Advertisement

Systemic Lupus Erythematosus

  • Eleftherios Pelechas
  • Evripidis Kaltsonoudis
  • Paraskevi V. Voulgari
  • Alexandros A. Drosos
Chapter

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease affecting multiple organ systems. The course of the disease is unpredictable with mild to life-threatening complications. Circulating autoantibodies directed against cell nuclear components is the main laboratory characteristic. As in other autoimmune diseases, the direct (health care costs) and indirect (productivity loss) socioeconomic costs of the disease are of major significance with an average annual direct medical cost to range approximately between 4000–10,000 euros (mild/severe cases respectively). Hippocrates was the first who described cutaneous ulcerations consistent with SLE. The word “lupus” comes from the Latin, which means “wolf”. It is attributed to the thirteenth century physician Rogerius who used it to describe erosive facial lesions that were reminiscent of a wolf’s bite. In 1872, cutaneous lupus (CL) was identified as a distinct form of SLE. In 1948 the lupus erythematosus cell (LE) was discovered by the American clinical haematologists Malcolm Hargraves and Robert Morton and it allowed the diagnosis of individuals with different forms of the disease.

References and Further Reading

  1. Alamanos Y, Voulgari PV, Papassava M, Tsamandouraki K, Drosos AA. Survival and mortality rates of systemic lupus erythematosus patients in Northwest Greece. Study of a 21-year incidence cohort. Rheumatology (Oxford). 2003;42:1122–3.CrossRefGoogle Scholar
  2. Alamanos Y, Voulgari PV, Siozos C, Katsimpri P, Tsintzos S, Dimou G, et al. Epidemiology of systemic lupus erythematosus in Northwest Greece 1982–2001. J Rheumatol. 2003;30:731–5.PubMedGoogle Scholar
  3. Bertsias G, Ioannidis JP, 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;67:195–205.CrossRefGoogle Scholar
  4. Bertsias G, Salmon JE, Boumpas DT. Therapeutic opportunities in systemic lupus erythematosus: state of the art and prospects for the new decade. Ann Rheum Dis. 2010;69:1603–11.CrossRefGoogle Scholar
  5. Bertsias G, Karampli E, Sidiropoulos P, Georgianaki I, Drosos AA, Sakkas L, et al. Clinical and financial burden of active lupus in Greece: a nationwide study. Lupus. 2016;25:1385–94.CrossRefGoogle Scholar
  6. Boumpas DT, Austin HA, Fessler BJ, et al. Systemic lupus erythematosus: emerging concepts: Part 1: renal, neuropsychiatric, cardiovascular, pulmonary, and hematologic disease. Ann Intern Med. 1995;122:940–50.CrossRefGoogle Scholar
  7. Boumpas DT, Fessler BJ, Austin HA, et al. Systemic lupus erythematosus: emerging concepts. Part 2: dermatologic and joint disease, the antiphospholipid antibody syndrome, pregnancy and hormonal therapy, morbidity and mortality, and pathogenesis. Ann Intern Med. 1995;12(1):42–53.CrossRefGoogle Scholar
  8. Cervera R, Khamashta MA, Fong J, et al. Morbidity and mortality in systemic lupus erythematosus during a 5-year period. A multicentre prospective study of 1.000 patients. European Working Party of Systemic Lupus Erythematosus. Medicine (Baltimore). 1999;78:167–75.CrossRefGoogle Scholar
  9. Drosos AA, Dimou GS, Siamopoulou-Mavridou A, Hatzis J, Moutsopoulos HM. Subacute cutaneous lupus erythematosus in Greece. A clinical, serological and genetic study. Ann Med Interne (Paris). 1990;141(5):421–4.Google Scholar
  10. Georgiou PE, Politi EN, Katsimbri P, Sakka V, Drosos AA. Outcome of lupus pregnancy: a controlled study. Rheumatology. 2000;39:1014–9.CrossRefGoogle Scholar
  11. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725.CrossRefGoogle Scholar
  12. Kokori SI, Ioannidis JP, Voulgarelis M, Tzioufas AG, Moutsopoulos HM. Autoimmune haemolytic anemia in patients with systemic lupus erythematosus. Am J Med. 2000;108(3):198–204.CrossRefGoogle Scholar
  13. Mavragani CP, Fragoulis GE, Somarakis G, Drosos AA, Tzioufas AG, Moutsopoulos HM. Clinical and laboratory predictors of distinct histopathological features of lupus nephritis. Medicine (Baltimore). 2015;94(21):e829.CrossRefGoogle Scholar
  14. Tektonidou MG, Laskari K, Panagiotakos DB, et al. Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies. Arthritis Rheum. 2009;61(1):29–36.CrossRefGoogle Scholar
  15. Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365:2110–21.CrossRefGoogle Scholar
  16. Vlachoyiannopoulos PG, Karassa FB, Karakostas KX, Drosos AA, Moutsopoulos HM. Systemic lupus erythematosus in Greece. Clinical features, evolution and outcome: a descriptive analysis of 292 patients. Lupus. 1993;2:303–12.CrossRefGoogle Scholar
  17. Voulgari PV, Katsimbri P, Alamanos Y, Drosos AA. Gender and age differences in systemic lupus erythematosus. A study of 489 Greek patients with a review of the literature. Lupus. 2002;11:722–9.CrossRefGoogle Scholar
  18. Zampeli E, Klinman DM, Gershwin ME, Moutsopoulos HM. A comprehensive evaluation for the treatment of lupus nephritis. J Autoimmun. 2017;78:1–10.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Eleftherios Pelechas
    • 1
  • Evripidis Kaltsonoudis
    • 1
  • Paraskevi V. Voulgari
    • 1
  • Alexandros A. Drosos
    • 1
  1. 1.Rheumatology Clinic - Department of Internal MedicineUniversity of IoanninaIoanninaGreece

Personalised recommendations