SLE is a typical autoimmune disease, which commonly means that the patient’s body produces a large number of autoantibodies, which do not protect their own tissues and organs, but attack and destroy them as “enemies”, and it may attack several organs at the same time, including heart, liver, brain, kidney, lung, blood, skin, muscle, joints, etc., or it may attack a single organ. It may attack several organs at the same time, including heart, liver, brain, kidney, lung, blood, skin, muscles, joints, etc., or it may attack one of the organs singly. Even the organs attacked by autoantibodies in the same patient at different times are not the same, which shows the variability of the disease. The following are some examples of the diversity and variability of SLE. 1. Fever as the first symptom: A 16-year-old male patient with fever for more than half a month and a body temperature as high as 39.3℃ came to our hospital for consultation after the application of various drugs in local hospitals was ineffective, and was diagnosed as SLE, and after professional systemic treatment, the symptoms disappeared and the body temperature returned to normal. An 18-year-old female patient with hypothermia for more than 10 days, a maximum temperature of 38.3℃ and painful swelling of the first metacarpophalangeal joint of her right hand for 2 days came to our hospital. Fever is the most common symptom of SLE, accounting for 90% of the cases, of which 65% are the first symptoms. It may be either high fever or prolonged low fever. 2. Leukopenia as the first symptom: There was a 43-year-old female patient with unexplained leukopenia for more than 10 years. After surgery for a suspected cancerous nevus on the right calf, she developed high fever with chest tightness and shortness of breath, and after examination, she was diagnosed with SLE and lupus pneumonia. This patient actually had mild lupus with leukopenia as the main symptom for a long time, and surgery induced a sudden aggravation of the disease and became heavy lupus. Leukopenia is also one of the common symptoms of lupus erythematosus, accounting for 50% to 60%. 3. Thrombocytopenia as the first symptom: A 13-year-old male patient was diagnosed with idiopathic thrombocytopenic purpura due to bleeding spots on the skin and thrombocytopenia. 2 years later, he suddenly developed epileptic convulsions and urine protein 3+, and after examination, he was finally diagnosed with systemic lupus erythematosus, lupus encephalopathy and lupus nephritis. 4. The first symptom was a decrease in all three lines of white blood cells, platelets and red blood cells: a 32-year-old female patient was found to have a decrease in all three lines at a local hospital and came to our hospital for bone marrow examination with suspicion of aplastic anemia, and the bone marrow was normal. After systematic treatment, all three systems returned to normal after one week. 5. Polyarticular swelling and pain as the first symptom: A 24-year-old female was diagnosed with rheumatoid arthritis in a foreign hospital for half a year because of polyarticular swelling and pain accompanied by fever for many days, but the treatment effect was not good and she came to our hospital. 6. Swelling of face and limbs as the first symptom: A 30-year-old female patient came to our hospital with swelling of face and limbs for more than 2 months, and was found to have positive antibodies such as antinuclear antibody, low complement and urine protein 3+. 7. Patients with lupus whose first symptoms are general discomfort, anxiety, skin erythema, chest tightness and shortness of breath, pleural effusion and pericardial effusion are also common, so we will not list them here. A female patient was diagnosed with idiopathic thrombocytopenic purpura at the age of 15 due to skin purpura and thrombocytopenia, and her condition was stabilized with long-term oral prednisone, and at the age of 41, she developed facial erythema, fever and light allergy, and was diagnosed with systemic lupus erythematosus at 301 Hospital, where she was given appropriate treatment and her condition was stabilized. At the age of 50, he developed cough and yellow sputum with hyperthermia after a cold scare, and the effect of antibiotics for a week was not obvious, and gradually developed dyspnea, cyanosis of the lips and mouth, and rapidly developed into shallow and slow breathing, pause and confusion. infection, acute respiratory distress syndrome, pulmonary atrophy syndrome, lupus nephritis, nephrotic syndrome, and subclinical pancreatitis. This patient first had hematologic damage, then skin damage appeared after 26 years, and then lung, pleural, and pancreatic damage appeared after 9 years, and all these series of damages were caused by SLE. From this case, we can see that the changes of the disease of SLE patients are complex and diverse, and even if the disease is stable, when there are triggers such as infection, surgery, and mood swings, the disease may suddenly deteriorate and even endanger life. The above examples illustrate the diversity and variability of SLE, and are intended to remind patients to consider the possibility of SLE when the cause of the above symptoms is unknown or the effect of treatment is poor, and to consult the Department of Rheumatology and Immunology in a timely manner. At the same time, patients with lupus erythematosus and their relatives should have a correct understanding of the disease, avoid triggers that cause the aggravation of the disease, and go to the hospital for regular review to control the development of the disease in a timely manner.