Systemic lupus erythematosus: literature review and update of classification criteria

Authors

  • Caio B. Abreu Universidade Federal de Roraima, Boa Vista, Roraima, Brasil.
  • Patrick R. José Hospital Geral de Roraima. Boa Vista, Roraima, Brasil.
  • Pâmella G. G. Fontenelle Universidade Federal de Roraima, Boa Vista, Roraima, Brasil.
  • João L. S. S. Ferreira Universidade Federal de Roraima, Boa Vista, Roraima, Brasil.
  • Ellem T. S. Weimann Universidade Federal de Roraima, Boa Vista, Roraima, Brasil/Hospital da Criança Santo Antônio, Boa Vista, Roraima, Brasil.

DOI:

https://doi.org/10.18227/hd.v2i2.7512

Keywords:

Systemic lupus erythematosus, classification criteria, serology, immune system, treatment

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that develops inflammatory foci in the most diverse organs and tissues of the body, with a large number of clinical manifestations. This study aims to reinforce the knowledge that exists about the disease and to update on the criteria determined in 2018 by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULA). Methods: The present study was carried out by means of a review of the literature available in the Scientific Electronic Library Online and National Institutes of Medicine of the US National Library of Medicine Health databases. Development: Malfunction of the immune system and consequent production of autoantibodies are of paramount importance in the pathogenesis and presentation of clinical signs and symptoms, but the etiopathogenesis of SLE is not fully elucidated. The diagnosis of SLE is hampered by the wide variety of systemic presentations and the low specificity of various symptoms, which are often mistaken for other diseases. In 2018, updated criteria were developed by the ACR and the EULA. Current treatment regimens consist of antimalarial, corticosteroid and immunobiological drugs. Conclusion: SLE is a disease of considerable complexity due to the lack of complete knowledge of its etiopathogenesis. Its clinical manifestations are confounded with that of several diseases, which hinders its rapid diagnosis and initiation of treatment. Studies on the discovery of new therapies for use in SLE are being carried out worldwide, with the aim of reducing the mortality of these patients.

Downloads

Download data is not yet available.

References

Abbas AK, Lichtman, AH, Pillai, S. Cellular and molecular immunology. Philadelphia, Elsevier, 2012.

Abeles A.M., Abeles M., 2013. The clinical utility of a positive antinuclear antibody test result. The American Journal of Medicine, 126(4), 342-348.

Alonso, M. D., Martinez-Vazquez F., Teran T.D., Miranda- Filloy J.A., Dierssen T., Blanco R., Gonzalez-Juanatey C., Llorca J., Gonzalez-Gay M.A., 2012. Late-onset systemic lupus erythematosus in Northwestern Spain: differences with early-onset systemic lupus erythematosus and literature review. Lupus 21(10), 1135–1148.

Alves V.L.P., Carniel A.Q., Costallat L.T.L., Turato E.R., 2015. Significados do adoecer para pacientes com lúpus eritematoso sistêmico: revisão da literatura. Revista Brasileira de Reumatologia, 55(6), 522-527.

American College of Rheumatology, 1997. 1997 Update of the 1982 American College of RheumatologyRevised Criteria for Classification of Systemic Lupus Erythematosus. https://www.rheumatology.org/Portals/0/Files/1997%20Update%20of%201982%20Revised.pdf (accessed: 25/09/2018).

Arbuckle M.R., McClain M.T., Rubertone M.V., Scofield R.H., Dennis G.J., James J.A., Harley J.B., 2003. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. New England Journal of Medicine, 349(16), 1526-1533.

Aringer M., Dörner T., 2018. Systemic Lupus Erythematosus (SLE) - New Classification Criteria. Deutsche Medizinische Wochenschrift, 143(11), 811-814.

Ballocca F., D'Ascenzo F., Moretti C., Omedè P., Cerrato E., Barbero U., Abbate A., Bertero M.T., Zoccai G.B., Gaita F., 2015. Predictors of cardiovascular events in patients with systemic lupus erythematosus (SLE): a systematic review and meta-analysis. European Journal of Preventive Cardiology, 22(11), 1435-1441.

