Health Condition

Systemic Lupus Erythematosus

About This Condition

Systemic lupus erythematosus (SLE) is an autoimmune illness that causes a characteristic butterfly-shaped rash on the face accompanied by inflammation of connective tissue, particularly joints, throughout the body. In autoimmune diseases, the immune system attacks the body instead of protecting it. Kidney, lung, and vascular damage are potential problems resulting from SLE.

The cause of SLE is unknown, though 90% of cases occur in women of childbearing age. Several drugs, such as procainamide, hydralazine, methyldopa, and chlorpromazine, may create SLE-like symptoms. Environmental pollution and industrial emissions were associated with an increased risk of SLE in one study.1 In one reported case, zinc supplementation appears to have aggravated drug-induced SLE.2 Ultraviolet radiation from sun exposure is a commonly recognized trigger of the skin manifestations of lupus.3 Some environmental chemicals such as hydrazine4 and food dyes such as tartrazine5 may be environmental triggers of SLE in susceptible people.

Risk factors include a family history of SLE, other collagen diseases or asthma,6 menstrual irregularity,7 beginning menstruation at age 15 or later,6 exposure to toxic chemicals,1 and low blood levels of antioxidant nutrients, such as vitamin A and vitamin E, or beta-carotene.10 Free radicals are thought to promote SLE.6

Discoid lupus erythematosus (DLE) is a milder form of lupus that affects the skin. Like SLE, it’s not known what causes DLE, though sun exposure may trigger the first outbreak. DLE is most common among women in their thirties.


Symptoms include decreased energy, weakness, fever, nausea, diarrhea, muscle and joint pain, chest pain, bruising, loss of appetite, weight loss, and a red, butterfly-shaped rash across the nose and cheeks. In addition, people with SLE may have symptoms of mouth sores, joint swelling, hair loss, changes in personality, seizures, and a coin-shaped, red skin rash elsewhere on the body that is aggravated by sunlight. Kidney, lung, and blood-vessel damage are potentially life-threatening manifestations of SLE.


1. Kardestuncer T, Frumkin H. Systemic lupus erythematosus in relation to environmental pollution: an investigation in an African-American community in North Georgia. Arch Environ Health 1997;52:85-90.

2. Fjellner B. Drug-induced lupus erythematosus aggravated by oral therapy. Acta Derm Venereol 1979;59:368-70.

3. Millard TP, Hawk JL, McGregor JM. Photosensitivity in lupus. Lupus 2000;9:3-10 [review].

4. Reidenberg MM, Durant PJ, Harris RA, et al. Lupus erythematosus-like disease due to hydrazine. Am J Med 1983;75:365-70.

5. Pereyo N. Hydrazine derivatives and induction of systemic lupus erythematosus. J Am Acad Dermatol 1986;14:514-5 [letter].

6. Nagata C, Fuyita, Iwata H, et al. Systemic lupus erythematosus: a case-control epidemiologic study in Japan. Int J Dermatol 1995;34:333-7.

7. Minami Y, Sasaki Ti, Komatsu S, et al. Female systemic lupus erythematosus in Miyagi Prefecture, Japan: a case-control study of dietary and reproductive factors. Tohoku J Exp Med 1993;169:245-52.

8. Comstock GW, Burke AE, Hoffman SC, et al. Serum concentrations of alpha-tocopherol, beta-carotene, and retinol preceding the diagnosis of rheumatoid arthritis and systemic lupus erythematosus. Ann Rheum Dis 1997;56:323-35.

9. Kelley VE, Ferretti A, Izui S, Strom TB. A fish oil diet rich in eicosapentaenoic acid reduces cyclooxygenase metabolites, and suppresses lupus in MRL-1pr mice. J Immunol 1985;134:2914-9.

10. Walton AJE, Snaith ML, Locniskar M, et al. Dietary fish oil and the severity of symptoms in patients with systemic lupus erythematosus. Ann Rheum Dis 1991;50:463-6.

