Seminar G - SLE Flashcards Preview

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Flashcards in Seminar G - SLE Deck (27)
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1
Q

Definition

A

A multi-system inflammatory disease with a wide range of clinical manifestations.

2
Q

Pathophysiology

A

Excess production of pathogenic autoantibodies

→Anti-nuclear anti-body (ANA)

3
Q

Epi

A

1 in 4000

Female: Male 9/13:1

4
Q

Genetic Link

A

First degree relative family members being 50 times more likely to develop the disease than the background population.
HLA-DR2 and DR3 (increased susceptibility)

5
Q

Environmental Link

A

Sex hormones are known to influence disease activity:

  1. Patients can experiences an exacerbation of symptoms pre-menstrually
  2. OCP can cause a flare
  3. Pregnancy can cause a flare (can be a threat to baby and mother)
  4. UV light → causes increased rashes and systemic flare
  5. Hydralazine – can causes a lupus-like illness.
6
Q

Autoantibodies

A

Anti-dsDNA
Anti-Ro
Anti-LA

7
Q

Antibodies cause

A

Complement mediated lysis
Enhanced phagocytosis (by mononuclear cells)
Vasculitis → via binding of immunoglobulins to intracellular proteins and nucleic acids
Glomerulonephritis

8
Q

Rare presentation

A

SLE may cause a symmetrical small-joint polyarthropathy similar to that seen in RA
Note: it is non-deforming (i.e. correctible) Jaccoud’s arthropathy

9
Q

5 year survival

A

90%

10
Q

15 year survival

A

85%

11
Q

Mortality from

A

Renal disease
Cardiovascular disease
Accelerated Atherosclerosis

12
Q

General Features

A

Fever
Malaise
Weight loss

13
Q

MSK

A

Arthralgia in 90%
Jaccoud’s arthropathy
Myalgia/myositis

14
Q

Skin

A
Butterfly rash in 30%
Other rashes
Photosensitivity
Alopecia
Mucosal ulceration
Raynaud’s phenomenon
15
Q

Cardiovascular

A
Pericarditis
Myocarditis
Endocarditis (libman-Sachs)
Thomboembolism (arterial and venous)
Accelerated atherosclerosis
16
Q

Pulmonary

A

Pleurisy (in up to 60%)
Pleural effusions
Interstial fibrosis

17
Q

Renal

A

Proteinuria/nephrotic Syndrome
Haematuria
Glomerulonephritis (any subtype)

18
Q

Haematological

A

Anaemia
Leukopenia (particularly lymphopenia)
Thrombocytopenia

19
Q

Neurological

A

Headaches
Seizures
Psychosis
Mononeuritis multiplex

20
Q

GI

A

Mesenteric vasculitis

Autoimmune hepatitis

21
Q

Immunological

A

Immune paresis

22
Q

Reproductive

A

Recurrent miscarriages
Premenstrual flares
Flares during pregnancy
Neonatal lupus with congenital heart block

23
Q

Treatment → Avoid

A

Sun exposure

High factor sun protection

24
Q

Treatment → NSAIDs for

A

Joint pains

Caution in pains with renal disease

25
Q

Treatment → Hydroxychloroquine

A

Alleviate symptoms in the medium term, but does nothing to treat the more serious manifestations of the disease such as neurological

26
Q

Treatment → Glucocorticoids

A

Under specialist supervision

27
Q

Treatment → Immunosuppressants

A

Azathioprine
Cyclophoshamide
Methotrexate

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