Hello. I'm Sara Tedeschi and I'm a Rheumatologist at
Brigham and Women's Hospital and Harvard Medical School in Boston Massachusetts.
Thank you for joining us in this lecture focused on
the diagnosis and management of systemic lupus erythematosus.
During this lecture, I will refer to systemic lupus erythematosus simply as lupus,
for the sake of brevity.
The information that we will discuss should be viewed as
a general overview of the way that Rheumatologists
consider whether a patient may have lupus and
considerations for treating specific lupus manifestations.
In clinical practice, lupus patients vary widely and the decision about
diagnosis and especially treatment must be individualized for each patient.
This lecture will begin with distinguishing the difference
between lupus classification criteria and a clinical diagnosis of lupus.
We'll then focus on the clinical and laboratory evaluation that is
commonly performed in rheumatology clinics to evaluate for suspected lupus.
We'll cover a general approach to treatment, including preventive care,
tailoring lupus therapy to specific manifestations,
and considerations for women of reproductive potential who may desire a future pregnancy.
Lupus is a relatively uncommon chronic autoimmune disease with a range of severity.
Recent estimates of the prevalence of lupus in the United States were conducted
by evaluating hospital discharge diagnosis codes in California and Pennsylvania.
And the estimates showed that
between 100 and 150 individuals per 100,000 adults have lupus in the United States.
Specifically among women, the prevalence is higher with two cases per 1,000 adult women.
In general, lupus affects younger patients and is predominately female with
ratios of approximately seven to nine women for one man who's affected.
Lupus disproportionately occurs in non-Caucasian patients and in many cases,
the manifestations may be more severe in those patients.
Lupus is a very heterogeneous condition both in terms of
the manifestations with a range of clinical abnormalities and immunologic abnormalities,
as well as a range of severity.
In some cases, patients may have
only cutaneous manifestations that require very little treatment,
whereas, on the other end of the spectrum,
some patients have very severe multi-organ disease
requiring hemodialysis or kidney transplant.
Importantly when we're considering lupus as a diagnosis,
we always need to make sure that we are ruling out conditions that may mimic lupus
and we'll go into that further when we talk about the evaluation.