11. Westberg G, Tarkowski A. Effect of MaxEPA in patients with SLE. Scand J Rheumatology 1990;19:137-43.

12. Wright SA, O'Prey FM, McHenry MT, et al. A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus. Ann Rheum Dis 2008;67:841-8.

13. Barry NN, McGuire JL, van Vollenhoven RF. Dehydroepiandrosterone in systemic lupus erythematosus: relationship between dosage, serum levels, and clinical response. J Rheumatol 1998;25:2352-6.

14. Van Vollenhoven RF, Morabito LM, Engleman EG, McGuire JL. Treatment of systemic lupus erythematosus with dehyroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol 1998;25:285-9.

15. Van Vollenhoven RF, Engleman EG, McGuire JL. Dehydroepiandrosterone in systemic lupus erythematosus. Results of a double-blind, placebo-controlled, randomized clinical trial. Arthritis Rheum 1995;38:1826-31.

16. Van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus 1999;8:181-7.

17. Orner GA, Mathews C, Hendricks JD, et al. Dehydroepiandrosterone is a complete hepatocarcinogen and potent tumor promoter in the absence of peroxisome proliferation in rainbow trout. Carcinogenesis 1995;16:2893-8.

18. Metzger C, Mayer D, Hoffmann H, et al. Sequential appearance and ultrastructure of amphophilic cell foci, adenomas, and carcinomas in the liver of male and female rats treated with dehydroepiandrosterone. Toxicol Pathol 1995;23:591-605.

19. Schwartz AG. Inhibition of spontaneous breast cancer formation in female C3H (A vy/a) mice by long-term treatment with dehydroepiandrosterone. Cancer Res 1979;39:1129-32.

20. McNeil C. Potential drug DHEA hits snags on way to clinic. J Natl Cancer Inst 1997;89:681-3.

21. Jones JA, Nguyen A, Strab M, et al. Use of DHEA in a patient with advanced prostate cancer: a case report and review. Urology 1997;50:784-8.

22. Zumoff B, Levin J, Rosenfeld RS, et al. Abnormal 24-hr mean plasma concentrations of dehydroisoandrosterone and dehydroisoandrosterone sulfate in women with primary operable breast cancer. Cancer Res 1981;41:3360-3.

23. Skolnick AA. Scientific verdict still out on DHEA. JAMA 1996;276:1365-7 [review].

24. Sahelian R. New supplements and unknown, long-term consequences. Am J Natural Med 1997;4:8 [editorial].

25. Casson PR, Santoro N, Elkind-Hirsch K, et al. Postmenopausal dehydroepiandrosterone administration increases free insulin-like growth factor-I and decreases high-density lipoprotein: a six-month trial. Fertil Steril 1998;70:107-10.

26. Stefanescu M, Matache C, Onu A, et al. Pycnogenol efficacy in the treatment of systemic lupus erythematosus patients. Phytother Res 2001;15:698-704.

27. Wang ZY. Clinical and laboratory studies of the effect of an antilupus pill on systemic lupus erythematosus. Chung His I Chieh Ho Tsa Chih 1989;9:452,465-8 [in Chinese].

28. Ruan J, Ye RG. Lupus nephritis treated with impact therapy of cyclophosphamide and traditional Chinese medicine. Chung Kuo Chung His I Chieh Ho Tsa Chih 1994;14:260, 276-8 [in Chinese].

29. Chen JR, Yen JH, Lin CC, et al. The effects of Chinese herbs on improving survival and inhibiting anti-ds DNA antibody production in lupus mice. Am J Chin Med 1993;21:257-62.

30. Wanzhang Q. Clinical observations on Tripterygium wilfordii in the treatment of 26 cases of discoid lupus erythematosus. J Trad Chin Med 1983;3:131-2.

31. Wanzhang Q. Tripterygium wilfordii hook F. in systemic lupus erythematosus. Report of 103 cases. Chin Med J 1981;94:827-34.

32. Chou WC, Wu CC, Yang PC, Lee YT. Hypovolemic shock and mortality after ingestion of Tripterygium wilfordii hook F: a case report. Int J Cardiol 1995;49:173-7.