Barbhaiya M., Costenbader K.H., 2016. Environmental Exposures and the Development of Systemic Lupus Erythematosus. Current opinion in rheumatology, 28(5), 497–505.

Brito F.A., Santos S.M.E., Ferreira G.A., Pedrosa W., Gradisse J., Costa L.C., Neves S.P.F., 2014. Detection of anti-nuclear antibodies by indirect immunofluorescence on HEp-2 cells: setting the appropriate screening dilution for the diagnosis of autoimmune rheumatic diseases. Revista Brasileira de Reumatologia, 54(1), 13-20.

Bruder R.C.S., Prudente I.M.C., Silva M.I.C., Defaveri J., 2004. A importância da contra-imunoeletroforese na detecção de antígenos nucleares extraíveis para o diagnóstico de doenças reumáticas sistêmicas. Jornal Brasileiro de Patologia e Medicina Laboratorial, 40(1), 15-19.

Bultink I.E., Harvey N.C., Lalmohamed A., Cooper C., Lems W.F., van Staa T.P., Vries F., 2014. Elevated risk of clinical fractures and associated risk factors in patients with systemic lupus erythematosus versus matched controls: a population-based study in the United Kingdom. Osteoporosis International, 25(4), 1275-1283.

Callado M.R.M., Lima J.R.C., Barroso M.N.A., Pinheiro A.T.M., Neto M.F.C., Abreu M.A.L., Vieira W.P., 2013. Utilidade da triagem dos anticorpos anti-dsDNA por quimioluminescência, seguida de confirmação por imunofluorescência indireta. Revista Brasileira de Reumatologia, 53(5), 412–418.

Chen X.W., Shen Y., Sun C.Y., Wu F.X., Chen Y., Yang C.D., 2011. Anti-class a scavenger receptor autoantibodies from systemic lupus erythematosus patients impair phagocytic clearance of apoptotic cells by macrophages in vitro. Arthritis Research & Therapy, 13(1), R9.

Chetrit B., 1993. The molecular basis of the SSA/Ro antigens and the clinical significance of their autoantibodies. British Journal of Rheumatology, 32(5), 396-402.

Cooper G.S., Dooley M.A., Treadwell E.L., St Clair E.W., Parks C.G., Gilkeson G.S., 1998. Hormonal, environmental, and infectious risk factors for developing systemic lupus erythematosus. Arthritis & Rheumatism, 41(10), 1714-1724.

Cooper G.S., Dooley M.A., Treadwell E.L., St Clair E.W., Gilkeson G.S., 2002. Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study. Arthritis & Rheumatism, 46(7), 1830-1839.

Dryglewska M., Kolarz B., Majdan M., 2018. Epigenetic disturbances in systemic lupus erythematosus. Wiadomości Lekarskie, 71(1), 32-39.

Fairhurst A.M., Wandstrat A.E., Wakeland E.K., 2006. Systemic lupus erythematosus: multiple immunological phenotypes in a complex genetic disease. Advances in Immunology, 92, 1-69.

Furie R., Petri M., Zamani O., Cervera R., Wallace D.J., Tegzová D., Sanchez-Guerrero J., Schwarting A., Merrill J.T., Chatham W.W., Stohl W., Ginzler E.M., Hough D.R., Zhong Z.J., Freimuth W., van Vollenhoven R.F.; BLISS-76 Study Group, 2011. A phase III, randomized, placebocontrolled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. Arthritis & Rheumatology, 63(12), 3918-3930.

Gergianaki I., Bertsias G., 2018. Systemic Lupus Erythematosus in Primary Care: An Update and Practical Messages for the General Practitioner. Frontiers in Medicine, 5, 161.

Go R.S., Winters J.L., Kay N.E., 2017. How I treat autoimmune hemolytic anemia. Blood, 129(22), 2971- 2979.

