Systemic lupus erythematosus: what should family physicians know in 2018?

Abstract

Systemic lupus erythematosus (SLE) is a complex multi-systemic autoimmune disease with considerable clinical and immunological heterogeneity. Family physicians should be familiar with the protean manifestations of SLE to aid early diagnosis and monitoring of disease progression. The role of family physicians in SLE includes education, counselling, psychological support, management of mild disease, and recognition of the need for referral to other specialists for more serious disease and complications. Surveillance of cardiovascular risk factors and osteoporosis and advice about vaccination and reproductive issues can be performed in the primary care setting under Systemic lupus erythematosus: what should family physicians know in 2018?

Systemic lupus erythematosus: what do Chinese patients and general practitioners know?

“…Along with the in-depth reform of the medical care system, a more holistic disease management, coordinated with general practitioner, might be an effective method to cope with the unmet need and manage patients better. General practitioners play an important role in the management of SLE patients which includes education, counselling, psychological support, monitoring and referral [18] . Yet, many primary medical institutions remain unaware of it, and efforts are still needed to spread high-quality patient education and standardise GPs' daily practice on SLE.…”

“…And there is no doubt that this requires a multidisciplinary approach to achieve better disease prognosis. American College of Rheumatology Ad Hoc Committee recommends that primary care physician(PCP) should be responsible for early diagnosis, appropriate referral, monitoring disease, and collaboration with a specialist [8,9] . Since the low incidence and severity of SLE, most primary care physicians may not be exprienced in the management of SLE patients.…”

Case Report: Pregnancy with Systemic Lupus Erythematosus (SLE)

“…Systemic Lupus Erythematosus or better known as SLE is one of the autoimmune rheumatic diseases that require special attention both in recognizing the clinical appearance of the disease and its management. As a doctor in primary care, general practitioners should understand that this disease has a thousand faces 1,2 . The patient does not present with the typical symptoms that he has SLE, but it can be just itching, redness of the face and joint pain, where the doctor may give a wrong diagnosis with allergies or arthritis.…”

“…However, the problems are (1) How should monitoring be done so that the patient can undergo a safe pregnancy even if he is suffering from lupus? ; (2) How can the baby growth be optimal and be able to undergo a safe delivery? ; (3) Can this patient give birth in primary care considering there are no complications?…”

“…Some of the following educational tips and practices can be done on these patients: 1) SLE is a hereditary disease. As many as 44% of SLE cases are hereditary cases that can be reduced 1,2,3 . The doctor can continue to observe the possibility of this case appearing in children with SLE or educate the hereditary possibility of this case in survivors of SLE; 2) Provision of vitamin D. Vitamin D is given to prevent bone loss; 3) Vaccination.…”