Systemic Lupus Erythomatosis Flashcards
What is the SLE aetiology? (5)
- genetics
- high oestrogen exposure (HRT, contraceptives)
- viruses (Epstein-Barr)
- UV light
- Silica dust
What is the SLE pathogenesis?
- loss of immune regulation
- increased (ineffective) apoptosis and necrosis
- auto-antigens released by necrotic cells
- B cells are stimulated to produce autoantibodies
Depostition of ______ ______ in the kidneys causes the renal disease in SLE. These activate the _____, leading to inflammation , ______ and ______
immune complexes
-nuclear antigen + anti-nuclear antibodies
complement
necrosis and scarring
What rashes are characteristic of Lupus?
Malar rash
- butterfly shape
- sparing of nasolabial folds
- post UV exposure
Discoid lupus erythematosus
-can lead to scarring
What are the mucocutaneous features of SLE? (6)
- photosensitivity
- malar rash
- discoid lupus erythematosus
- subacute cutaneous lupus
- mouth ulcers
- alopecia
What are the MSK features of Lupus?
- Non-deforming polyarthritis (no erosion on X-ray)
- Deforming arthropathy (Jaccoud’s arthritis)
- Myopathy
Serositis in SLE can affect what organs?
Heart
- pericarditis
- pericardial effusion
Lungs
- pleural effusion
- pleurisy
What are the diagnostic renal features in SLE?
Proteinuria >500mg in 24h
Red cell cast
What are the five antibodies in SLE?
- ANA (anti-nuclear antibody)
- Anti-dsDNA
- Anti-Sm
- Anti-Ro
- Anti-RNP
Which auoantibody is the most specific for SLE?
anti-dsDNA
What is the first diagnostic test for patient with suspected SLE?
Urinalysis - check for kidney disease
CRP rises during an SLE flare up (T/F)
False
Complement levels rise in SLE (T/F)
False
-Complement (C3/C4) levels fall
What drugs are used for SLE?
NSAIDs Hydroxychloroquine Steroids Immunosuppressants (Azathioprine, methotrexate) Biologics (Rituximab)
Urinalysis should always be carried out when suspecting SLE to test for _________. What is being tested?
glomerulonephritis
-blood and protein