Hartman EAR, van Royen-Kerkhof A, Jacobs JWG, Welsing PMJ, Fritsch-Stork RDE, 2018. Performance of the 2012 Systemic Lupus International Collaborating Clinics classification criteria versus the 1997 American College of Rheumatology classification criteria in adult and juvenile systemic lupus erythematosus. A systematic review and meta-analysis. Autoimmunity Reviews, 17(3), 316-322.

Hochberg M.C.,1997. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism. 40(9), 1725.

Horák P., Hermanová Z., Faltýnek L., Pospísil Z., Scudla V., 1997. The autoantibody profile and disease activity in patients with systemic lupus erythematosus. Vnitr Lek,43(10), 639-644.

Ighe A., Dahlström Ö., Skogh T., Sjöwall C., 2015. Application of the 2012 Systemic Lupus International Collaborating Clinics classification criteria to patients in a regional Swedish systemic lupus erythematosus register. Arthritis Research & Therapy, 17(3), 1-8.

Javierre B.M., Fernandez A.F., Richter J., Al-Shahrour F., Martin-Subero J.I., Rodriguez-Ubreva J., Berdasco M., Fraga M.F., O'Hanlon T.P., Rider L.G., Jacinto F.V., Lopez- Longo F.J., Dopazo J., Forn M., Peinado M.A., Carreño L., Sawalha A.H., Harley J.B., Siebert R., Esteller M., Miller F.W., Ballestar E., 2010. Changes in the pattern of DNA methylation associate with twin discordance in systemic lupus erythematosus. Genome Research, 20(2), 170-179.

Kandala N.B., Connock M., Grove A., Sutcliffe P., Mohiuddin S., Hartley L., Court R., Cummins E., Gordon C., Clarke A., 2013. Belimumab: a technological advance for systemic lupus erythematosus patients? Report of a systematic review and meta-analysis. BMJ Open, 3(7), pii: e002852.

Kasitanon N., Magder L.S., Petri M., 2006. Predictors of survival in systemic lupus erythematosus. Medicine (Baltimore), 85(3), 147–156.

Klumb E.M., Silva C. A. A., Lanna C.C.D., Sato E.I., Borba E.F., Brenol J.C.T., Albuquerque E.M. N., Monticielo O.A., Costallat L.T.L., Latorre L.C., Sauma M.F.L.C., Bonfa E.S.D.O., Ribeiro, F.M., 2015. REVISTA BRASILEIRA DE REUMATOLOGIA, 55(1), 1-21.

Laboratório Alvaro, 2018. Menu de exames: ANTI-SM. http://www.alvaro.com.br/laboratorio/menu-exames/SM (accessed: 12/11/2018).

Laboratório Rocha, 2017. Menu de exames: complemento C 3. http://www.laboratoriorocha.com/exame/complemento-c3-247 (accessed: 11/11/2018).

Laboratório Rocha, 2017. Menu de exames: complemento C 4. http://www.laboratoriorocha.com/exame/complemento-c4-248 (accessed: 11/11/2018).

Laboratório Rocha, 2017. Menu de exames: complemento CH50.http://www.laboratoriorocha.com/exame/complemento-total-ch50-249 (accessed: 11/11/2018).

Lan L., Han F., Chen J.H., 2012. Efficacy and safety of rituximab therapy for systemic lupus erythematosus: a systematic review and meta-analysis. Journal of Zheijang University SCIENCE B, 13(9), 731-744.

Lindholm C., Börjesson-Asp K., Zendjanchi K., Sundqvist A.C., Tarkowski A., Bokarewa M., 2008. Longterm clinical and immunological effects of anti-CD20 treatment in patients with refractory systemic lupus erythematosus. The Journal of Rheumatology, 35(5), 826-833.

Lo M.S., Tsokos G.C., 2012. Treatment of systemic lúpus erythematosus: New advances in targeted therapy. Annals of the New York Academy of Sciences, 1247(1), 138–152.

