Systemic lupus arthritis

Question 1

Describe systemic lupus erythematosus and the effects of kidney damage

Answer 1

• Auto-immune disease where anti-DNA anti-bodies are made (attack DNA)
• Affects many organs of body and damages the central nervous system (CNS), heart and kidneys
• Damage to kidneys leads to proteinuria (leakage of protein) and hematuria (hemorrhage)

Question 2

Describe the aetiology of systemic lupus erythematosus (3)

Answer 2

Genetic predisposition that can be exacerbated by:
• UV light
• Hormones
• Drugs (induce SLE like symptoms)

Question 3

List the general signs and symptoms of systemic lupus erythematosus (11)

Answer 3

• Fever with no other cause
• Joint pain
• Haematuria
• Chest pain when taking a deep breath
• Fatigue
• General discomfort, uneasiness, or ill feeling (malaise)
• Skin rash – a “butterfly” rash over the cheeks and bridge of the nose which worsens in sunlight
• Sensitivity to sunlight
• Swollen lymph nodes
• Hair loss
• Mouth Ulcers

Question 4

List the organ specific symptoms of systemic lupus erythematosus:
• Brain and nervous system
• Digestive tract
• Heart
• Lung
• Skin

Answer 4

• Brain and nervous system: headaches, numbness, tingling, seizures, vision problems, personality changes
• Digestive tract: abdominal pain, nausea, and vomiting
• Heart: abnormal heart rhythms (arrhythmias)
• Lung: coughing up blood and difficulty breathing
• Skin: patchy skin colour, fingers that change colour when cold (Raynaud’s phenomenon)

Question 5

List the oral signs and symptoms of systemic lupus erythematosus (4)

Answer 5

• Mouth ulcers
• Keratotic, rough-surfaced palate
• Red rash on hard palate
• Discrete red and white plaque on the hard palate

Question 6

List the medications used for systemic lupus erythematosus in and describe their purpose:

• Mild disease (3)
• Severe disease (2)

Answer 6

Mild disease:
• NSAIDs: for arthritis and pleurisy
• Corticosteroid creams: for skin rashes
• Antimalaria drug (hydroxychloroquine) and low-dose corticosteroids: skin and arthritis symptoms

More severe disease:
• High-dose corticosteroids: decrease the immune system response
• Cytotoxic drugs (drugs that block cell growth): when corticosteroids aren’t effective or symptoms get worse