• Zahir Amoura, Brigitte Bader-Meunier, Marie Antignac, Nathalie Bardin, Cristina Belizna, Alexandre Belot, Bernard Bonnotte, Jean-David Bouaziz, François Chasset, Laurent Chiche, Fleur Cohen, Nathalie Costedoat-Chalumeau, Eric Daugas, Hervé Devilliers, Elisabeth Diot, Elisabeth Elefant, Stanislas Faguer, Nicole Ferreira, Eric Hachulla, Thomas Hanslik, Miguel Hie, Noémie Jourde-Chiche, Véronique Le Guern, Thierry Martin, Alexis Mathian, Marc Michel, Makoto Miyara, Thomas Papo, Christophe Richez, Marc Scherlinger, Jean Sibilia, Yurdagul Uzunhan, Denis Wahl, Géraldine Wojtasik, Cécile Yelnik, and Collaborators.
• Department of Internal Medicine, Institute E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, Antiphospholipid Syndrome, and Other Autoimmune Diseases, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: zahir.amoura@aphp.fr.
• Rev Med Interne. 2024 Aug 26.

AbstractBecause Systemic Lupus Erythematosus (SLE) is a rare disease, and due to the significant prognostic impact of early management, a diagnosis confirmed by a physician with experience in SLE is recommended, for example from an expert center. Once the diagnosis is confirmed, existing manifestations should be identified in particular, renal involvement by an assessment of proteinuria, disease activity and severity should be determined, potential complications anticipated, associated diseases searched for, and the patient's socioprofessional and family context noted. Therapeutic management of SLE includes patient education on recognizing symptoms, understanding disease progression as well as when they should seek medical advice. Patients are informed about routine checkups, treatment side effects, and the need for regular vaccinations, especially if they are receiving immunosuppressive treatment. They are also advised on lifestyle factors such as the risks of smoking, sun exposure, and dietary adjustments, especially when they are receiving corticosteroids. The importance of contraception, particularly when teratogenic medications are being used, and regular cancer screening are emphasized. Support networks can help relieve a patient's isolation. The first-line medical treatment of SLE is hydroxychloroquine (HCQ), possibly combined with an immunosuppressant and/or low-dose corticosteroid therapy. The treatment of flares depends on their severity, and typically involves HCQ and NSAIDs, but may be escalated to corticosteroid therapy with immunosuppressants or biologic therapies in moderate to severe cases. Because there is no curative treatment, the goals of therapy are patient comfort, preventing progression and flares, and preserving overall long-term health and fertility. The frequency of follow-up visits depends on disease severity and any new symptoms. Regular specialized assessments are necessary, especially when treatment changes, but a frequency of every 3 to 6 months is recommended during periods of remission and monthly during active or severe disease, especially in children. These assessments include both clinical and laboratory tests to monitor complications and disease activity, with specific attention to proteinuria.Copyright © 2024. Published by Elsevier Masson SAS.

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