of possible clinical presentations of SLE.

Although joint symptoms and a rash are common at onset it may present as a neurological, cardiovascular or obstetric problem without more obvious clues to the diagnosis and lupus should be considered in the differential diagnosis of a wide variety of clinical problems. The prevalence of lupus, however, is low and over-reliance on a positive antinuclear antibody, especially at low titre, can lead to error, especially in the context of musculoskeletal symptoms.