What is SLE (Systemic Lupus Erythematosus)?
SLE is a chronic autoimmune disease in which the immune system mistakenly attacks the body’s own tissues and organs and is characterized by persistently active illness or alternating periods of exacerbations (flares) and remissions. SLE is complex and can target any or multiple body organs, including the skin, joints, muscles, blood and blood vessels, brain, kidney, and heart. Although SLE is the most common form of lupus, other types also exist (e.g., drug-induced lupus) (Lupus Canada, 2015).
Estimations are that at least five million people worldwide have a form of lupus (Lupus Society of America, 2016). In Canada, while incidence and prevalence rates vary by age, sex, and ethnicity (e.g., a recent study estimates SLE prevalence in Alberta to be 1 case per 366 females and 1 case per 311 First nations females [Barnabe et al., 2012]), it is estimated that approximately one in every 1000 Canadian men, women and children are affected (Lupus Canada, 2015). Typically starting between the ages of 15 and 44, 90% of those affected are women (Arthritis Society, 2017); in those over 45 or below 15, both sexes are affected equally (Lupus Canada, 2015). Non-white populations have the highest rates of SLE, with wide ethnic and geographic variations in incidence (O’Neill & Cervera, 2010). While SLE is no longer considered to be fatal, it is potentially damaging to many parts of the body. Common physical symptoms include extreme fatigue, skin rashes, sun sensitivity, joint pain and swelling, and complications with heart disease, the kidneys, diabetes and neurological dysfunction also exist. Symptoms are often not visible or obvious to others, meaning that those diagnosed are not always perceived as ‘sick’. Further, the illness’ long-term and unpredictable nature (lupus often goes in cycles, with periods of time in which symptoms may disappear) can have serious negative impacts on emotional, psychological and social functioning, and can create a sense of constant uncertainty and fear for the future (Lupus: Patient Voices, 2018). Like other chronic diseases, it has been associated with the contraction of social networks and a general loss of identity, and can have significant impacts on an individual’s ability to engage in meaningful employment. Because of the nature of the disease, each individual’s experience of diagnosis and living with SLE is different, which can make it more difficult to manage in the workplace or other social or volunteer commitments.
While there is no specific cause of SLE and knowledge of its etiology is still limited, complex interactions between genetic predisposition and the environment push an individual across the ‘disease threshold’ (Edwards & James, 2006). Environmental factors may include the in-utero environment, diet, exposure to UV light, infectious agents, smoking, as well as socioeconomic factors; all of which may be important at different points across the lifecourse (Edwards and James, 2006). While various treatment plans exist, there is currently no cure available for SLE (Lupus Canada, 2015).
- Arthritis Society. (2017). Systemic Lupus Erythmatosus. Accessed: https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/systemic-lupus-erythematosus.
- Barnabe, C., et al. (2012). Prevalence of systemic lupus erythematosus and systemic sclerosis in the First Nations population of Alberta, Canada. Arthritis Care & Research. 64(1): doi:10.1002/acr.20656.
- Edwards, C.J., James, J.A. (2006). Making lupus: a complex blend of genes and environmental factors is required to cross the disease threshold. Lupus, 15(11): 713-714.
- Lupus Canada. (2015). Living well with Lupus FACTS. Accessed: https://www.lupuscanada.org/wp-content/uploads/2015/10/Lupus-Canada-Fact-Booklet-2015.pdf.
- Lupus Society of America (2016). Lupus facts and statistics. Accessed: https://www.lupus.org/resources/lupus-facts-and-statistics.
- Lupus: Patient Voices. (2018). Report on Externally-led Patient-Focused Drug Development Meeting: September 25, 2017. Accessed: http://lupuspfdd.org/LupusPatientVoicesFINAL.pdf.
- O’Neill, S., & Cervera, R. (2010). Systemic lupus erythematosus. Best Pract Res Clin Rheumatol. 24(6): 841-855.