Systemic lupus erythematosus

Systemic lupus erythematosus is a disease with both genetic and environmental pathogenesis. It has protean manifestations and can mimic most other clinical entities. Its severity varies widely among patients and its course commonly fluctuates from mild to severe in a single patient as the disease waxes and wanes. Since disease presentation is variable its treatment requires individualization. Some patients can be managed with NSAIDs and antimalarials without steroids. Patients with involvement of the nervous system, kidney and hematologic system usually require steroids--often in high doses. Immunosuppressants such as cyclophosphamide are useful in managing lupus emergencies and in maintaining control of disease in others.