systemic lupus erythematous Flashcards
what is SLE
complex autoimmune disease with multi-system involvement
can affect virtually all tissues
what autoantibody is strongly associated with SLE
anti-nuclear antibody
epidemiology of SLE
significant geographical variation for prevalence
most common in women of child bearing age
pathogenesis of SLE
complex interaction between exposome (environmental factors ) and genome resulting in epigenetic change which alters expression of certain genes
name 2 environmental and 2 genetic factors influencing SLE
environment - UVB radiation, infections
genetic - macrophage failure, deficiency of complement proteins
Extra oral manifestations of SLE
- butterfly rash due to photosensitivity
- vascular dermatitis (raised red dry lesions)
- raynauds
intra oral manifestations of SLE
- xerostomia (sjogrens or drug induces)
- active lesions - apthous ulcers
- non active lesions - pigmentation due to hydroxychloroquine
diagnosis of SLE
ACR-EULAR criteria
1. must have ANA titre of >=1.80 on HPe-2 cells
2. must score at least 10 on weighted criteria
weighted criteria in ACR - EULAR diagnosis of SLE
7 clinical categories e.g musculoskeletal, renal
3 immunological categories e.g complement proteins
discoid lupus
primarily affects mucocutaneously, no systemic involvement
main drug used in treatment of SLE
hydroxychloroquine
phases of drug treatment for SLE
- hydroxychloroquine = 1st line drug
- glucocorticoids e.g prednisolone for flare ups
- immunosuppresive agents if max dose 1 and 2 e.g azathioprine
- monoclonal antibody therapy if max 3 e.g rituximab