Systemic Lupus Erythematosus N029

Current RMA Instruments:

Changes from previous Instruments:

ICD Coding:

• ICD-10-AM Codes: M32, L93.1, L93.2

Brief description

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease characterised by the presence of special proteins in the blood called antibodies. These antibodies mistakenly target parts of the body's own cells, resulting in healthy tissues being attacked. SLE can affect the skin, joints, kidneys, lungs, brain, and other organs.

Confirming the diagnosis

SLE can present in different ways, and there is no single test that definitively confirms the diagnosis. It is typically diagnosed through a combination of clinical assessment and investigation tests, most often by a rheumatologist or a general medicine physician. Blood tests, imaging and sometimes biopsy results are required for confirmation and exclusion of alternative diagnoses. 

Given its complexity and potential to affect multiple organs, a range of medical specialists are often involved in the ongoing care of patients with SLE. 

Additional diagnoses that are covered by SOP

• Drug induced systemic lupus erythematosus 
• Lupus nephritis
• Lupus pneumonitis 

Conditions that may be covered by SOP (see comments)

• Cutaneous lupus erythematosus (if occurring as part of SLE)

Conditions not covered by SOP

• Acute cutaneous lupus erythematosus (if occurring in isolation and not part of SLE) #
• Subacute cutaneous lupus erythematosus (if occurring in isolation and not part of SLE) #
• Chronic cutaneous lupus erythematosus * Discoid lupus erythematosus SoP
• Discoid lupus erythematosus *
• Mixed connective tissue disease #

* another SoP applies  - the SoP has the same name unless otherwise specified

^# non-SoP condition

Comments

There are a number of forms of cutaneous lupus erythematosus. Discoid lupus is the most common form and has its own SoP.  Cutaneous lupus in isolation is not covered by the SLE SoP and if not the discoid form, is a non-SoP condition. Acute, sub-acute and chronic forms of cutaneous lupus may occur as part of the wider disease of SLE.

Clinical onset

Diagnosis of SLE can be difficult and may involve a lengthy process. Common clinical manifestations of systemic lupus erythematosus include polyarthritis and arthralgia, photosensitivity, rash, serositis, and renal, haematological and neurological disorders. The clinical onset is the first symptoms and/or signs of this condition confirmed to be consistent with SLE by the treating specialist (usually rheumatologist).

Clinical worsening

Systemic lupus erythematosus (SLE) can run a varied clinical course, ranging from a relatively benign illness to a rapidly progressive disease with fulminant organ failure and death. The condition has a remitting and relapsing course in some patients. Establishing clinical worsening beyond the normal course of the disease is likely to be difficult and require specialist opinion.