lupus Flashcards
There are two types of Lupus
SLE: Systemic Lupus Erythematosus.
DLE: Discoid Lupus Erythematosus:
only affects the skin
Smaller percentage have this type
SLE is a (Janie is inflammed)
chronic inflammatory disease of unknown cause that affects the skin, joints, kidneys, lungs, nervous system , serous membranes and other organs of the body.
SYSTEMIC LUPUS ERYTHEMATOSUS ETIOLOGY - what causes lupus?
Etiology is unknown and is clearly multifactorial:
Genetic predisposition.
Hormonal involvement.
Immunological abnormalities.
Environmental triggers.
PATHOPHYSIOLOGY of SLE - antibodies are produced against which antigens?
Auto-antibodies are produced against antigens:
DNA/RNA
WBC’s
RBC’s
Platelets
OTHER IMMUNOLOGIC FACTORS MAY BE RESPONSIBLE for SLE (Ray and Janie)
HLA-DR2, 3, and 4 are associated with SLE
Hormones play a role in SLE.
Estrogens ↑ immune response
↑ SLE in post partum period.
May be precipitated by certain DRUGS & foods (Janie w/ celery)
Pronestyl shiitake mushrooms
Apresoline Parsley
Bactrim (Sulfa) Celery
Oral contraceptives
Alfalfa Sprouts
CLINICAL MANIFESTATIONS of SLE - is it fast or slow? Remission?
Extremely variable in its severity. It can be mild to severe, rapid to slow onset
Any organ can be affected
SLE is characterized by periods of exacerbation and remission.
CLINICAL MANIFESTATIONS of SLE (3 things) and what is the most common? (Janie is hot, tired and skinny)
Constitutional Sx: fatigue, fever, weight loss
Fatigue: the most common complaint and occasionally the most debilitating.
Fatigue: occurs in 80 to 100 of the cases.
Weight loss: occurs prior to diagnosis. Weight gain later due to treatment
Fever: thought to be due to active disease.
CLINICAL MANIFESTATIONS of SLE SPECIFIC ORGAN INVOLVEMENT - Mucocutaneous - (mucus butterfly)
The most common lesion is the butterfly rash: erythema over the cheeks and nose. Present in 40 % of SLE cases.
CLINICAL MANIFESTATIONS of SLE SPECIFIC ORGAN INVOLVEMENT - MUSCULOSKELETAL (janie and poly have joint pain)
Polyarthralgia (pain in joints) may precede the onset of multi-system disease by many years.
CLINICAL MANIFESTATIONS of SLE SPECIFIC ORGAN INVOLVEMENT - CARDIO-VASCULAR-PULMONARY (Janie ends my peri)
Contributes significantly to morbidity and mortality. Increased risk of CAD
Pericarditis 25% , endocarditis
Pleural effusions 50% , PTN,
Abnormal Pulmonary function test 90%
CLINICAL MANIFESTATIONS of SLE SPECIFIC ORGAN INVOLVEMENT - renal - what is the leading cause of death w/ SLE?
50% with renal involvement
Lupus Nephritis is leading cause of death in SLE.
CLINICAL MANIFESTATIONS of SLE SPECIFIC ORGAN INVOLVEMENT - neurologic (Janie is psycho)
Neurologic deficit may result from immune complex deposit in the brain tissue:
Organic brain syndrome, delirium, psychosis
Hematological involvement: issues w/ blood and lupus (Janie’s blood is TAL)
Antibodies are formed against blood cells:
98% ANEMIA
80% mild LEUKOPENIA
36% THROMBOCYTOPENIA (platelets)
INFECTIONS in SLE - which one causes the most deaths?
↓ antibodies
↑ infections
30% of SLE deaths occur from infections (PNA (pneumonia) (most common)