Lora P.S., Laurino C.C.F.C., Freitas A.E., Brenol J.C., Montecielo O., Xavier R.M., 2007. Antinuclear antibodies (ANA) immunofluorescent patterns in HEp-2 cells on samples positive for anti-SSA/Ro. Revista Brasileira de Reumatologia, 47(1), 4-9.

Michalski J.P., Kodner C., 2010. Systemic lupus erythematosus: safe and effective management in primary care. Primary Care, 37(4), 767-778.

Mok C.C., Lau C.S., 2003. Pathogenesis of systemic lupus erythematosus. Journal of Clinical Pathology, 56(7), 481– 490.

Molina J.F., Drenkard C., Molina J., Cardiel M.H., Uribe O., Anaya J.M., Gomez L.J., Felipe O., Ramirez L.A., Alarcon-Segovia D., 1996. Systemic lupus erythematosus in males. A study of 107 Latin American patients. Medicine (Baltimore), 75(3):124-130.

Mota L.M.H., Haddad G.P., Lima R.A.C., Carvalho J.F., Junqueira M.I.M., Neto L.L.S., Lima F.A.C., 2007. Druginduced lupus – from basic to spplied immunology. Revista Brasileira de Reumatologia, 47(6), 431-437.

Nakashima, C.A.K., Galhardo A.P., Silva J.F.M., Fiorenzano G.R., Santos A.B.S., Leite M.F.S., Nogueira M.A., Menolli P.V.S., Menolli R.A., 2011. Incidência e aspectos clínicolaboratoriais do lúpus eritematoso sistêmico em cidade do Sul do Brasil. Revista Brasileira de Reumatologia, 51(3), 231-239.

Peene I., Van Ael W., Vandenbossche M., Vervaet T., Veys E., De Keyser F., 2000. Sensitivity of the HEp-2000 substrate for the detection of anti-SSA/Ro60 antibodies. Clinical Rheumatology, 19(4), 291-295.

Petri M., Orbai A.M., Alarcón G.S., Gordon C., Merrill J.T., Fortin P.R., Bruce I.N., Isenberg D., Wallace D.J., Nived O., Sturfelt G., Ramsey-Goldman R., Bae S.C., Hanly J.G., Sánchez-Guerrero J., Clarke A., Aranow C., Manzi S., Urowitz M., Gladman D., Kalunian K., Costner M., Werth V.P., Zoma A., Bernatsky S., Ruiz-Irastorza G., Khamashta M.A., Jacobsen S., Buyon J.P., Maddison P., Dooley M.A., van Vollenhoven R.F., Ginzler E., Stoll T., Peschken C., Jorizzo J.L., Callen J.P., Lim S.S., Fessler B.J., Inanc M., Kamen D.L., Rahman A., Steinsson K., Junior A.G.F. , Sigler L., Hameed S., Fang H., Pham N., Brey R., Weisman M.H., Junior G.M., Magder L.S., 2012. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis & Rheumatology, 64(8), 2677–86.

Pons-Estel G.J., Alarcón G.S., Scofield L., Reinlib L., Cooper G.S., 2010. Understanding the epidemiology and progression of systemic lupus erythematosus. Seminars in Arthritis and Rheumatism, 39(4), 257-268.

Ponticelli C., Moroni G., 2017. Hydroxychloroquine in systemic lupus erythematosus (SLE). Expert Opinion on Drug Safety, 16(3), 411-419.

Pope J.E., 2007. The diagnosis and treatment of Raynaud's phenomenon: a practical approach. Drugs, 67(4), 517-525.

Rainsford K.D., Parke A.L., Clifford-Rashotte M., Kean W.F., 2015. Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases. Inflammopharmacology, 23(5), 231-269.

Ramsey-Goldman R., Li J., Dervieux T., Alexander R.V., 2017. Cell-bound complement activation products in SLE. Lupus Science & Medicine, 4(1), e000236.

