SLE Flashcards

1
Q

What is systemic lupus erythematosus (SLE)?

A

An autoimmune disease characterized by inadequate T cell suppressor activity and increased B cell activity

SLE is a complex multisystem disease with variable presentations and prognosis.

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2
Q

What are the common symptoms and signs of SLE?

A

SOAP BRAIN mnemonic:
* S - Serositis (pleurisy, pericarditis)
* O - Oral ulcers (usually painless)
* A - Arthritis (small joints nonerosive)
* P - Photosensitivity (malar or discoid rash)
* B - Blood disorders (low WCC, lymphopenia, thrombocytopenia, hemolytic anemia)
* R - Renal involvement (glomerulonephritis)
* A - Autoantibodies (ANA positive in >90% cases)
* I - Neurologic issues (seizures , refractory headachesor psychosis)

The mnemonic helps recall the major clinical features of lupus.

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3
Q

What is the significance of antinuclear antibodies (ANA) in SLE?

A

95% of patients are antinuclear antibody positive

ANA positivity is a hallmark of SLE and indicates an autoimmune process.

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4
Q

What laboratory findings are common in SLE?

A

Common findings include:
* Raised ESR or plasma viscosity
* Anemia and leukopenia
* Anti-Ro and Anti-La antibodies
* Rising anti-dsDNA titre with disease activity
* Decreasing C3 and C4 with disease activity
* Urinalysis vital for detecting renal disease
- Antiphospholipid antibodies increase the risk of prnancy loss and thrombosis
- skin/renal biopsy

These findings assist in diagnosing and monitoring the disease.

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5
Q

What is a key lifestyle recommendation for patients with SLE?

A

Sun protection

UV light triggers SLE by altering DNA structure in the dermis, making it more immunogenic.

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6
Q

Which medications are commonly used to treat SLE?

A

Commonly used medications include:
* Hydroxychloroquine helpful for rash and arthralgia
* Mycophenolate mofetil
* Azathioprine
* Rituximab
* Short courses of prednisolone for flares

These medications help manage symptoms and prevent flares.

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7
Q

True or False: SLE is more common in men than in women.

A

False

Lupus is 9 times more common in women.

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8
Q

What age group has the peak onset for SLE?

A

Early adulthood

This is when most patients are diagnosed with SLE.

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9
Q

Fill in the blank: Estradiol may prolong the life of _______ lymphocytes.

A

[autoreactive B and T]

Estrogens are thought to be permissive for autoimmunity.

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10
Q

What is a simple diagnostic clue for SLE?

A

Full blood count (FBC) is abnormal in most patients

An abnormal FBC can indicate underlying hematological issues associated with SLE.

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11
Q

What is the relationship between SLE and cardiovascular risk?

A

SLE is associated with a high cardiovascular disease (CVD) risk

Patients with SLE need to be monitored for cardiovascular health due to increased risk factors.

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12
Q

What are drugs that trigger SLE-like syndrome

A
  • isoniazid
  • minocycline
  • TNF inhibitors
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13
Q

who does SLE more commonly affected

A
  • women
  • asian, african, carribean
  • young to middle aged adult
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14
Q

describe the course of SLE

A

relapsing-remitting: flares of worse symptoms and periods where symptoms settle

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15
Q

what are significant complications of SLE

A
  • CVD
  • infection
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16
Q

which antibodies are highly specific to SLE

A

anti-dsDNA
- this means a positive result suggests SLE rather than other causes
- levels vary with disease activity making them helpful in monitoring disease activity and response to treatment

17
Q

what investigation can be used to help diagnose and differentiate between specific CT disorders

A

extractable nuclear antigen panel: looks for antibodies to specific proteins in the cell nucleus

  • Anti-Sm (highly specific to SLE but not very sensitive)
  • Anti-centromere antibodies (most associated with limited cutaneous systemic sclerosis)
  • Anti-Ro and anti-La (most associated with Sjögren’s syndrome)
  • Anti-Scl-70 (most associated with systemic sclerosis)
  • Anti-Jo-1 (most associated with dermatomyositis)
18
Q

what antibodies can occur secondary to SLE and what are they associated with

A

antiphospholipid
- inc risk of VTE

19
Q

what can anemia in SLE be due to

A
  • anaemia of chronic disease
  • autoimmune haemolytic anaemia
  • bone marrow suppression by meds or kidney disease
20
Q

what drugs can be used to treat active disease in SLE (4)

A

Rituximab
Cyclophosphamide
Mycophenolate mofetil
Belimumab (purpose built for lupus)

21
Q

What drugs are used for maintenance remission therapy in SLE (3)

A

Hydroxychloroquine methotraexate
Azathioprine
Leflunomide