SLE

Question 1

What is Systemic Lupus?

Answer 1

o Effects mostly women of childbearing years, typically African or Caribbean decent
o Autoimmune complexes that cause damage to tissues

Question 2

SLE pathophysiology

Answer 2

Genetic predisposition + Environmental stimulus (smoking, UV light, Silica, EBV)
Autoimmune changes cause the increase of cytokines and chemokines and TNF, results in large quantities of autoantigens and autoantibodies.
The deposition of these abnormal immune complexes causes inflammation, oxidative stress, sclerosis, fibrosis with irreversible tissue damage.

Question 3

SLE s/s

Answer 3

o The Classic triad is fever, joint pain, and rash
o Fatigue, arthralgias, weight changes, myalgias, arthritis, macular rash, photo sensitivity, AKI, CKD, seizures, psychosis, pleural effusions, interstitial lung disease, pulm htn, nausea, abd pain, pericarditis, myocarditis, hematologic penias

Question 4

SLE diangostics

Answer 4

o CBC w/ diff (will show elevated leukocytes), Elevated creatinine, ESR/CRP elevated, complement, liver function, ANA, elevated CK

Question 5

SLE pharmacotherapy

Answer 5

Anti-malarials (Hydroxychloroquine) is the main stay treatment for pain, rash, inflammation
Adjuncts
• NSAIDS are used to treat fever and mild joint pain
• Corticosteroids for flares and inflammation
• NonBiologic DMARDs (methotrexate, cylcosporine) immune suppression
• biological DMARDs (Rituximab) immune suppression

Question 6

SLE patient education

Answer 6

o Avoid sunlight
o Medication adherence
o High risk for infection and cardiovascular disease
o Aggressive lipid an blood pressure control for prevention of CVD