Clinical features of systemic lupus erythematosus

Case reports, case series, and analytical clinical research studies continue to define and refine our understanding of the clinical presentation of lupus and its evolution over time. Major areas of interest in the past year have included malignancies, osteoporosis, neonatal lupus, central nervous system lupus, pregnancy, and renal disease. New emphasis has been placed on the importance of gynecologic malignancies in systemic lupus erythematosus. Osteoporosis, especially the role of corticosteroid therapy in the development of osteoporosis, remains a controversial area, particularly in premenopausal women. The poor outcome of many infants with neonatal lupus has been documented in several reports. A more sensitive brain imaging test for central nervous system lupus--brain single photon emission computed tomography--has been introduced. The effect of pregnancy on disease activity and the appropriate use of second-line agents in pregnancy have been reviewed. The importance of hypertension and other clinical variables in predicting renal outcome (as opposed to reliance on renal biopsy findings) was emphasized in two studies.