Clinical Aspects of Systemic Lupus Erythematosus

The clinical manifestations of systemic lupus erythematosus are nearly infinitely complex. Patients may be inflicted with one or many manifestations of lupus at once, intermittently or chronically. The severity of the manifestations can similarly vary from a self-resolving photosensitive rash to life-threatening major organ involvement. Even the less objective manifestations of lupus such as fatigue drastically impair quality of life and activities of daily living. We are hampered in the clinical care of patients with lupus by grossly inadequate biomarkers of lupus disease activity. Further, as we attempt to develop new therapeutics for lupus, we must attempt to quantify both the level of disease activity and the response to therapy. Thus, an awareness and appreciation of the protean manifestations of SLE is an imperative for the lupus doctor as well as those involved in lupus research. We attempt a broad discussion of these manifestations in this chapter.