Systemic Lupus Erythematosus (SLE)

SLE may first look like a musculoskeletal problem: symmetric hand pain, morning stiffness, arthralgia, myalgia, or fatigue. The examination cannot stop at the joints, however. The same autoimmune process can inflame skin, serosal surfaces, blood cells, the nervous system, and glomeruli, and kidney disease may be clinically quiet while irreversible damage accumulates. At the NP level, three questions organise the encounter: Is this lupus activity, infection, medication toxicity, or another disease? Is the activity organ-threatening? What treatment will control inflammation while limiting glucocorticoid harm? Canada has no separate national SLE or lupus-nephritis guideline; practice is generally informed by current EULAR, ACR, and KDIGO recommendations together with provincial pathways and product monographs.