Systemic Lupus Erythmatous Flashcards
SLE Definition
Inflammatory disease characterised by auto antibody nuclear material
May involve any organ system
-> ANA associated
SLE Epidemiology
1/4000
Females
Asians, Indians, Afro carribeans
3rd to 4th decad
SLE Aetiology
Genetic
Uv light exposure
Oral contraceptives
Chlorpromazine, hydralazine, isoniazid
SLE Pathology
B cell hyperactivity
Impaired immune complex clearance
Dysfunctional complement system -> intracellular material is not disposed of correctly -> antibodies produced
Abnormal coagulation cascade
SLE Clinical features-constitutional
15-40y Initially mild and vague Fatigue and malaise Fever Wt loss
SLE Musculoskeletal symptoms
90% arthralgia -poly articular -small joint -symmetrical Myalgia
SLE Dermatological symptoms
60% photo sensitivity -> malar rash Discoid rash Alopecia Ulceration Vasculitis -purpura -splinter haemorrhages -nail edge infarcts
SLE Cardiovascular symptoms
Pericarditis
Myocarditis
50% raynauds
SLE Pulmonary symptoms
Pleurisy
Pleural effusions
Pneumonia is
SLE Renal symptoms
Glomerulonephritis
Proteinuria
Increased BP
SLE Neurological symptoms
CNS and peripheral nerves Headaches Psych Strictures Neruopathies Chorea
SLE Haematological symptoms
Lymphopenia
Neutropenia
Anaemia
Thrombosis
SLE GI symptoms
Less common
Aseptic peritonitis
Hepatosplenomegally
Mesenteric vasculitis
SLE Investigations
Urine dip
- protein
- blood
Bloods
- anaemia
- leukopenia
- thrombocytopenia
- u and e
- increased ESR
- normal CRP
Serology
- hypocomplementaemia
- 90% ANA
- 60% ds DNA antibodies
- anti ro and anti lo
- antihistone 90%
Skin biopsy
-IgG and complement deposition dermal-epidermal
SLE Management mild
NSAIDS
life style advice-> avoid sunlight