SLE Flashcards
What populations is SLE more common in?
women during their childbearing years and in black, Hispanic, and Asian people
Mucocutaneous sxs in SLE?
Raynaud phenomenon
aphthous ulcers
nonscarring alopecia
numerous rashes, most of which are photosensitive:
acute cutaneous lupus (malar rash or generalized 50% SLE)
subacute cutaneous lupus: psoriasiform plaques, or annular/polycyclic plaques with central clearing (nonscarring, 50% SLE)
chronic cutaneous lupus: discoid plaques (discoid lupus), heal with scarring, and localized alopecia (25% will have SLE)
MSK sxs in SLE?
nonerosive inflammatory polyarthralgia polyarthritis myalgia myositis Jaccoud arthropathy (chronic non-erosive reversible joint disorder that may occur after repeated bouts of arthritis)
Kidney manifestations of SLE?
lupus nephritis
renal artery or vein thrombosis in patients with a hypercoagulable state (may be associated with antiphospholipid antibodies)
Neuropsychiatric manifestations of SLE?
headache cognitive dysfunction mood disorder transverse myelitis cerebral vasculitis peripheral neuropathy seizure
CV manifestations of SLE?
pericarditis (often asymptomatic)
myocarditis
valvular abnormalities (Libman–Sacks endocarditis)
increased risk of ischemic heart disease
Pulmonary involvement of SLE?
pleurisy/pleural effusions ILD acute lupus pneumonitis diffuse alveolar hemorrhage (rare) shrinking lung syndrome (pleuritic chest pain, shortness of breath, and progressive decrease in lung volume)
Hematologic signs of SLE?
anemia, leukopenia, thrombocytopenia
hypercoagulability and antiphospholipid antibody syndrome
GI sxs of SLE?
esophageal dysmotility
sterile peritonitis
mesenteric vasculitis
mesenteric thrombosis (in patients with APLS) autoimmune hepatitis
Diagnosis of SLE?
complement components (C3, C4)
coagulation studies with lupus anticoagulant
direct antigen test
urine albumin or protein analysis
AutoAb: ANA, dsDNA, anti-Sm, anti-Ro/La/RNA, anticardiolipin, anti-beta2-glycoprotein 1, lupus anticoagulant
TTE, EKG, imaging of chest, abdomen, or CNS; PFTs; nerve conduction studies; renal bx
4/17 criteria with 1 clinical + 1 immunological OR lupus nephritis proven by bx with a +ANA or anti-dsDNA test
(Acute/chronic cutaneous lupus, oral ulcers, non-scarring alopecia, >2 joint synovitis, serositis, neurological, renal, hemolytic anemia, leukopenia <4000, thrombocytopenia <100K, ANA, dsDNA, anti-Sm, antiphospholipid Ab, low complement, direct coombs test if no hemolytic anemia
Treatment of SLE?
hydroxychloroquine NSAIDs glucocorticoids antimalarial agents methotrexate (for inflammatory arthritis) azathioprine mycophenolate mofetil mycophenolate sodium cyclophosphamide B-cell–targeted therapies: rituximab (anti-CD20), belimumab (anti-BlyS)
