Systemic lupus erythemtosus (SLE) Flashcards
What is SLE?
This is a systemic autoimmune condition that can affect almost any part of the body, in which the immune system attacks cells and tissue resulting in inflammation and tissue damage and forming immune complexes
How is most likely to be affected by SLE?
Females (9:1)
Afro-carribean, Hispanic American, Asian and Chinese ethnicity
What are some predisposing factors of SLE?
- Genetic susceptibility (HLA genes)
- Environmental factors (UV, infection)
- Immune factors
- Hormonal factors (Oestrogen)
Describe the pathogenesis of SLE?
Immune disregulation => Fast apoptosis and defective nuclear clearing
=> Macrophage phagocytosis of nuclear material
=> B & T cells produce auto-antibodies
=> Formation of immune complexes in basement membrane via nucleosome-mediated binding
=> Activation of complement system
=> Neutrophil activation
=> Basement membrane destruction and scarring
What are the 2 categories of SLE symptoms?
- Subacute cutaneous lupus erythymatosus (SCLE)
- Discoid lupus erythematosus (DLE)
What are some cutaneous presentations in SCLE?
Photosensitive malar rash
Non-Scarring alopecia
Oral ulceration
Raynaud’s phenomenon
What are some cutaneous presentations in DLE?
Discoid lupus erythematosus will cause a non-cancerous, chronic skin condition with erythematous, scalding plaques with active infalmmation, affecting the face, head and neck
How can SLE affect the joints?
Arthritis and Jaccouds arthropathy (Picture) can occur in SLE
What are some neurological symptoms of SLE?
Delirium
Psychosis
Seizure
Headache
Cranial nerve disorder
What are some haematological and cardiological symptoms of SLE?
Pleural or pericardial effusion
Acute pericarditis
Leukopenia
Haemolytic anaemia
Thrombocytopenia
What renal symptom is common in SLE?
Lupus nephritis
How can lupus nephritis be tested for?
Urinalysis showing proteinuria of >0.5g in 24 hours
Biopsy can prove nephritis
What classification criteria is used in SLE?
EULAR/ACR criteria
What tests are required in diagnosis of SLE?
Clinical examination
Immunological testing
What EULAR/ACR score provides a diagnosis of SLE?
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