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Systemic lupus erythematosus

Última revisão: 20 Aug 2025
Última atualização: 05 Oct 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • malar (butterfly) rash
  • photosensitive rash
  • discoid rash
Detalhes completos

Outros fatores diagnósticos

  • fatigue
  • weight loss
  • fever
  • oral ulcers
  • alopecia
  • arthralgia/arthritis
  • fibromyalgia
  • Raynaud phenomenon
  • chest pain and shortness of breath
  • venous or arterial thrombosis
  • hypertension
  • signs of nephrosis (e.g., edema)
  • lymphadenopathy
  • abdominal pain, vomiting, or diarrhea
  • nose ulcers
  • poorly localized proximal limb inflammatory pain with weakness
  • dysrhythmias (e.g., tachycardia), conduction defects, or unexplained cardiomegaly
  • CNS signs: seizures, cranial nerve abnormalities, cognitive defects, psychosis
  • dysphagia
Detalhes completos

Fatores de risco

  • female sex
  • age >30 years
  • African descent in Europe and US
  • drugs
  • sun exposure
  • family history of SLE
  • tobacco smoking
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • complete blood count and differential
  • activated partial thromboplastin time
  • BUN and electrolytes
  • erythrocyte sedimentation rate and C-reactive protein
  • antinuclear antibodies, double-stranded (ds)DNA, Smith antigen
  • urinalysis
  • chest x-ray
  • ECG
Detalhes completos

Investigações a serem consideradas

  • blood and urine cultures
  • antiphospholipid antibodies
  • Coombs test
  • 24-hour urine collection for protein or spot urine for protein/creatinine ratio
  • complement levels
  • creatine phosphokinase
  • plain x-rays of affected joint(s)
  • renal ultrasound
  • chest computed tomography
  • pulmonary function tests
  • pleural aspiration
  • brain magnetic resonance imaging
  • echocardiography
  • skin biopsy
  • renal biopsy
  • thyroid-stimulating hormone
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

joint symptoms and serositis

mucocutaneous disease

lupus nephritis

neuropsychiatric lupus

hematologic manifestations

Colaboradores

Autores

Meng May Chee, MBChB, MRCP

Consultant Rheumatologist

Queen Elizabeth University Hospital

Glasgow

UK

Declarações

MMC was sponsored by Abbvie to attend the European League Against Rheumatism 2020 online conference.

Rajan Madhok, MD, FRCP(Glasg)

Consultant Physician and Rheumatologist

Department of Rheumatology

Glasgow Royal Infirmary

Glasgow

UK

Declarações

RM holds shares in GSK to the value less than £12,000.

Agradecimentos

Dr Meng May Chee and Dr Rajan Madhok would like to gratefully acknowledge Dr Gayle McKellar, a previous contributor to this topic.

Declarações

GM declares that she has no competing interests.

Revisores

James C. Oates, MD

Associate Director

Medical University of South Carolina

Charleston

SC

Declarações

JCO declares that he has no competing interests.

Nancy J. Olsen, MD, PhD

Professor of Medicine

University of Texas Southwestern Medical Center

Dallas

TX

Declarações

NJO declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Systemic lupus erythematosus images
  • Diagnósticos diferenciais

    • Rheumatoid arthritis
    • Antiphospholipid syndrome
    • Systemic sclerosis
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  • Diretrizes

    • Guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
    • 2019 update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Systemic lupus erythematosus

    Mais Folhetos informativos para os pacientes
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