Systemic Lupus Erythematosus Flashcards
SLE - Environmental Risk Factors
UV light
stress
smoking
drugs
viruses
SLE - Hormonal Risk Factors
estrogen
prolactin
SLE - Pre-Clinical Phase Pathophysiology
B-cell & T-cell overactivation
elevated CD4:CD8 ratio
dysregulation of cellular apoptosis
SLE - Clinical Phase Pathophysiology
autoantibody production -> immune complexes form and deposit in vasculature and tissues -> Type III hypersensitivity reaction -> inflammation -> organ involvement
SLE - Diagnostic Criteria
4/11 needed to diagnose
serositis
oral ulcers
arthritis
photosensitivity
blood disorders
renal involvement
antinuclear antibodies
immunology
neurologic disorder
malar rash
discoid rash
SLE - Signs & Symptoms
fatigue
fever
weight loss
myalgia
Raynaud’s syndrome
dyspepsia, abdominal pain
alopecia
dry eyes
SLE - Antibodies Involved
antinuclear
anti-dsDNA
anti-Sm
antiphospholipid
Antiphospholipid Syndrome
aPL (+) and thrombotic event
Lupus Nephritis
kidney inflammation due to deposition of immune complexes in either glomeruli or glomerular basement membrane
Lupus Nephritis - Diagnostic Criteria
persistent proteinuria or cellular casts
renal biopsy to confirm
Lupus Nephritis - Clinical Presentation
foamy urine
peripheral edema
concomitant hypertension
SLE - Maintenance Drug of Choice
hydroxychloroquine 200-400 mg QD
Hydroxychloroquine - Adverse Reactions
flu-like symptoms
ocular toxicity
allergic skin eruptions
hematological changes
GI upset
cardiomyopathy
SLE - Glucocorticoids’ Role in Therapy
adjunctive treatment for moderate-to-severe initial presentation / organ- or life-threatening SLE / inadequate response to hydroxychloroquine / poor QOL
SLE - Belimumab’s Role in Therapy
adjunctive treatment - to be used in combination with standard
B-lymphocyte stimulator antagonist
preferred in: non-active-CNS, LN III / IV / V
Belimumab - Adverse Reactions
NVD
infusion reactions
depression / CNS effects
PML
infections
SLE - Anifrolumab’s Role in Therapy
adjunctive treatment - to use in combination with standard
interferon antagonist
NOT in active LN or CNS disease
SLE - Immunosuppressants’ Role in Therapy
refractory disease
organ-threatening SLE (mainly LN)