Incomplete Lupus

Patients who meet less than four American College of Rheumatology (ACR) criteria or have other representative, noncriteria systemic lupus erythematosus (SLE) manifestations have incomplete lupus erythematosus. The most common clinical manifestations in patients with incomplete lupus include rashes, arthritis, Raynaud's phenomenon, and cytopenias. ANA (anti-nuclear antibodies) is the most commonly detected serological finding, but the presence of anti-dsDNA, anti-phospholipid antibodies, and low complements is associated with higher risk of progression to SLE. Despite a generally mild clinical course without nephritis, vasculitis, or CNS involvement, the disease-related mortality and cardiovascular morbidity are indistinguishable from the one in SLE, indicating a need for continued monitoring, vigilance in recognizing this entity, and consideration of early start of treatment.