1b Lupus Flashcards

1
Q

What is SLE?

A

Chronic tissue inflammation in the presence of antibodies directed against self antigens

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2
Q

What are the three key autoantibodies?

A

Antinuclear antibodies – key to diagnosis of lupus
Anti-double stranded DNA antibodies
Anti-phospholipid antibodies

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3
Q

What is the hallmark of SLE?

A

Multi-site inflammation - particularly joints, skin and kidney

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4
Q

What rash is a key hallmark feature of SLE?

A

malar rash -

erythema which spares the nasolabial fold (the creases extending form nose edges to mouth edges)

(αυτό που ήξερα ωσ buterfly rash)

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5
Q

What phenomenon is common in connective tissue disorders?

A

Raynaud’s phenomenon

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6
Q

What is raynaud’s phenomenon?

A

Intermittent vasospasm of digits on exposure to cold
Typical colour changes – white to blue to red
Vasospasm leads to blanching of digit
Cyanosis as static venous blood deoxygenates
Reactive hyperaemia
Raynaud’s phenomenon is most commonly isolated and benign condition (‘Primary Raynaud’s phenomenon’)

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7
Q

What is a common organ involvement for SLE?

A

Renal disease = glomerulonephritis

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8
Q

Describe what happens in glomerulonephritis?

A

deposition of immune complexes in the glomerulus which triggers inflammation, resulting in glomerular nephritis

IgG in the glomerulus activates the Fc receptors on the inflammatory cells which triggers the complement system

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9
Q

What are the mucosal involvements of SLE?

A

Mouth ulcers
Hair loss

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10
Q

What risk is also present if there is high anti-phospholipids present?

A

risk of thrombosis = so give anti platelets

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11
Q

Which autoantibody is specific for SLE?

A

Anti-double stranded DNA antibodies (anti-dsDNA)

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12
Q

What is seen in SLE with regards to inflammatory markers?

A

high ESR but CRP is normal, unless there is an infection present

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13
Q

What is ESR

A

an erythrocyte sedimentation rate (ESR) test measures how quickly red blood cells settle to the bottom of a test tube

if they sink faster the normal it means possible inflammation

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14
Q

What haematological conditions might be seen in SLE?

A

Haemolytic anaemia, Lymphopenia, Thrombocytopenia

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15
Q

What renal investigations are important to do?

A

Measure urine protein to creatinine ration

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16
Q

What are the levels of complement in SLE?

A

Low C3 and C4

17
Q

Describe the Complement and anti-ds-DNA levels in SLE?

A

Unwell lupus patient has LOW complement C3 and C4 levels and HIGH levels of anti-ds-DNA antibodies

18
Q

What is an early warning sign for glomerular nephritis?

A

urine protein to creatinine ratio

19
Q

What is the treatment of SLE?

A

aims at remission or low disease activity and prevention of flares

Hydroxychloroquine is recommended in all patients with lupus