Lupus Flashcards
What is discoid lupus?
only affects the skin, looks like a deep skin rash but it is not itchy or sore
What is systemic lupus - SLE?
connective tissue disorder that is a spontaneous overactivity or dysfunction of the immune system
Who is more prone to lupus - males or females? Ethnicities?
Females x9
Afro carribeans, afro americans, asians
What is the aetiology of SLE?
smoking
oestrogen exposure
genetic predisposition
What is the pathogenesis of lupus?
dead cells not being cleared quickly enough due to defective apoptosis, this means they float about in the immune system for longer
This causes necrotic cells to release nuclear material which acts as autoantigens and results in autoimmunity
The autoimmunity stimulates B and T cells and autoantibodies are produced against normal parts of the body
Why is there low levels of complement in SLE?
immune complexes cause damage to vessel walls which activates complement - so complement is all being used up in the blood
Complement causes cytokine release which causes more scarring and inflammation
What are the presenting features of SLE?
weight loss fatigue photosensitive malar rash myopathy polyarthritis renal disease glomernephritis antiphospholipid syndrome many more - check book
What are the biological signs of SLE?
ANA+ve Anti-DNA+ve Anti Sm Antiphospholipid Ab low complement Coombs test
What is the first line investigation for SLE?
URINALYSIS
What are the other investigations for SLE?
depending on presentation: CXR CT chest renal biopsy echocardiogram MRI brain urine protein pulmonary function tests
How is SLE disease activity monitored?
high Anti-DNA = high disease activity
low C3/C4 = high disease activity
FBC, urinalysis
How is SLE treated?
EVERYONE = hydroxychloroquinone (antimalarial)
steroids if more severe
Immunosuppressives - methotrexate etc..
Biologics - Anti CD20 and Anti-Blys
What is mild SLE?
simple cutaneous change
What is moderate SLE?
arthritis, effusions
Wht is severe SLE?
organ threatening disease
