Systemic Lupus Erythematosus The Prototypic Immune Complex Mediated Disease

SLE is a chronic, remitting and relapsing, multisystem autoimmune disease that affects predominantly women, with an incidence of 1 in 700 among women between the ages of 20 and 60 years (about 1 in 250 among black women) and a female-to-male ratio of 10 : 1. The principal clinical manifestations are rashes, arthritis, and glomerulonephritis, but hemolytic anemia, thrombocyto-penia, and CNS involvement are also common. Many different autoantibodies are found in patients with SLE. The most frequent are antinuclear, particularly anti-DNA, antibodies; others include antibodies against ribo-nucleoproteins, histones, and nucleolar antigens. Immune complexes formed from these autoantibodies and their specific antigens are responsible for glomerulonephritis, arthritis, and vasculitis involving small arteries throughout the body. Hemolytic anemia and thrombocytopenia are due to autoantibodies against erythrocytes and platelets, respectively. The principal diagnostic test for the disease is the presence of antinuclear antibodies; antibodies against double-stranded native DNA are specific for SLE.

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