Systemic Lupus Erythematosus Flashcards
A person with SLE can experience active periods (____) and times where there is decreased activity or even inactivity (____)
A person with SLE can experience active periods (flares) and times where there is decreased activity or even inactivity (remission)
which states have more cases of lupus
prevalence is 73/100k in michigan and georgia
internal factors (sex, age and race) that increase risk of lupus
- sex: SLE is more common in women
- age: although SLE affects people of all ages, it’s most often diagnosed between the ages of 15-46
- Race. SLE is more common in African-Americans, hispanics and asian americans
extenal factors that increase risk of SLE
- sun exposure
- hormonal and reproductive factors
- viruses
- drugs
- smoking
why does light exacerbate SLE
UV light on epidermal DNA –> inflammation and production of cytokines and oxygen-free radicals.
people with SLE should:
Avoid prolonged sun exposure, especially at mid-day when UV light is strongest.
Use a sunscreen with an SPF 30 or higher.
Reapply sunscreen after spending time outside or in the water.
Wear sun protective clothing and use sun shields on your house and car windows.
Avoid tanning beds altogether.
relationship between birthcontrol and SLE
- oral contraceptives and post menopausal hormone therapy were both associated with increased risk for SLE. risk was elevated in women who recently started contraceptive use, thus suggesting an acute effect in a small subgroup of susceptible women.
- in a trail tho, OCPS do not increase the risk of flare among women with STABLE SLE
which virus is linked to SLE
EBV seropositivity is much higher in patients with SLE than in age-matched control participants.
Many potential mechanisms… Molecular mimicry between EBV & SLE antigens?
No studies to date have conclusively established that EBV infection is linked to future risk for the
development of SLE.
_____, which is a constituent of alfalfa sprouts, can cause ANA, anti-dsDNA, low complements, and hemolytic anemia.
Not recommended for patients with SLE!
L-canavanine, which is a constituent of alfalfa sprouts, can cause ANA, anti-dsDNA, low complements, and hemolytic anemia.
Not recommended for patients with SLE!
____ is the most common and earliest
manifestation in SLE, affecting 90% of patients.
_____ ____ occurs in 10–35% of SLE.
JA most commonly manifests as severe deformations
of the hands, including ulnar deviation, swan neck and
boutonniere deformities, and Z-deformity of the thumb,
with multiple non-erosive subluxations.
Arthritis is the most common and earliest
manifestation in SLE, affecting 90% of patients. Jaccoud’s arthropathy occurs in 10–35% of SLE. JA most commonly manifests as severe deformations
of the hands, including ulnar deviation, swan neck and
boutonniere deformities, and Z-deformity of the thumb,
with multiple non-erosive subluxations.
characteristic rash in lupus
a butterflu/malar rash: erythema and edema of cheeks, sparing nasolabial folds lasting hours to days.
acute CLE affects at least 50% of pateints with SLE.
- many are sick, young, fair-skinned females with photosensitivity
rashes in acute vs subacute SLE
acute= buttergu rash
subacute= annular configuraiton with raised red bordes and central clearing. may be a papulosquamous or eczematous appearance.
characteristic rash in chronic CLE
discoid LE– rashes usually neck and above. plaques with folliular prominence.
kidney condition caused by SLE
Lupus nephritis. renal involvement of SLE remains the storngest predictor for morbidity and mortality. lupus nephritis can be categorized into separate classes.
mucosal ulcers in SLE involves most commonly the ___ mucosa
buccal and palate mucosa– tongue is less frequently involved
which labs to order if you suspect lupus nephritis
creatine, microscopic urinalsis – see if theres hematuria, leukocyturia, proteinurea, casts.
also order urinary protein adn creatinine excretion, serum creatinine, C3, C4 and anti-dsDNA
lupus can cause which heart diseases?
basically anything lol. can affect the pericardium. the myocardium, endocardium, conduction system.
lung manifestations of SLE
list 4 nervous system abnormalities that happen with SLE
common eye problems in SLE
Sicca: dry eye or keratoconjunctivities as a result of secondary sjogren syndrome
Retinal vasculopathy: causes cotton wool spots.
if ANA isn’t specific for SLE, what else could you order?
anti-dsDNA and Anti-Smith/part of ENA panel.
- you usually order this when you suspect systemic lupus before you formally diagnose lupus.
Complement activation, reflected by diminished serum
levels of ____ and ___, plays a major role in the tissue
inflammation and organ damage. Patients with ____
____ are more likely to have reduced levels of these complements
Complement activation, reflected by diminished serum
levels of C3 & C4, plays a major role in the tissue
inflammation and organ damage. Patients with lupus
nephritis are more likely to have reduced levels of C3 & C4.
general categories of the classification criteria for lupus
constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal, antiphosphlipid antibodies, complement proteins, SLE-specific antibodies (anti-dsDNA or anti-SMITH)
non pharmacological treatments for SLE
bone mineralization strategies to prevent osteoarthritis
outline the immunologic, antithrombotic, cardiovascular and antimicrobial effects of antimalarials
