Week 2 - SLE Flashcards
what are the main connective tissue diseases?
SLE (lupus)
sjogrens syndrome
systemic sclerosis
mixed connective tissue disease (MCTD)
what is SLE?
chronic autoimmune disease affecting any organ system in the body but mainly the skin, joints, kidneys, blood cells and nervous system
how is lupus diagnosed?
4 or more criteria from the SLICC classification guide
(at least 1 from both clinical and immunological criteria)
OR
biopsy proven lupus nephritis with ANA or anti DNA antibody present
what is the pathogenesis of SLE?
defective apoptosis means more cell death and defective clearance of dead cell debris
cell debris acts as antigens after floating around the body for so long
Immune system forms antibodies against this material
the persistence of these antigens allows large immune complexes to form which can become lodged in small vessels or basement membranes of skin and kidneys
this activates complement and triggers inflammation which can lead to fibrosis, necrosis etc
describe the epidemiology of SLE
more common in women (child bearing age)
common in black people in UK and US but not reported in African black people
Genetic factor - often in monozygotic twins
through what systems can SLE present?
constitutional MSK mucocutaneous renal respiratory haematological cardiovascular GI neuropsychiatric
constitutional symptoms?
fever
weight loss
fatigue
MSK symptoms?
arthralgia
myalgia
inflammatory arthritis
avascular necrosis
mucocutaneous symptoms?
photosensitivity - malar rash discoid lupus subacute cutaneous lupus oral/nasal ulceration raynauds alopecia
renal symptoms?
lupus nephritis (glomerulonephritis)
resp symptoms?
pleurisy PE pleural effusion pneumonitis pulmonary hypertension ILD
cardio symptoms?
pericarditis
pericardial effusion
elevated ischaemic heart disease
haematological symptoms?
leukopenia
lymphopenia
thrombocytopenia
anaemia
neuropsychiatric symptoms?
seizures
depression/psychosis
headache
GI symptoms?
rare
hepatitis
pancreatitis
