Systemic Lupus Erythematosus: Update Οn the Diagnosis, Prevalence, Clinical Management, Inflammatory Markers, New Horizons in the Pathogenesis, Manifestations and Progress in Treatment

Introduction: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem involvement, generating chronic inflammation and damage of more than one organ. It is usually clinically and serologically diagnosed with the presence of autoantibodies. Lupus is a Latin term meaning wolf, due to the fact that the typical facial eruptions of the pathology are very similar to the bite marks of a wolf. Objective: to detail the current information related to systemic lupus erythematosus, description, etiology, epidemiology, pathophysiology, histology, classification, clinical manifestations, treatment and differential diagnosis. Methodology: a total of 45 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 35 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: lupus, SLE, autoimmune, multisystemic. Results: Familial segregation and high concordance rates in identical twins strongly suggest a genetic contribution to SLE, however there is no obvious pattern of inheritance. Females have 10 times the risk of developing SLE compared to males. Lupus in males is less common but has a propensity to be more severe. About 80 to 90% of individuals with SLE show musculoskeletal involvement in the course of the disease, ranging from mild arthralgias to deforming arthritis. Avascular necrosis with or without the use of steroids may occur in 10% of individuals with SLE and is most often bilateral and affects the hip joints. Conclusions: systemic lupus erythematosus presents a wide range of clinical and histopathologic manifestations. Adequate education of affected individuals with systemic lupus erythematosus about the possible clinical manifestations can lead to early recognition and intervention, which may prevent potential significant organ damage. The role of markers and autoantibodies in the differential diagnosis of the pathology is essential. Treatment of SLE is aimed at preventing organ damage and achieving remission. The choice of treatment will depend on the altered organ system(s) and the extent of the involvement. Education of the affected individual, physical measures, lifestyle and emotional support play an important role in the comprehensive treatment of SLE. KEY WORDS: lupus, SLE, autoimmune, manifestations, treatment.