Lupus Flashcards
(22 cards)
Two classifications of lupus
Discoid lupus erythematosus (DLE)
Systemic lupus erythematosus (SLE)
What is DLE?
DLE only affects the skin and only a small percentage of people with lupus has this.
What is SLE?
Chronic, progressive, inflammatory connective tissue disorder that can cause major body organs and systems to fail.
Some characteristics of SLE?
Spontaneous remission and exacerbation.
Onset may be acute or insidious (slow).
Fatal but survival rate improved if diagnosed early and treated adequately.
Is lupus an autoimmune disease?
Yep!
ANA’s affect the DNA, RNA, and other components within the cell. As a result, immune complexes form in the serum and organ tissues, which cause inflammation, damage, and destruction. These complexes invade organs directly or cause vasculitis (vessel inflammation), which deprives the organs of arterial blood and oxygen.
Autoimmune complexes in SLE tend to be most attracted to:
glomeruli of the kidneys.
Many of these patients have some degree of kidney involvement, called lupus nephritis - the leading cause of death. Other causes of death from disease are cardiac and CNS involvement.
When does the onset of lupus generally occur?
During childbearing years (20-40yrs).
Affects women 10x more often than men. Black women are most often affected.
What is lupus caused by?
A combination of genetic and environmental factors
What are the major manifestation of DLE and SLE?
dry, scaly rash on the face (“butterfly” rash)
and
Polyarthritis in small joints and knees
Some other manifestations of SLE
Skin: inflammed, red rash. Discoid (round) lesions
Renal: nephritis
Cardiovascular: pericarditis, Reynaud’s phenomenon
Pulmonary: Pleural effusions
Neuro: CNS lupus
GI: Abdominal pain
Musculo: joint inflammation, myositis
Other: fever, fatigue, anorexia, vasculitis.
Two most common findings in SLE?
Fever and fatigue
Fever is the classic sign of an exacerbation.
How is DLE diagnosed?
Skin biopsy to look for lupus cells
How is SLE diagnosed?
Rheumatoid factor, ANA, sed rate, protein electrophoresiss,
A CBC on someone with Lupus may reveal:
pancytopenia (decrease of all cell types)
Skin protection for patients with lupus:
Cleanse with mild soap like Ivory
Dry by patting, not rubbing
Apply lotion liberally to dry skin areas
Avoid using powder and other drying agents like rubbing alcohol.
Use cosmetics that contain moisturizers
Avoid direct sunlight & other types of UV light, including tanning bed.
Wear large-brim hat, long sleeve, long pants when in sun.
SPF of at least 30
Inspect skin daily for open areas and rashes.
What is the major concern for patients with DLE?
Rash or discoid lesions.
Patients with SLE are also concerned about skin changes!
What drug is used to reduce inflammation and promote fading of skin lesions?
Topical cortisone.
What is hydroxychloroquine (Plaquenil)?
An anti-malarial agent used to decrease the absorption of UV light by the skin and decreases the risk for skin lesions.
Are NSAID’s used to treat lupus?
They are used to treat musculoskeletal problems like arthritis and myalgia, but not to treat SLE itself.
What other drugs are used to treat the systemic disease process?
Chronic steroid therapy
What drug would be used to treat renal or CNS lupus?
Immunosuppressive agents: Methotrexate (Rheumatrex) or azathioprine (Imuran)
For severe renal involvement, what combination of meds is prescribed?
immunosuppressants and steroids.