Rees F., Doherty M., Grainge M.J., Lanyon P., Davenport G., Zhang W., 2016. Mortality in systemic lúpus erythematosus in the United Kingdom 1999-2012. Rheumatology (Oxford), 55(5), 854-860.

Richardson B., 2012. Epigenetics and lupus. Arthritis Research & Therapy, 2012; 14(3), A1.

Ruiz-Arruza I., Barbosa C., Ugarte A., Ruiz-Irastorza G., 2015. Comparison of high versus low-medium prednisone doses for the treatment of systemic lupus erythematosus patients with high activity at diagnosis. Autoimmunity Reviews, 14(10), 875-879.

Sabahi R., Anolik J.H., 2006. B-cell-targeted therapy for systemic lupus erythematosus. Drugs, 66(15), 1933–1948.

Santamaria J.R., Badziak D., Barros M.F., Mandelli F.L., Cavalin L.C., Sato M.S., 2005. Síndrome antifosfolípide. Anais brasileiros de dermatologia, 80(3), 225-239.

Vilar M.J.P., Sato E.I., 2002. Estimating of systemic lupus erythematosus in a tropical region (Natal, Brazil). Lupus, 11(8), 528-532.

Seelig C.A., Bauer O., Seelig H.P., 2016. Autoantibodies Against DFS70/LEDGF Exclusion Markers for Systemic Autoimmune Rheumatic Diseases (SARD). Clinical Laboratory, 62(4), 499-517.

Shaikh M.F., Jordan N., D'Cruz D.P., 2017. Systemic lupus erythematosus. Clinical Medicine, 17(1), 78–83.

Silva, A.C.S., Amorim E.C., Silva G.G., Silva J.S., Correia D.S., 2013. Lúpus: efeitos nos cuidados de si e nas relações familiares. Psicologia em revista, 19(1), 30-42.

Tan E.M., Cohen A.S., Fries J.F., Masi A.T., McShane D.J., Rothfield N.F., Schaller J.G., Talal N., Winchester R.J., 1982. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatology, 25(11), 1271-1277.

Teruel M., Alarcón-Riquelme M.E., 2016. The genetic basis of systemic lupus erythematosus: What are the risk factors and what have we learned. Journal of Autoimmunity, 74, 161-175.

Tiao J., Feng R., Carr K., Okawa J., Werth V.P., 2016. Using the American College of Rheumatology and Systemic Lupus International Collaborating Clinics Criteria to Determine the Diagnosis of Systemic Lupus Erythematosus in Patients with Subacute Cutaneous Lupus Erythematosus. Journal of the American Academy of Dermatology, 74(5), 862-869.

Tompson D., Juby A., Davis P., 1993. The clinical significance of autoantibody profiles in patients with systemic lupus erythematosus. Lupus, 2(1), 15–19.

Wang Y., Yuan J., Dai D., Liu J., Xu J., Miao X., Wang H., Mao C., Xiao Y., 2018. Poly IC pretreatment suppresses B cell-mediated lupus-like autoimmunity through induction of Peli1. Acta biochimica et biophysica Sinica, 50(9), 862- 868.

Zahr Z.A., Fang H., Magder L.S., Petri M., 2013. Predictors of corticosteroid tapering in SLE patients: the Hopkins Lupus Cohort. Lupus, 22(7), 697-701.

Zhao L., Ye Y., Zhang X., 2015. B cells biology in systemic lupus erythematosus-from bench to bedside. Science China Life Sciences, 58(11), 1111-1125.

Published

06/12/2018

How to Cite

Abreu, C. B. ., José, P. R. ., Fontenelle, P. G. G. . ., Ferreira, J. L. S. S. ., & Weimann, E. T. S. . (2018). Systemic lupus erythematosus: literature review and update of classification criteria. Health & Diversity Journal, 2(2), 76–85. https://doi.org/10.18227/hd.v2i2.7512

Issue

Section

Articles