Autoimmune & Systemic Rheumatic Diseases Flashcards
Systemic lupus erythematosus (SLE) Polymyalgia rheumatica Sarcoidosis Vasculitis (18 cards)
What is systemic lupus erythematosus
a multisystem, inflammatory, autoimmune connective tissue disorder
Describe the epidemiology of systemic lupus erythematosus
- much more common in females (F:M = 9:1)
- more common in Afro-Caribbeans and Asian communities
- onset is usually 20-40 years
What type of hypersensitivity reaction is involved in Systemic Lupus Erythematosus?
Type III hypersensitivity reaction.
Which HLA types are associated with Systemic Lupus Erythematosus?
HLA-B8, HLA-DR2, and HLA-DR3.
What are some general features of Systemic Lupus Erythematosus?
- Fatigue
- fever
*mouth ulcers - lymphadenopathy
What are common skin manifestations of Systemic Lupus Erythematosus?
- malar (butterfly) rash: spares nasolabial folds
- discoid rash
- photosensitivity
- Raynaud’s phenomenon
- livedo reticularis
- non-scarring alopecia
What is a discoid rash in Systemic Lupus Erythematosus?
- scaly, erythematous, well demarcated rash in sun-exposed areas
- Lesions may progress to become pigmented and hyperkeratotic before becoming atrophic
What are common musculoskeletal symptoms of Systemic Lupus Erythematosus?
Arthralgia (joint pain) and non-erosive arthritis.
What are common cardiovascular manifestations of Systemic Lupus Erythematosus?
- pericarditis (mc)
- myocarditis
What are two common respiratory manifestations of Systemic Lupus Erythematosus?
Pleurisy and fibrosing alveolitis
What are common renal manifestations of Systemic Lupus Erythematosus?
- Proteinuria
- glomerulonephritis (particularly diffuse proliferative glomerulonephritis).
What are common neuropsychiatric symptoms in Systemic Lupus Erythematosus?
Anxiety, depression, psychosis, and seizures.
What antibodies may be positive in Systemic Lupus Erythematosus
- 99% are ANA positive (high sens, low spec)
- 20% rheumatoid factor +ve
- anti-dsDNA: highly specific
- anti-Smith: highly specific (> 99%)
What abnormalities might be seen on a full blood count in Systemic Lupus Erythematosus?
- Anaemia (of chronic disease or haemolytic)
- low white cell count
- Thrombocytopenia (due to immune-mediated destruction)
What inflammatory marker is typically used to monitor Systemic Lupus Erythematosus activity?
ESR (Erythrocyte Sedimentation Rate).
What does a raised CRP indicate in Systemic Lupus Erythematosus?
A raised CRP may indicate an underlying infection since CRP can remain normal during active disease
What happens to complement levels during active Systemic Lupus Erythematosus?
Complement levels (C3, C4) are typically low during active disease due to the consumption of complement in immune complex formation.
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