Systemic lupus erythematosus: safe and effective management in primary care

Systemic lupus erythematosus is an autoimmune inflammatory disorder that frequently affects women of childbearing age. A diagnosis is made by confirming the presence of at least 4 of 11 criteria proposed by the American College of Rheumatology. Almost all patients should take hydroxychloroquine and most require corticosteroids, with immunosuppressive drugs frequently given as well. With better management, patients with lupus live longer but are at increased risk of disease and treatment-related complications, including infection, cardiovascular disease, and osteoporosis. These problems should be monitored and treated in the primary care setting.