systemic lupus erythematosus Flashcards
1
Q
definition
A
Systemic lupus erythematosus (SLE) is a chronic multi-system disorder that most commonly affects women during their reproductive years. It is characterised by the presence of antinuclear antibodies. In addition to constitutional symptoms, it most frequently involves the skin and joints, although serositis, nephritis, haematological cytopenias, and neurological manifestations may occur during the course of the disease. Earlier diagnosis and better management have resulted in a lower prevalence of life-threatening disease.
2
Q
epidemiology
A
- incidence is increasing
- The disease is both much more common and severe in those of African and Asian descent than in white populations in Europe and the US.
3
Q
signs and symptoms
A
- malar (butterfly) rash
- photosensitive rash
- discoid rash
- fatigue
- weight loss
- fever
- oral ulcers (painless but recurring)
- alopecia
- arthralgia/arthritis
- fibromyalgia
- raynaud’s
- hypertension
- signs of nephrosis (oedema etc.)
- lymphadenopathy
- abdominal pain, diarrhoea, vomitting
- chest pain, SOB
- venous or arterial thrombosis
4
Q
risk factors
A
- female
- 14-45 y/o
- african/asian descent
- drugs
(The association was first reported with procainamide,[17] thought to predispose by inhibiting DNA methylation. Frequently prescribed drugs that may result in SLE include minocycline[18][19] (data on other tetracyclines are not as firm), isoniazid,[22] terbinafine,[20] phenytoin,[23] carbamazepine,[24] and sulfasalazine (presumed due to its sulfonamide component).[21]
More recently, a link has been noted with monoclonal antibodies against tumour necrosis factor-alpha[37] and interferons.[38]
The clinical features resolve when the offending drug is discontinued.) - sun exposure
- family history of SLE
- tobacco smoking
5
Q
investigations
A
FBC activated PTT U&Es ESR, CRP antinuclear antibodies, double stranded DNA, smith antigen urinalysis CXR ECG
