SLE Flashcards
Pathophysiology of SLE
Characterised by anti-nuclear antibodies
When the immune system is activated by these antibodies targeting proteins in the cell nucleus it generates an inflammatory response
Presentation of SLE
Non-specific symptoms
Fatigue Arthralgia (joint pain) and non-erosive arthritis Myalgia (muscle pain) Fever Lymphadenopathy
Photosensitive malar rash. - – – This is a “butterfly” shaped rash across the nose and cheek bones that gets worse with sunlight.
Lymphadenopathy and splenomegaly
Shortness of breath Pleuritic chest pain Mouth ulcers Hair loss Raynaud’s phenomenon
Investigations in suspected SLE
Autoantibodies:
- First test for ANA
- Also test for anti-dsDNA and anti-Smith
FBC - to exclude other causes of vague Sx, may also show anaemia of chronic disease
CRP and ESR
U&Es
Urinalysis - for proteinuria in lupus nephritis/renal involvement
CXR if respiratory symptoms
Diagnosis of SLE
SLICC Criteria or the ACR Criteria
Complications/other systems presentation of SLE
Renal complications:
- Lupus nephritis - can progress to end stage renal failure
Anaemia of chronic disease
Cardiovascular disease - Chronic inflammation in the blood vessels leads to hypertension and coronary artery disease.
Pericarditis
Pleuritic chest pain (Pleurisy/pleuritis)
ILD leading to pulmonary fibrosis
Neuropsychiatric SLE:
- Psychosis
- Optic neuritis
- Transverse myelitis
Antiphospholipid syndrome can occur secondary to SLE
Treatment of SLE
NSAIDs
Hydroxychloroquine (first line for mild SLE)
- Other immunosuppressants or biologics e.g. methotrexate, rituximab in resistant or severe lupus
Suncream/sun avoidance (for the photosensitive the malar rash)
Treatment of complications
