Connective Tissue Disease 1 -Systemic Lupus Erythomatosus

Question 1

What is the pathophysiology behind SLE?

Answer 1

Type 3 hypersensitivity reaction and the formation of immune complexes between ANA antibodies and cells. These then block the vasculature

This occurs after the cells apoptose and display nucleur antibodies on their surface

Question 2

What are the common symptoms in lupus?

Answer 2

• Constiutional symptoms
• Butterfly rash which is photosensitive and crosses the midline
• Photosensitive rashes
• alopecia
• Non destructive polyarthritis (different to RA)

Question 3

What is this?

Answer 3

Non erosive arthritis

Question 4

What are some intermediately common symptoms?

Answer 4

Serositis

glomerulanephritis

Thrombocytopenia

Raynauds

Question 5

What inflammatory markers are raised in SLE?

Answer 5

ESR/CRP

Question 6

What is the serological testing for SLE?

Answer 6

ANA - 100% sensitive but not specific as occurs in non SLE patients

dsDNA, antiSMITH - Highly specific but not sensitive

Question 7

Why would you do a urine test?

Answer 7

To check for nephritis

Question 8

What is the management of SLE?

Answer 8

it depends on what symptoms are present but involves:

NSAIDS/hydroxycholoriquine (anti inflammatory)

Steroids if more severe

Cyclophosphymide if severe systemic symptoms

Question 9

What is the prognosis?

Answer 9

Good with treatment. Poor without due to renal failure (nephritis, glomerulonephritis)

Question 10

What is a drug that is particularly used in SLE and RA?

Answer 10

Hydroxycholoroquine