Sysetemic Lupus Erythematosus Flashcards
Give some background information on lupus and it’s clinical features
More common in young females, common in Afro-carribean, Asian and Chinese. It principally affects joints and shins as well as lungs, kidneys and haematology.
Genetic associations of C1q and C3 (if deficient)
Clinical features: malaise, fatigue, fever, weight loss, lymphadenopathy, butterfly rash, athralgia, rayneaurds phenomenon. Other features: inflammation of kidneys, CNS, heart and lungs, accelerated atherosclerosis and vasculitis.
Describe the pathogenesis of SLE
Tend to have an overactive immune system, particularly humeral immunity - B cell hyper reactivity. This may be due to a defect in the apoptotic pathway so over reactive B cells exposed to nuclear antigen
Look at 6 steps
Explain the diagnosis method of SLE
- Check serum for auto nuclear antibodies (ana) eg Abs to DNA, a lot of stuff look (no confirm )
- Anti-dsDNA and Sm (RNP) (specific)
- Anti-RO and La - closely associated to Auto immune diseases
How would you asses disease sensitivity
- Identify pattern of organ involvement
- Monitor function affected organ - renal, BP, lung function, skin, haem
- Identify pattern of auto antibodies expressed - anti-dsDNA and anti-sm
Pre-empt severe attacks: wt loss, fatigue, malaise, hair loss, alopecia, rash, ESR (if CRP goes up is bad), increased complement consumption, increase anti-dsDNA
What are the levels of SLE and how would you treat
- Mild - joint +- skin Involvement - - paracetamol with maybe NSAIDs, hydroxycholorquine (if rash) and maybe tropical steroid.
- Inflammation of other organs, pleuritic, pericarditis, mild nephritis, treated with corticosteroids (look), azathioprine, cyclophosphamide.
- Severe: inflammation of vital organs, severe nephritis, CNS disease, pulmonary disease, cardiac involvement, AIHA, thrombocytopenia. Treated with mycophenolate mofetil and rituximab.
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