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Systemischer Lupus erythematodes (SLE)

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Definition:
Der systemische Lupus erythematodes (SLE) ist eine chronische, in Schüben verlaufende Autoimmunerkrankung. Es können praktisch alle Organe in unterschiedlichem Schweregrad betroffen sein. Klinisches Bild, Verlauf und Prognose sind ausgesprochen variabel.
Prävalenz:
Sie beträgt in Deutschland etwa 40/100.000, das Verhältnis Frauen zu Männer liegt etwa bei 9:1.
Symptome:
Die Erkrankung kann alle Organsysteme betreffen. Neben Allgemeinsymptomen wie Abgeschlagenheit und Fieber betrifft die Symptomatik vor allem Gelenke, Haut, Nieren und zentrales Nervensystem.
Befunde:
Neben den Veränderungen im Bereich der betroffenen Organsysteme werden hämatologische (Anämie, Leukozytopenie, Thrombozytopenie) und immunologische (verschiedene Autoantikörper) Befunde erhoben.
Diagnostik:
Anhand eines Klassifikationssystems, das klinische, hämatologische und immunologische Kriterien umfasst.
Therapie:
Allgemeinmaßnahmen wie Sonnenschutz und Impfschutz. Medikamentös mit Antimalariamitteln, Glukokortikoiden, Immunsuppressiva und Biologika.
  • European League Against Rheumatism (EULAR). Update of the EULAR recommendations for the management of systemic lupus erythematosus. Stand 2019. www.eular.org 
  • European League Against Rheumatism (EULAR). Recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations. Stand 2010. www.eular.org 
  • European League Against Rheumatism (EULAR). Update of the  recommendations for the management of lupus nephritis. Stand 2019. www.ard.bmj.com 
  • European League Against Rheumatism (EULAR). Recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Stand 2017. www.eular.org 
  • T2T/SLE Working Group. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Stand 2014. www.ard.bmj.com 

 

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  • Michael Handke, Prof. Dr. med., Facharzt für Innere Medizin, Kardiologie und Intensivmedizin, Freiburg i. Br.