Systemic Lupus Erythmatous Flashcards

1
Q

SLE Definition

A

Inflammatory disease characterised by auto antibody nuclear material
May involve any organ system
-> ANA associated

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2
Q

SLE Epidemiology

A

1/4000
Females
Asians, Indians, Afro carribeans
3rd to 4th decad

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3
Q

SLE Aetiology

A

Genetic
Uv light exposure
Oral contraceptives
Chlorpromazine, hydralazine, isoniazid

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4
Q

SLE Pathology

A

B cell hyperactivity
Impaired immune complex clearance
Dysfunctional complement system -> intracellular material is not disposed of correctly -> antibodies produced
Abnormal coagulation cascade

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5
Q

SLE Clinical features-constitutional

A
15-40y
Initially mild and vague
Fatigue and malaise
Fever 
Wt loss
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6
Q

SLE Musculoskeletal symptoms

A
90% arthralgia 
-poly articular
-small joint
-symmetrical
Myalgia
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7
Q

SLE Dermatological symptoms

A
60% photo sensitivity -> malar rash
Discoid rash
Alopecia
Ulceration 
Vasculitis
-purpura
-splinter haemorrhages
-nail edge infarcts
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8
Q

SLE Cardiovascular symptoms

A

Pericarditis
Myocarditis
50% raynauds

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9
Q

SLE Pulmonary symptoms

A

Pleurisy
Pleural effusions
Pneumonia is

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10
Q

SLE Renal symptoms

A

Glomerulonephritis
Proteinuria
Increased BP

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11
Q

SLE Neurological symptoms

A
CNS and peripheral nerves
Headaches
Psych
Strictures
Neruopathies
Chorea
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12
Q

SLE Haematological symptoms

A

Lymphopenia
Neutropenia
Anaemia
Thrombosis

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13
Q

SLE GI symptoms

A

Less common
Aseptic peritonitis
Hepatosplenomegally
Mesenteric vasculitis

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14
Q

SLE Investigations

A

Urine dip

  • protein
  • blood

Bloods

  • anaemia
  • leukopenia
  • thrombocytopenia
  • u and e
  • increased ESR
  • normal CRP

Serology

  • hypocomplementaemia
  • 90% ANA
  • 60% ds DNA antibodies
  • anti ro and anti lo
  • antihistone 90%

Skin biopsy
-IgG and complement deposition dermal-epidermal

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15
Q

SLE Management mild

A

NSAIDS

life style advice-> avoid sunlight

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16
Q

SLE Management moderate

A

Anti malarial drugs
Methotrexate
Azothiprine
Corticosteroids

17
Q

SLE Management severe

A

Cytotoxic and corticosteroids.

18
Q

SLE Management adjuvant

A
Anti hypertensives
Anti coagulation
Anticonvulsants
Lipid lowering 
Bone prophylaxis