SLE

Question 1

Aetiology and risk factors of systematic Lupus Erythamatous

Answer 1

Connective tissue disorder AID
Characterised by anti-nuclear antibodies (anti-ds DNA esp in SLE)
Multi-organ disease with features nearly anywhere

Polygenic-so many are associated with SLE
usually issues in clearing apoptotic cells-> hyperactivity-> loss of tolerance for cell AG-> immune complexes (deposit in vessels, activate complement, inflammation cascades)

risk factors
Women 
Age 15-45
African descent
FHx

Question 2

Signs and Sx systematic Lupus Erythamatous

Answer 2

Immune complex damage small vesels
skin- malar flush (spare labia), worse in the Sun
Hair loss
Fatigue, weight loss
Reynauds
Lymphadenopathy

Inflammatory joint disease-arthirits worse in morning

glomerulonephritis-oedema

pleural effusion and pericardial effusions happen

mild-skin hair joints
moderate-lung/heart
Severe-kidneys and brain

Question 3

Investgations of systematic Lupus Erythamatous

Answer 3

ANA-dsDNA positive is hallmark of SLE
CRP should NOT be raised
but ESR is raised

also complement C4 would be very low (all used up in immune complexes). if C3 low too-probs very active disease
-> ESR, dsDNA, complement-markers of activity

FBC-aneamia, thrombocytopenia, leukpenia

U&E-renal involvment
Urinanalysis is actually much better (get it much before-heamatouria, proteinuria)

LFT-can get hepatotos

CXR-for pleural effusion
ECG for heart

Question 4

Management of systematic Lupus Erythamatous

Answer 4

Hydroxychloroquine is great for mild disease-especially for skin

For more active/acute-steroids (prednisolone)

other agents available-azathioprine, etc

Question 5

Complications of systematic Lupus Erythamatous

Answer 5

Kidney disease-need dialysis after a point

Brain involvement

its a balance between drug side effects and others