8- Systemic Lupus Erythematosus (SLE)

Question 1

General info
pg 20 reader
pg 1065 text

Answer 1

However, in the case of lupus, the immune system mistakenly attacks normal, healthy tissues (including the skin, joints, kidneys and lining of the heart and lungs), causing ongoing inflammation and pain.

SLE can range from mild to life-threatening. This very much depends on the parts of the body that are being attacked by the immune system. While pain and inflammation of the skin and joints can impact on your quality of life, the damage that SLE may cause to your major organs, such as the kidneys or nervous system, is much more serious.

• realtively common disorder
• disease is characterised as a generalised connective tissue disorder involving multiple organ systems and demonstrating significant immunologic abnormalities
• SLE is a chronic disease interspersed with periods of acute exacerbation and exhibits variable prognosis

Question 2

What are the clinical features of Systemic Lupus Erythematosus
pg 20

Answer 2

F>M especially 2nd-4th decade

• rash on neck, face and elbow, hand
• serious feature is renal involvement
• 90% have articular symotoms (especially in hands)
• reversible deformities
• steroid use leads to osteoporosis
• ESR elevated, anaemia (erythrocyte sedimentation rate)-when there is inflammation fibrinogen is present in the blood which causes cells to stick together and settle faster.

Skin rashes (both on the face and body)
Joint and muscle pain
Hair loss
Fatigue
Mouth and nose ulcers
Chest pain (as a result of inflammation of the lining of the heart or lungs)
Anaemia (a deficiency in the number or quality of red blood cells)
Poor kidney function
Seizures or visual disturbances (resulting from inflammation of the nervous system)
Fever.

Question 3

Radiographic features of Systemic Lupus Erythematosus

21

Answer 3

-most prominent features visible in hands
-reversible subluxations, dislocations and deformities
Spine: atlantoaxial instability, steroid-induced compression fractures
Chest: Pleural effusion and thickening etc
-soft tissue calcifications
-osteopoorosis

Hand
− Ulnar deviation, boutonniere, swan neck deformities
− Usually no bone changes, but can see mechanical erosions from repeated
dislocations
− Changes in joint space unusual
− Generalized osteoporosis
− Soft tissue changes include calcification in the subcutaneous tissues, and
arteriosclerosis
− DDX: RA