Clinical and laboratory manifestations of systemic lupus erythematosus
| Pathogenesis | Examples of disease manifestations |
|---|---|
| Nonspecific inflammatory response | Fever, fatigue, arthralgia, weight loss, anemia of chronic disease, elevated erythrocyte sedimentation rate |
| Immune complex deposition (commonly in the synovium, skin, serosa, kidneys, and lungs) | Inflammatory arthritis, photosensitive skin rashes, pleurisy, pericarditis, glomerulonephritis, pneumonitis, or interstitial lung disease |
| Direct antibody-mediated attack | Hemolytic anemia (red cell antibodies), thrombocytopenia (antiplatelet antibodies), lymphopenia (lymphocytotoxic antibodies), neuropsychiatric manifestations such as depression and psychosis (antiribosomal P antibodies) |
| Associated features | Recurrent thrombosis and miscarriages (antiphospholipid syndrome), dry eyes and mouth (Sjögren syndrome) |
| Laboratory clues | Hemolytic anemia, leukopenia, lymphopenia, thrombocytopenia, elevated erythrocyte sedimentation rate, normal C-reactive protein, low complement (due to immune complex formation), and abnormal urinalysis (proteinuria, hematuria, red cell casts, or dysmorphic red cells) |