Systemic lupus erythematosus (SLE) is one of the most serious rheumatic diseases. SLE can affect so many organs that a cause of death in some people with SLE may not be directly attributed to the condition. A primary cause of death among patients with lupus is atherosclerosis, a disease of the coronary blood vessels resulting from accelerated buildup of plaque.
SLE is unpredictable and varies greatly form one individual to the next.
Mild SLE. About 20 - 30% of cases are mild. The only symptoms may be the skin rashes of discoid lupus erythematosus (DLE) or subacute cutaneous lupus erythematosus (SCLE) with or without joint aches. The number and intensity of symptoms in mild cases often decrease over time, as does the likelihood of major organ involvement. Patients with mild SLE should still be tested for organ involvement.
Widespread SLE. More commonly, SLE is a chronic, life-long disease, alternating between periods of symptom relapse, (called flares), and remission. The disease may begin in any of the various systems of the body and progress unpredictably to others. The following are typical patterns:
The degree of severity depends on different factors:
Vital organs or systems, such as lungs, kidneys, nervous system, joints skin, and others are affected in over a half of patients with SLE. Infections followed by kidney failure are the chief causes of death in patients with SLE.
Because of more effective and aggressive treatment, the prognosis for SLE has improved markedly over the past two decades. Treatment early in the course of the illness improves long-term progress. About 85 - 95% of people with lupus survive 10 years, and many people have a normal life span. SLE that develops later in life is generally less serious than SLE that strikes in childhood or young adulthood.
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