Systemic Lupus Erythematosus Flashcards
1
Q
What is systemic lupus erythematosus?
A
- inflammatory autoimmune connective tissue disorder
- inadequate T cell suppressor activity with increased B cell activity
- erythematosus refers to malar rash across face
2
Q
What is the pathophysiology of SLE?
A
- Characterised by anti nuclear antibiodies ANA
- ANA are autoantibodies against proteins within cell nuclei
- this generates a chronic inflammatory response
3
Q
Typical demographic of SLE
A
- women
- African, Caribbean, Asian or Hispanic ethnicity
- young-middle age
4
Q
Presentation of SLE
A
- fatigue
- weight loss
- photosensitive malar rash
- joint + muscle pain
- non erosive arthritis of small joints
- pleuritic chest pain
- mouth ulcers
- hair loss
- fever
- SOB
- oedema due to nephritis
- lymphadenopathy
- Raynaud’s phenomenon
5
Q
Investigations of SLE
A
- autoantibodies (ANA)
- FBC - anaemia of chronic disease, low white cell + platelets
- C3+C4 fall with active disease
- urinalysis, PCR, renal biopsy - lupus nephritis
- ESR raised
- plasma viscosity raised
6
Q
Management of SLE
A
- sun protection/avoidance
- lifestyle advice due to cardiovascular risk
- first line drugs: hydroxychloroquine, NSAIDs + steroids
- for more severe SLE: DMARDs e.g. methotrexate, mycophenolate mofetil + biological therapies e.g. rituximab + belimumab
7
Q
First line drug treatment of SLE
A
hydroxychloroquine
NSAIDs
Steroids e..g prednisolone
8
Q
Complications of SLE
A
- increased CVD risk
- infection risk
- anamia of chronic disease
- low white cells, neutrophils + platelets
- pericarditis
- interstitial lung disease > pulmonary fibrosis
- lupus nephritis
- miscarriage
- optic neuritis
9
Q
What features might suggest active disease (a flare up) of SLE?
A
- decreased C3 + C4
- worsening of symptoms
- increased ESR
10
Q
What monitoring is required when using SLE treatment long term?
A
FBC
LFTs
U&Es
