1b Lupus Flashcards
What is SLE?
Chronic tissue inflammation in the presence of antibodies directed against self antigens
What are the three key autoantibodies?
Antinuclear antibodies – key to diagnosis of lupus
Anti-double stranded DNA antibodies
Anti-phospholipid antibodies
What is the hallmark of SLE?
Multi-site inflammation - particularly joints, skin and kidney
What rash is a key hallmark feature of SLE?
malar rash - photosensitive rash which misses the smile lines
erythema which spares the nasolabial fold
What phenomenon is common in connective tissue disorders?
Raynaud’s phenomenon
What is raynaud’s phenomenon?
Intermittent vasospasm of digits on exposure to cold
Typical colour changes – white to blue to red
Vasospasm leads to blanching of digit
Cyanosis as static venous blood deoxygenates
Reactive hyperaemia
Raynaud’s phenomenon is most commonly isolated and benign condition (‘Primary Raynaud’s phenomenon’)
What is a common organ involvement for SLE?
Renal disease = glomerulonephritis
Describe what happens in glomerulonephritis?
deposition of immune complexes in the glomerulus which triggers inflammation, resulting in glomerular nephritis
IgG in the glomerulus activates the Fc receptors on the inflammatory cells which triggers the complement system
What are the mucosal involvements of SLE?
Mouth ulcers
Hair loss
What risk is also present if there is high anti-phospholipids present?
risk of thrombosis = so give anti platelets
Which autoantibody is specific for SLE?
Anti-double stranded DNA antibodies (anti-dsDNA)
What is seen in SLE with regards to inflammatory markers?
high ESR but CRP is normal, unless there is an infection present
What haematological conditions might be seen in SLE?
Haemolytic anaemia, Lymphopenia, Thrombocytopenia
What renal investigations are important to do?
Measure urine protein to creatinine ration
What are the levels of complement in SLE?
Low C3 and C4
