A Modern Approach to the Diagnosis and Management of Systemic Lupus Erythematosus

Abstract

Objective: Using available information on epidemiology, to analyse the impact from genetic factors and environment on development of systemic lupus erythematosus (SLE); to discuss asymptomatic and clinical periods of the disease; to assess the intensity of the disease, organ damages, comorbidities; to discuss the ways to improve SLE diagnosis and management. Key Points. The number of SLE cases has grown recently. The magnitude of clinical manifestations, cycles with remissions and aggravation make this disease one of the most difficult to diagnose, manage and assess therapy efficiency. As there are no diagnostic criteria for the disease, classification criteria are improved constantly. Despite the fact that the onset of the disease in half of patients is with low SLE intensity, later the disease progresses and affects several organs and systems. About 70% of patients failed to have a long-lasting remission; therefore, therapy protocols should be improved and should include immunosuppression and biological therapy. Conclusion. One of the burning issues in the modern rheumatology is lack of methods for early diagnosis and prognosis of the disease. Development and practical implementation of therapy recommendations can improve the therapy results and disease outcome. Keywords: systemic lupus erythematosus, epidemiology, criteria of the European League Against Rheumatism/American College of Radiology 2019, intensity, lupus nephritis.