When should I consider referring a patient with SLE to a specialist, and what information should I include in the referral?

When to refer a patient with systemic lupus erythematosus (SLE) to a specialist:

• Refer patients with suspected or confirmed SLE to a rheumatologist or specialist experienced in managing autoimmune diseases when there is diagnostic uncertainty, active disease requiring specialist management, or organ involvement (e.g., renal, neurological, or severe hematological manifestations).
• Urgent referral is warranted if there are signs of severe disease flare, such as rapidly progressive organ dysfunction or life-threatening complications.

Information to include in the referral:

• Patient demographics and contact details.
• Clinical history including symptom onset, duration, and pattern.
• Details of clinical findings, including joint involvement, skin manifestations, and any systemic symptoms.
• Results of relevant investigations such as ANA, anti-dsDNA, complement levels, full blood count, renal function, and urinalysis.
• Current and past treatments and response.
• Any complications or organ involvement noted.
• Reason for referral and urgency.

Providing comprehensive clinical and laboratory information facilitates timely specialist assessment and management planning.