Lupus Flashcards
Systemic lupus erythematosus?
Autoimmune disease involving innate and adaptive immune system disturbance
Has autoantibodies - antibodies to nuclear components
Antibody-antigen (immune complexes) -> chronic tissue inflammation (particularly joints, skin and kidney)
SLE rash example?
Malar rash
Autoimmune connective tissue disorder? General points
- Arthralgia and arthritis typically non-erosive (unlike RA)
- Serum autoantibodies characteristic
- Raynaud’s phenomenon common
Raynaud’s phenomenon?
Intermittent vasospasm of digits, usually triggered by cold exposure
Triphasic colour changes
Typical Raynaud’s colours?
White - vasospasm leading to blanching of digit
Blue - cyanosis as static venous blood deoxygenates
Red - reactive hyperaemia
Severe Raynaud’s - tissue ischaemia, ulcers and necrosis
SLE epidemiology?
15-45
F:M - 9:1
Africa > Asian > white European
Clinical features? Skin
Malar rash - erythema that spares nasolabial fold
Photosensitive rash
Mouth ulcers
Hair loss
Clinical features? Vascular
Raynaud’s
Clinical features? MSK
Arthralgia and arthritis (non-erosive)
Clinical features? Internal organs
Serositis (pericarditis, pleuritis, rarely peritonitis)
Renal disease - glomerulonephritis
Cerebral disease
Myocarditis
Clinical features? Haematological
Autoimmune thrombocytopenia
Haemolytic anaemia
Lymphopenia
Clinical features? Other
Lymphadenopathy
Fever in absence of infection
Anti-nuclear antibodies?
Hallmark of SLE, in all patients
Examples of other autoantibodies:
Anti-ds-DNA antibody
Anti-Ro
Anti-La
Anti-Smith
Anti-RNP
Anti-phospholipid antibodies?
Directed to phospholipids on cell membrane
Associated with increased risk of thrombosis and pregnancy loss
persistent APL + clinical event = anti-phospholipid antibody syndrome
Main autoantibodies in SLE?
Antinuclear antibodies - in all SLE, non-specific
Anti-double stranded DNA antibodies - specific for SLE, serum level DO correlate with disease activity
Anti-phospholipid antibodies - can occur in absence of SLE (primary anti-phospholipid antibody syndrome)
Anti-Sm antibodies - specific for SLE, serum levels DON’T correlate with disease activity