Systemic Lupus Erythematosus Flashcards
What are connective tissue diseases?
Diseases involving spontaneous over-activity of the immune system
What is systemic lupus erythematosus?
A connective tissue disease in which the immune system attacks the body’s cells and tissues
There is commonly a genetic predisposition to SLE. True/false?
True
Which hormone is thought to play a particular role in SLE?
Oestrogen
Give some environmental factors that may be involved in SLE
Viruses
UV light
Cigarette smoke
Outline the pathogenesis of SLE
Clearance of dead cells is delayed triggering the immune system to recognise them as antigens and produce autoantibodies
Why does renal disease commonly occur in lupus?
As a complex is formed between antibodies and antigens that are deposited in the kidney
For a patient to be diagnosed with SLE, they must have a combination of what criteria?
Clinical and immunological
Give some examples of clinical criteria for SLE
Rashes
Arthritis
Renal disease
Leukopenia
Give some immunological criteria for SLE
ANA
Anti-dsDNA
Low complement
What are some mucocutaneous features of SLE?
Malar rash
Discoid lupus erythematosus
Mouth ulcers
What are some musculoskeletal features of SLE?
Polyarthritis
Myopathy
Jacooud’s arthritis
Serositis can cause what conditions?
Pericarditis
Pleurisy
Pleural effusion
What is the main renal feature of SLE?
Proteinuria of >500mg
Give some neurological features of SLE
Depression
Migraines
Seizures
Give some haematological features of SLE
Lymphadenopathy
Leucopenia
Haemolytic anaemia
What are the features of anti-phospholipid syndrome?
Venous and arterial thrombosis
Recurrent miscarriage
Association with SLE
ANA has a good/poor sensitivity and good/poor specificity
Good
Poor
What other antinuclear antibodies are important in SLE?
Anti-dsDNA
Anti-Sm
Anti-Ro
Anti-RNP
What is the most useful autoantibody in diagnosing SLE? Why?
Anti-dsDNA
High specificity
What are the anti-phospholipid syndrome antibodies?
Anti-cardiolipin
Lupus anticoagulant
Anti-beta 2 glycoprotein
What other possible investigations can be done in SLE?
CXR CT Pulmonary function Renal biopsy ECHO
How can SLE activity be monitored?
C3/C4 levels
Anti-dsDNA level
Urinalysis
What drug should be given to all patients with SLE?
Hydroxychloroquine
Are steroids indicated in SLE?
Yes
What is the first choice immunosuppressant in SLE?
Cyclophosphamide
