SLE Flashcards
in someone with SLE what is a typical esr and crp reading
esr 100, crp is 0
describe whate you would expect to find in a person with sle when looking at blood cells and complement
cytopenia(low blood cells) and low complement c3/c4
list the targets of autoantibodies in SLE
dna, nucleosomes, C1q, a actinin, Sm, NDMA receptor
systemic lupus erthematosus is a multi system autoimmune is this statement true
yes
what environmental factors can trigger sle
sunlight, drugs smoking and viruses
how do genes contribute to SLE
the genes cause defective apoptosis, which creates autoantigens, stimulates immune response against self
what factors contribute to SLE as it’s direct cause is unknown
Female hormones • Genetics • Drugs • Environmental factors • Ethnic origin
who is most likely to get sle
females and individuals of african and asian
name some symptoms of sle in women aged 15-45
malaise, fatigue, hair loss, arthritis, aches and pains, mouth ulcers, rashes
what are the types of cutaneous lupus
discoid lupus(coin shaped lesions) and subacute acute cutaneous lupus
sle lesions feel cold to touch and are on the hands and feet what are they called
chillblain lupus
lupus can also cause lupus vasculitits name examples of small vessel vasculitis
- Splinter haemorrhages
- Digital infarcts
- Palpable purpura
- Vasculitic ulcers
- Urticarial vasculitis
medium or large vessel vasculitis can result in …
Digital ischaemia/gangrene
course of sle follows three stages, pre clinical, clinical disease, comorbididties. state what each stage is represented by
pre clinical just autoantibodies, clinical disease involves organs and flare ups and damage.
comorbidities comes last and involves infections, malignancies and atherosclerosis
what can peripherial vascular disease cause in SLE
- Critical limb/digital ischemia
- Gangrene
- Amputations
how can lupus affect the pulmonary system
lupus pnemonitis or lupus serositis
lupus can affect the heart causing pericarditis how is it treated
Common
Rapidly resolves with corticosteroids
Rarely leads to tamponade
list the ways in which lupus can effect the cardiac system
pericarditis, endocarditis,myocarditis,
name some features of Neuropsychiatric lupus
- Psychosis
- Seizures
- Strokes
- Psychological disorders
- Transverse myelitis
SLE can affect the kidneys cause lupus nephritis what are some of the presenting features
Asymptomatic proteinuria Nephrotic syndrome Renal failure Rapidly progressive glomerulonephritis Dysmorphic / fragmented red cells Granular casts
Because SLE is a chronic condition what three things should be kept in mind when assessing it
disease activity, quality of life and damage
how do you assess disease activity in sle
Bilag, SLEDAI
how do you assess quality of life in lupus
LupusQoL
SF36, HAQ
what are the aims of sle treament
prevent disease flares, avoid long term damage, Induction and maintenance of durable remission
-Minimise toxicity and treatment related damage
how can you treat sle
first off avoiding sun, using sunscreen, topical steroids, stop smoking and analgesics (not NSAIDS contra), then cortico steroids after these steps, then after that monoclonal antibodies such as belimumab
why should caution be used when treating sle with corticosteroids
Excessive doses: 1mg/kg/day NOT evidence based!
Major contributor to damage
Use the lowest effective dose for
the shortest period of time
name some antimalarials used to treat sle
Hydroxychloroquine
• Mepacrine/Quinacrine
• (Chloroquine)
• Combination antimalarials
indivudal has been given sle intial sle treatment but has renal issues and fertility issues what treatments should they be given
severe treatment cyclophosphamide,Mycophenolate , iv methylprednisolone
what is The Antiphospholipid syndrome in SLE
antiphospholipid antibodies which can cause thrombosis or pregnancy morbidity
cns lupus can cause strokes and tias how can we treat this
anti coagulation
how do you treat systemic sclerosis form sle in early stage
Treatment
• Early: low dose steroids immunosuppressives
how do you treat systemic sclerosis form sle in late stage
Late: Symptomatic Rx
BP control
