ABSTRACT
Although published studies of systemic lupus erythematosus (SLE) define SLE by fulfillment of four American Rheumatism Association epidemiological criteria, in individual cases clinicians feel comfortable making a clinical diagnosis of SLE when fewer than four criteria are satisfied. An important minority of women with SLE have anti-phospholipid antibody. There is no universally accepted definition of SLE activity (lupus “flare”). Demonstration of inflammation and of immunologic abnormalities is considered as frequent guidelines. Obvious at the extremes (with fever, rash, arthritis, lymphadenopathy and nephritis), SLE flare at lesser degrees is often a matter of judgement. In assessing flare in an individual patient it is important to distinguish between “activity” and “damage”. In patients with active SLE, pregnancy does not modify the occurrence of inflammatory arthritis, inflammatory rash, lymphadenopathy, fever, hematuria and cylindruria, leukopenia, or anti-DNA antibody. Pregnancies threatened with maternal illness, pregnancies threatened with fetal death, and extreme prematurity each create special stresses.
