SLE Flashcards
1
Q
Definition
A
Multi-rgan, mutli-system, autoimmune disease that is relapsing and remitting with variable presentation
2
Q
Epidemiology
A
- femlae
- 20-30y
- afro carribean more severe disease
3
Q
Criteria
A
>4 criteria (at least 1 clinical and 1 immmunologiclal or biposy-proven lupus nephritis with postive ANA or anti-DNA
DOPAMINE RASH
- Discoid rash
- Oral ulcer
- Photosensitivity
- Arthritis
- Malar rash
- Immunomarkers
- Neuro changes (seizures, personality)
- Elevated ESR
- Renal disorder
- ANA+
- Serositis (pleuristiy)
- Haematologic (haemolytic anaemia, thrombocytopenia, leucopenia)
4
Q
Immunology
A
- target is double stranded dna
- Polyclonal B-cell secretion of pathogenic autoatnibodies in response to apoptotic autoantigen released
- cause tissue damage via immune complex deposition, immune coplex formation or complement activation
5
Q
Diagnosis
A
- Anti-dsna Ab
- Complement C3 decreased, C4 decreased
- ESR
Others
- ESR increase but CRP normal
- FBCs (normochrombi, normocytic anaemia) , U and Es, LFTs
- urine casts for proteins
- raised immnoglobulins
- antiphospholipid antibodies in 30-40%
6
Q
Drug-induced lupus
A
- remits even if drug is stopped
- isoniazide, quinidine
- Anti-histone antibodies 100%
7
Q
Antibody markers
A
ANA - antinuclear antibody not specific
Anti-DsDNA (antibody to dna) - specific 70%
Anti-smith - specific
Anti-histone - drug induced lupus
Anti-SSA - sjogrens syndrome
8
Q
management
A
- Cutaenous - topical steroids, avoid sun-exposure
- Maintenance- hydroxycholroquine and NSAIDs manage lupus flares and joint problems
- Lupus nephritis - intensive immunosuppression with cyclophosphamide
- rituximab - targeted to CD20 B cells
- methotrxate- anti- mitotoc
- sunscreen- photosensitivity
9
Q
Causes of a positive ANA
A
SLE (95%)
Sjogrens 80%
RA 30%
Autoimmue hepatitis
