Treatment Guideline Chart
Systemic lupus erythematosus is a chronic, multisystem, inflammatory, autoimmune disorder characterized by formation of autoantibodies directed against self-antigens and immune-complex formation.
It can be diagnosed with a single organ involvement such as lupus nephritis.
It is predominantly diagnosed in females of childbearing age.
Clinical presentation varies in different patients and the disease activity varies over time in a single patient. Majority of patients have arthralgia of the hand.

Systemic Lupus Erythematosus References

  1. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999 Sep;42(9):1785-1796. doi: 10.1002/1529-0131(199909)42:9<1785::AID-ANR1>3.0.CO;2-#. PMID: 10513791
  2. Bertsias G, Loannidis JPA, Boletis J, et al. EULAR recommendations for the management of systemic lupus erythematosus: report of a task force of the EULAR standing committee for international clinical studies including therapeutics. Ann Rheum Dis. 2008 Feb;67(2):195-205. doi: 10.1136/ard.2007.070367. PMID: 17504841
  3. Bertsias GK, Ioannidis JP, Aringer M, et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010 Dec;69(12):2074-2082. doi: 10.1136/ard.2010.13047. PMID: 20724309
  4. Cervera R, Font J. Therapeutic perspectives in systemic lupus erythematosus. Current Rheumatol Rev. 2005 Jan;1(1):45-47
  5. Gill JM, Quisel AM, Rocca PV, et al. Diagnosis of systemic lupus erythematosus. Am Fam Physician. 2003 Dec;68(11):2179-2186. PMID: 14677663
  6. Kumar A. Indian guidelines on the management of SLE. J Indian Rheumatol Assoc. 2002;10:80-96
  7. Petri M. Treatment of systemic lupus erythematosus: an update. Am Fam Physician. 1998 Jun;57(11):2753-2760. PMID: 9636338
  8. Knott HM, Martinez JD. Innovative management of lupus erythematosus. Dermatol Clin. 2010 Jul;28(3):489-499. doi: 10.1016/j.det.2010.03.007. PMID: 20510759
  9. Hahn BH, McMahon MA, Wilkinson A, et al; American College of Rheumatology. American College of Rheumatology guidelines for screening, case definition, treatment and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012 Jun;64(6):797-808. doi: 10.1002/acr.21664. PMID: 22556106
  10. Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012 Aug;64(8):2677-2686. doi: 10.1002/art.34473. PMID: 22553077
  11. Yong PFK, D’Cruz DP. Mycophenolate mofetil in the treatment of lupus nephritis. Biologics. 2008 Jun;2(2):297-310. PMID: 19707362
  12. Gripenberg-Gahmberg M. Systemic lupus erythematosus (SLE). EBM Guidelines. Evidence-Based Medicine. Helsinki, Finland: Wiley Interscience, John Wiley & Sons; 2006 May
  13. Tassiulas IO, Boumpas DT. Clinical features and treatment of systemic lupus erythematosus. In: Firestein GS, Budd RC, Harris ED Jr, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia: Elsevier W.B. Saunders; 2008
  14. Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, ed-in-chief. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby, an imprint of Elsevier; 2009.
  15. Klein-Gitelman MS. Systemic lupus erythematosus. In: Kliegman RM, Behrman RE, Jenson HB, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
  16. MedWorm
  17. Hsieh C. Belimumab for systemic lupus erythematosus. American College of Rheumatology. Accessed 29 Aug 2013.
  18. Bartels CM. Systemic lupus erythematosus. eMedicine. 2007. Accessed 22 Sep 2008.
  19. Klein-Gitelman MS. Systemic lupus erythematosus. eMedicine. 2006.
  20. Klein-Gitelman MS. Systemic lupus erythematosus. eMedicine. seborrheic+AND+dermatitis. 2006.
  21. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019 Sep;78(9):1151-1159. doi: 10.1136/annrheumdis-2018-214819. Accessed 10 May 2020. PMID: 31383717
  22. Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019 Jun;78(6):736-745. doi: 10.1136/annrheumdis-2019-215089. Accessed 06 May 2020. PMID: 30926722
  23. Gordon C, Amissah-Arthur MB, Gayed M, et al; British Society for Rheumatology Standards, Audit and Guidelines Working Group. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults. Rheumatology (Oxford). 2018 Jan 1;57(1):e1-e45. doi: 10.1093/rheumatology/kex286. PMID: 29029350
  24. Castrejon I, Rua-Figueroa I, Rosario MP, et al. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: a systematic literature review. Reumatol Clin. Sep-Oct 2014;10(5):309-320. doi: 10.1016/j.reuma.2014.01.012. Accessed 13 Jun 2020. PMID: 25022441
  25. Chessa E, Piga M, Floris A, et al. Use of Physician Global Assessment (PGA) in systemic lupus erythematosus: a systematic review of its psychometric properties. medRxiv. 17 Apr 2020. Accessed 13 Jun 2020.
  26. Fanouriakis A, Kostopoulou M, Cheema K, et al. 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. Ann Rheum Dis. 2020 Jun;79(6):713-723. doi: 10.1136/annrheumdis-2020-216924. PMID: 32220834
  27. Dermatologicals. WHO Collaborating Centre for Drug Statistics Methodology. 14 Dec 2021. Accessed 09 Feb 2022.
  28. Chasset F, Richez C, Martin T, et al. Rare diseases that mimic systemic lupus erythematosus (lupus mimickers). Joint Bone Spine. 2019 Mar;86(2):165-171. doi: 10.1016/j.jbspin.2018.10.007. PMID: 30837156
  29. Lam NCV, Ghetu MV, Bieniek ML. Systemic lupus erythematosus: primary care approach to diagnosis and management. Am Fam Physician. 2016 Aug 15;94(4):284-294.
  30. Thanou A, James JA, Arriens C, et al. Scoring systemic lupus erythematosus (SLE) disease activity with simple, rapid outcome measures. Lupus Sci Med. 2019 Dec 30;6(1):e000365. doi: 10.1136/lupus-2019-000365. PMID: 31921432
  31. Kyttaris VC. Biologic agents in the treatment of systemic lupus erythematosus. In: Lahita RG. Systemic Lupus Erythematosus. 5th ed. Philadelphia, PA: Elsevier, Inc.; 2011.
  32. Ameer MA, Chaudhry H, Mushtaq J, et al. An overview of systemic lupus erythematosus (SLE) pathogenesis, classification, and management. Cureus. 2022 Oct 15;14(10):e30330. doi: 10.7759/cureus.30330. PMID: 36407159
  33. Fanouriakis A, Tziolos N, Bertsias G, et al. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis. 2021 Jan;80(1):14-25. doi: 10.1136/annrheumdis-2020-218272. PMID: 33051219
  34. Lee MH, Koh JWH, Ng CH, et al. A meta-analysis of clinical manifestations in Asian systemic lupus erythematous: the effects of ancestry, ethnicity and gender. Semin Arthritis Rheum. 2022 Feb;52:151932. doi: 10.1016/j.semarthrit.2021.12.004. PMID: 34996626
  35. Mok CC. A consensus for the management of systemic lupus erythematosus in Asia. Journal of Clinical Rheumatology and Immunology. 2021;21(1):1-6. doi: 10.1142/S266134172101001X.
Editor's Recommendations
Special Reports