Page 61 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology An update on SLE

by the development of autoantibodies, accumulation (ESR) indicates active SLE, although C-reactive protein
of immune complexes, inflammation, and ultimately, (CRP) levels are typically within the normal range or only
irreversible organ damage. SLE can impact individuals slightly increased. The complete blood count test can
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of all ages, ethnicities, and genders. However, over 90% detect thrombocytopenia, leukopenia, lymphopenia, and
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of newly diagnosed SLE patients are women in their specific hematological alterations, including autoimmune
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reproductive years. It involves the activation of both hemolytic anemia (AIHA). Renal parameters should
innate and adaptive immune responses. The interplay include serum creatinine measurements, urine function
between genetic and environmental factors leads to various evaluation, and urinary sediment examination.
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immunological changes, resulting in ongoing immune Antinuclear antibodies (ANA), anti-double-stranded
reactions against one’s nucleic acids. Tissue damage DNA (anti-dsDNA) antibodies, anti-Sm antibodies,
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caused by autoantibodies or immune complex deposits can and levels of C3 and C4 should be identified as indicators
affect several organs and systems, including the kidneys, of SLE. The evaluation of SLE involves precise diagnosis,
heart, blood vessels, central nervous system, skin, lungs, continuous monitoring of disease activity, assessment of
muscles, and joints. 7-10 This damage can lead to significant long-term damage and morbidity, and determination of
illness and an increased risk of death. 11 the patient’s overall health condition. 29
During the late 1940s, nearly 40% of individuals This paper will review SLE in-depth, including its
diagnosed with SLE experienced mortality within 3 years epidemiological rate and pathogenesis. Furthermore, it
after the initial manifestation of symptoms. Subsequently, will discuss its manifestation features and the diagnosis
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the survival rates of individuals with SLE have significantly and treatment options.
increased to over 90% for 5- and 10-year periods. Based
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on the nationwide mortality database, the mortality rate 2. SLE mortality rate and (Epidemiology in
of SLE between the years 1968 and 2013 accounted for the KSA)
underlying cause of death in a total of 50,249 individuals SLE is a complex autoimmune condition that affects
across the United States (US). During the period from multiple organ systems and is more prevalent in
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1999 to 2013, there were an additional 12,463 deaths in women, with a ratio of 9 females to 1 male. The disease
which SLE was identified as a contributing factor. In often manifests during childbearing age and presents a
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addition, in Germany, the incidence of SLE in 2002 was significant public health issue due to its chronic nature
36.7 cases/100,000 individuals, with a female-to-male and potential to cause considerable organ damage and
ratio of 4:1. It is linked to a mortality risk approximately increased mortality. Globally, the prevalence of SLE varies
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2 – 5 times higher than the general population’s. Early significantly based on geographic and ethnic factors,
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mortality, defined as death occurring within 1 year of ranging from 20 to 150 cases/100,000 population. In North
diagnosis, is believed to be primarily caused by severe America and Europe, the prevalence is generally higher,
disease activity. 17 typically within the range of 20 – 70 cases/100,000. In

On the other hand, later mortality is more often contrast, Asian and African populations are believed to
attributed to difficulties arising from long-standing disease have even greater incidence rates.
and the use of immunosuppressive medications. Both In Saudi Arabia, the exact prevalence of SLE is less
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infection and increased atherosclerosis contribute to late well-documented compared to other regions. However,
mortality. Although there have been many improvements in recent studies indicate a rising trend in the diagnosis of
diagnosing and treating SLE and its related comorbidities, autoimmune diseases, including SLE. While the specific
this disease continues to cause substantial illness and prevalence of SLE in Saudi Arabia is not fully established, the
death. 19 general burden of chronic autoimmune and inflammatory

Substantial evidence indicates a significant relationship diseases in the country mirrors global trends. A regional
between SLE and a deficiency in complement C1q. This study conducted at King Khalid University Hospital in
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deficiency contributes to the activation of CD8 T cells in Riyadh reported that the incidence of SLE in the Saudi
+
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the SLE model. Autoantibody-producing B cells and self- population was estimated at 19.28/100,000 people, with
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reactive T cells are known to significantly contribute to the a higher frequency among younger women.
development and progression of autoimmune diseases, Mortality rates linked to SLE are significantly affected
including SLE. The diagnosis of SLE can be supported by by the progression of the disease and its complications,
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laboratory testing, although it is initially based on clinical especially concerning renal, cardiovascular, and infectious
signs. Initially, it is advisable to conduct a screening causes. In Saudi Arabia, while mortality data specifically
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laboratory test. An elevated erythrocyte sedimentation rate linked to SLE is sparse, international studies suggest
Volume 9 Issue 3 (2025) 53 doi: 10.36922/EJMO025090042