Systemic lupus is multi-systemic autoimmune disease, targeting ds-DNA and nuclear proteins and most commonly in females (estrogen-related) and African-Caribbean and South Asian descent.
The definition of Mild SLE is clinically stable lupus with no severe (life-threatening) organ involvement, limited to arthritis, rash, mucocutaneous lesions and mild pleuritis. The SLE disease activity index of mild lupus is <6 (SLEDAI<6).
Lupus dependent on a primarily on careful clinical evaluations of the patient with relevant hematological, biochemical and immunological testing.
For clinically and serologically stable disease activity (remission); 6-12 months outpatient appointment is adequate.
For clinically stable disease but with serological activity (active); 1-3 months outpatient appointment is adequate.
Periodic lab investigtions check:
blood pressure (1+/A)
renal function (1+/A)
full blood count (3/C)
liver function tests (4/D)
complement levels (2+/C)
anti-dsDNA antibodies (2++/B)
Periodic Lupus co-morbidities check:
Treatment-related:atherosclerotic disease, osteoporosis, avascular necrosis, malignancy, infection, hypertension, dyslipidemia, diabetes, high body mass index.
This goal aims primarily to remit the disease activities from evolving into a moderate or severe lupus with a high priority to minimize pharmacological intervention to only hydroxychloroquine.
Level 1 is based on the preventive measures.
Level 2 added a systemic steroid as a pulse therapy for remission induction.
*Level 3 added a low dose approach of MTX as an addition or substitution to level2.