33. Huang L, Feng S, Wang H. Decreased bone mineral density in female patients with systemic lupus erythematosus after long-term administration of Tripterygium wilfordii Hook. F. Chinese Med J 2000;113:159-61.

34. Abou-Raya A, Abou-Raya S, Helmii M. The effect of vitamin D supplementation on inflammatory and hemostatic markers and disease activity in patients with systemic lupus erythematosus: a randomized placebo-controlled trial. J Rheumatol 2013;40:265–72.

35. Lima GL, Paupitz J, Aikawa NE, et al. A randomized double-blind placebo-controlled trial of vitamin D supplementation in adolescents and young adults with juvenile-onset SLE: improvement in disease activity and fatigue scores. Arthritis Care Res 2015 May 18 [Epub ahead of print].

36. Klepser T, Nisly N. Astragalus as an adjunctive therapy in immunocompromised patients. Alt Med Alert 1999;Nov:125-8 [review].

37. Tewthanom K, Janwitayanujit S, Totemchockcyakarn K, et al. The effect of high dose of N-acetylcysteine in lupus nephritis: a case report and literature review. J Clin Pharm Ther 2010;35:483-5.

38. Diumenjo MS, Lisanti M, Valles R, Rivero I. Allergic manifestations of systemic lupus erythematosus. Allergol Immunopathol (Madr) 1985;13:323-6 [in Spanish].

39. Nagata C, Fuyita, Iwata H, et al. Systemic lupus erythematosus: a case-control epidemiologic study in Japan. Int J Dermatol 1995;34:333-7.

40. Carr RI, Tilley D, Forsyth S, et al. Failure of oral tolerance in (NZB X NZW)F1 mice is antigen specific and appears to parallel antibody patterns in human systemic lupus erythematosus (SLE). Clin Immunol Immunopathol 1987;42:298-310.

41. Rutkowska-Sak L, Legatowicz-Koprowska M, Ryzko J, Socha J. Changes in the gastrointestinal system of children with inflammatory systemic connective tissue diseases. Pediatr Pol 1995;70:235-41 [in Polish].

42. Carr R, Forsyth S, Sadi D. Abnormal responses to ingested substances in murine systemic lupus erythematosus: apparent effect of a casein-free diet on the development of systemic lupus erythematosus in NZB/W mice. J Rheumatol 1987;14 (suppl 13):158-65.

43. Bardana EJ Jr, Malinow MR, Houghton DC, et al. Diet-induced systemic lupus erythematosus (SLE) in primates. Am J Kidney Dis 1982;1:345-52.

44. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308(22):1361 [letter].

45. Malinow MR, McLaughlin P, Bardana EJ Jr, Craig S. Elimination of toxicity from diets containing alfalfa seeds. Food Chem Toxicol 1984;22:583-7.

46. Clark WF, Parbtani A, Huff MW, et al. Flaxseed: a potential treatment for lupus nephritis. Kidney Int 1995;48:475-80.

47. Prasad K. Hydroxyl radical-scavenging property of secoisolariciresinol diglucoside (SDG) isolated from flax-seed. Mol Cell Biochem 1997;168:117-23.

48. Shigemasa C, Tanaka T, Mashiba H. Effect of vegetarian diet on systemic lupus erythematosus. Lancet 1992;339:1177 [letter].

49. Minami Y, Sasaki Ti, Komatsu S, et al. Female systemic lupus erythematosus in Miyagi Prefecture, Japan: a case-control study of dietary and reproductive factors. Tohoku J Exp Med 1993;169:245-52.

50. Corman LC. The role of diet in animal models of systemic lupus erythematosus: possible implications for human lupus. Semin Arthritis Rheum 1985;15:61-9 [review].

51. Hardy CJ, Palmer BP, Muir KR, et al. Smoking history, alcohol consumption, and systemic lupus erythematosus: a case-control study. Ann Rheum Dis 1998;57:451-5.

Copyright © 2018 Healthnotes, Inc. All rights reserved. www.healthnotes.com

Learn more about Healthnotes, the company.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

We do not have information on this condition