Systemic Lupus Erythematosus (SLE)

What does a positive ANA mean?
What is Systemic Lupus Erythematosus Disease?
Is lupus a hereditary disease?
How does a person get lupus?


What does a positive ANA mean?

The antinuclear antibody (ANA) test is used as a primary test to help evaluate a person for autoimmune disorders that affect many tissues and organs throughout the body (systemic) and is most often used as one of the tests to help diagnose systemic lupus erythematosus (SLE).


What is Systemic Lupus Erythematosus Disease?

Systemic lupus erythematosus (SLE) is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.

Is lupus a hereditary disease?

Lupus is not contagious. Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis, and autoimmune thyroid disorders are more common among relatives of people with lupus than the general population.

How does a person get lupus?

There is no cure, but in most cases lupus can be managed. Lupus sometimes seems to run in families, which suggests the disease may be hereditary. Having the genes isn’t the whole story, though. The environment, sunlight, stress, and certain medicines may trigger symptoms in some people.

Systemic Lupus Erythematosus is also known as SLE, Discoid Lupus, Disseminated Lupus Erythematosus, Lupus Erythematosus or just Lupus. Although “Lupus” actually includes a number of different diseases, SLE is the most common type of Lupus, and when people say “Lupus,” they are often referring to SLE.

What is Systemic Lupus Erythematosus?

Systemic Lupus Erythematosus (SLE) is an autoimmune disease which can affect the skin, joints, kidneys, brain, and other organs. SLE can affect any organ system. (Systemic: Involving multi organ, Lupus: Literal Latin term is wolf, Erythematosus: Red rashes over the skin and looks like a wolf’s bite especially over the face). The immune system normally fights off dangerous foreign substances (infections like bacteria, virus, fungus, parasite or toxins, chemicals) to keep the body healthy. An autoimmune disease occurs when the body’s immune system mistakenly attacks its own healthy tissue because it confuses it for something foreign. It is characterized by an autoantibody response to nuclear and cytoplasmic antigens. There are many autoimmune diseases, including systemic lupus erythematosus (SLE). Rheumatoid Arthritis is also an auto immune disease. Rheumatoid Arthritis is commonly thought to be limited to the joints,

SLE is a chronic disease that can have phases of worsening symptoms that alternate with periods of mild symptoms. More than 90% of cases of SLE occur in women, frequently starting at childbearing age. It may occur at any age, but appears most often in people between the ages of 10 and 50. African Americans and Asians are affected more often than people from other races. Millions of people worldwide are living with diagnosed lupus. The number of people who actually suffer from the condition is likely much higher. Many cases go undiagnosed.

Causes of Systemic Lupus Erythematosus

The exact cause of SLE is still not known, but several factors have been associated with the disease.

  • Genetics: The disease is not linked to a certain gene, but people with lupus often have family members with other autoimmune conditions.
  • Environment: There may be environmental triggers like ultraviolet rays, certain medications, a virus, physical or emotional stress, and trauma.
  • Gender and Hormones: SLE affects more women than men. Women also experience worsening of symptoms during pregnancy and with their menstrual periods. Both of these observations have led some medical
  • professionals to believe that the female hormone estrogen may play a role in causing SLE. However, more research is still needed to prove this theory.
  • Drugs: SLE may also be caused by certain drugs.

Symptoms of Systemic Lupus Erythematosus

lupus-1 lupus-3

As Lupus can affect any organ in the body including the brain, heart, digestive organs, kidneys, joints and skin, it can lead to any number of symptoms. Nevertheless, certain symptoms are considered classic Lupus symptoms. Commonly found Lupus symptoms are as below:

Symptoms vary from person to person, and may come and go. Also symptoms can change over time.

Pain in joints: Almost everyone with SLE has joint pain and swelling. Some develop arthritis. The joints of the fingers, hands, wrists, and knees are often affected.
Other common symptoms include:

Skin rash: A “butterfly” rash is experienced by about half people with SLE. The rash is most often seen over the cheeks and bridge of the nose, but can be widespread. It gets worse in sunlight.
Fever with no other cause
General discomfort, uneasiness, or ill feeling (malaise)
Sensitivity to sunlight: Sensitivity to sun exposure is very common in Lupus. It can cause the skin to become seriously irritated. Sun exposure can also flare the disease internally in some patients.

Hair loss
Blood-clotting problems
Mouth sores
Swollen lymph nodes
Chest pain when taking a deep breath
Other symptoms depend on which part of the body is affected

Brain and Nervous system: Headaches, numbness, tingling, seizures, vision problems, personality changes
Digestive tract: abdominal pain, nausea, vomiting
Heart: abnormal heart rhythms (arrhythmias)
Lung: coughing up blood and difficulty breathing
Skin: patchy skin color, fingers turning white/blue and tingle when cold (Raynaud’s syndrome)
Kidney: swelling in the legs, weight gain
Some people have only skin symptoms. This is called Discoid Lupus.

Diagnosis of Systemic Lupus Erythematosus

Tests used to diagnose SLE may include:

Antinuclear Antibody (ANA)
CBC with differential
Chest x-ray
Serum Creatinine

Results of the ANA panel are used to help make a diagnosis. The tests alone however do not make a diagnosis, but must be used along with your medical history, physical examination and other tests.

Nearly all people with Lupus have a positive test for Antinuclear Antibody (ANA). However, having a positive ANA alone does not mean you have Lupus in most cases. Some normal people have a low level of ANA. Thus, the presence of a low level of ANA is not always abnormal. However, a lack of ANA makes that diagnosis much less likely. Although ANA are most often identified with SLE, a positive ANA test can also be a sign of other autoimmune diseases. The ANA can be positive in relatives of people with SLE who do not have SLE themselves. There is a very low chance of developing Systemic Lupus Erythematosus at some time later in life if the only finding is a low titer of ANA.

Conventional Treatment of Systemic Lupus Erythematosus

Treatment can vary depending on how severe your symptoms are and which parts of your body are affected. Severe symptoms that involve the heart, lungs, kidneys, and other organs often need treatment from specialists. Conventional treatment of mild SLE may include:

Anti-inflammatory medications for joint pain and stiffness
Steroid creams for rashes
Corticosteroids of varying doses to minimize the immune response
Antimalarial drugs for skin and joint problems
Conventional treatment for SLE is not curative. The goal is to ease the symptoms of Lupus.