Systemic lupus erythematosus Flashcards
classic clinical presentation of SLE
rash, joint pain and fever
SLE is MC in (sex, age, origin)
female of reproductive age and African descent
Lupus endocarditis - name
Lidman - Sacks endocarditis
Lidman - Sacks endocarditis of lupus?
nonbacterial, wart-lile (verrucous) vegetations on both sides of valve (mitral) or aortic valve
Lupus nephritis is a result of
type III hypersensitivity
Lupus nephritis - MC
nephritic - diffuse proliferative glomerulonephritis
nephrotic - membranous glomerulonephritis
MC and severe type is diffuse proliferative
Common causes of death in SLE
- cardiovascular disease
- Infection
- Renal disease
SLE symptoms/findings/treatment etc
mnemonic: RASH OR PAIN
Rash, Arthritis, Soft tissues/Serositis, Hematologic disorders, Oral and nasopharyngeal ulcers, Renal disease/Raynaud phenomenon, Photosensitivity, Antinuclear antibodies, Immunologic disorfer (anti-dsDNA, anti-SM, antiphospholipids), Neurologic disorders
SLE - neurologic disorders - examples
seizures, psychosis
SLE - hematologic disorders - example
pancytopenia
SLE - heart
it can affect any layer of the heart (endo,myi,pericarditis)
SLE - rash
malar or discoid
SLE - treatment
- NSAID 2. Steroids 3. immunosuppressants
4. hydroxychloroquine
SLE - lab findings
- antinuclear antibodies (ANA)
- anti-dsDNA antibodies
- anti-Smith antibodies
- decreased C3, C4, CH50
- Anti-histone antibodies
SLE -decreased C3, C4, CH50 due to
immune complex formation
SLE- sensitive, not specific test
ANA
SLE - specific, poor prognosis test
anti-dsDNA (renal disease)
SLE - specific, not prognostic test
anti-Smith
SLE - sensitive for drug induced lupus
antihistone antibodies
Anti-Smith antibodies - against ….
snRNPs
antiphospholipid syndrome is a …. or …. disorder
1ry or 2ry autoimmune disorder
antiphospholipid syndrome as a 2ry autoimmune disorder is MC in
SLE
antiphospholipid syndrome - autoantibodies against
phospholipids
diagnosis of antiphospholipid syndrome is based on
clinical criteria and lab findings
clinical criteria of antiphospholipid syndrome
- history of thrombosis (arterial or venous)
2. recurrent spontaneous abortion
antiphospholipid syndrome arterial or venous thrombosis includes
- DVT
- hepatic vein thrombosis
- placental thrombosis
antiphospholipid syndrome - lab findings
- lupus anticoagulants
- anticardiolipin
- anti-β2 glycoprotein antibodies
Lupus anticoagulant is an
immunoglobulin that binds to phospholipids and proteins associated with the cell membrane.
antiphospholipid syndrome - lupus anticoagulants and anticardiolipin antibodies can cause …. (lab)
false positive VDRL/RPR
falsely elevated PTT
antiphospholipid syndrome - treatment
systemic anticoagulation
Drug induced lupus - drugs
- Hydralazine
- Procainamide
- Isoniazid
Lupus endocarditis - valves
- mitral
2. aortic
Mixed connective tissue disease - clinical presentation
Feature of SLE, systemic sclerosis, and/or polyomyositis
Mixed connective tissue disease - Labs
anti-U1 RNP antibodies (speckled ANA)
SLE - lab findings (and their characteristics)
- antinuclear antibodies (ANA) - sensitive, Not specific
- anti-dsDNA antibodies - Specific, poor prognosis (renal disease)
- anti-Smith antibodies - Specific, not prognostic (directed against snRNPs)
- decreased C3, C4, CH50 - due to immune complex formation
- Anti-histone antibodies - sensitive for drug-induced lupus)
