SLE

Question 1

What is SLE?

Answer 1

systemic lupus erythematosus

Question 2

What type of disease is SLE?

Answer 2

• chronic inflammatory disease
• has an autoimmune basis
• onset can acute or insidious
• has exacerbations and remissions

Question 3

What organs are affected by SLE?

Answer 3

any organ system can be effected by SLE

Question 4

Whos is most often affected by SLE?

Answer 4

• more prevalent in women (10:1)

- more common in non-Caucasian population

Question 5

What causes SLE?

Answer 5

idiopathic (likely multifactoral)

Question 6

What etiologic factors play a role in SLE?

Answer 6

• familial tendency
• genes for HLA proteins
• hormones (androgens protective and estrogens as risk?)
• environmental triggers: UV light, chemicals (hair dyes, drugs), foods, infectious agents

Question 7

What is the pathology of SLE?

Answer 7

• imbalanced sex hormones heighten helper T cells, weaken suppressor T cells and cause B cell hyperactivity?
• B cell hyperactivity increases antibodies, including auto-antibodies
• auto-antibodies bind to target cells > damage > inflammation > decreased function

Question 8

What auto-antibodies are involved in SLE?

Answer 8

• antinuclear antibodies (including anti-DNA antibodies)
• antibodies against cytoplasmic cell components
• antibodies against blood components (RBCs, WBCs, platelets, plasma proteins)

Question 9

What are manifestations of SLE related to the skeletal system?

Answer 9

• joint pain
• arthritis
• destruction of ligaments, tendons, joint capsules

Question 10

What are manifestations of SLE related to the integument?

Answer 10

• malar “butterfly” rash on nose and cheeks
• fingertip lesions
• hair loss
• mucous membrane lesions (oral ulcers)

Question 11

What are manifestations of SLE related to the renal system?

Answer 11

• damage to kidney (glomerulonephritis)
• proteinuria and consequent edema
• renal failure?

Question 12

What are manifestations of SLE related to the pulmonary system?

Answer 12

• pleural effusions

- pleuritis

Question 13

What are manifestations of SLE related to the cardiac system?

Answer 13

• pericarditis
• myocarditis
• congential heart block in infants whose moms have SLE
• hypertension
• infective endocarditis secondary to valvular lesions from SLE

Question 14

What are manifestations of SLE related to the CNS?

Answer 14

• CVA
• damage to nerve cells
• seizures
• psychotic symptoms, depression, change in LOC, confusion

Question 15

What are manifestations of SLE related to the blood?

Answer 15

• hemolytic anemia
• leukopenia, lymphopenia, thrombocytopenia
• lymphadenopathy (swollen lymph nodes)

Question 16

How is SLE diagnosed?

Answer 16

• group of symptoms
• blood test for auto-antibodies (presence of ANAs not specific, but presence of anti-DNA antibodies is)
• RBC count (anemia)
• WBC with differential (thrombocytopenia, leukopenia)

Question 17

How is SLE treated?

Answer 17

manage symptoms

medication by step:

1) NSAIDS
2) antimalarial drug hydroxychloroquine for skin and musculoskeletal manifestations
3) corticosteroids when symptoms significant (CNS or renal involved)
4) immuno-suppressive drugs if severe