[Crisis states in systemic lupus erythematosus]

Systemic lupus erythematosus is a chronic autoimmune disease with multiple organ involvements. Dup to earlier diagnosis and more effective therapeutic possibilities the survival in lupus has improved significantly in recent decades, however, critical situations may develop.

In the present work the authors aimed to summarise critical complications of lupus requiring urgent therapeutic modification, hospitalisation, sometimes at intensive care units.

As a systemic autoimmune disorder lupus may involve all vital organs of the human body and as such, it may result in heart failure, respiratory and renal insufficiency, and severe, life-threatening central nervous system complications. These can develop within a short period due to an acute flare, but also as the consequence of chronic progression. Infections, pregnancy, withdrawal of therapy, physical and psychological stress may provoke the worsening of the disease. However, critical situations can be the consequence not only directly of lupus, but due to side-effects of therapy, associating disorders and co-incidence with other severe diseases.

Lupus may cause several critical situations that require urgent intervention and/or hospitalisation. The recognition and the solution of these severe lupus crises is a complex, multidisciplinary challenge that should be organised by competent, well-prepared immunologic centres.