Flashcards in SLE and CTD Deck (25):
Where can SE affect?
Any part of the body
Briefly, what occurs in SLE?
Immune syste attacks body resulting in inflam and tissue damage. Antibody-immune complexes precipitate and cause further immune response, Immune complexes get stuck in and damage the basement membrane of blood vessels.
What aspects of genetic, enviromental and hormonal affect the pathogenesis of SLE?
Females > males
urban > rural
Increased incidence in asains, hispanics, afro-carribeans and afro-americans
What are the cardinal features of SLE?
What mucocutaneous features are often present in SLE?
malar rash with sparing of nasolabial fold
How can SLE present in the cardiovascular system?
diffuse lung infiltration and fibrosis
Why do patients with SLE require frequent urinalysis?
Renal disease from SLE presens with few symptoms very late on once the patient is in severe renal failure so do not want to miss this
What haematological features can be present in SLE?
How do you differentiate severe SLE from mild SLE?
Mild - skin rash, fatigue, mouth ulcers
Moderate - Sinusitis, joint swelling
Severe - Renal or neurological impairment
What investigations are required for SLE?
How useful are meauring autoantibodies in SLE?
Anti-nuclear antibody - gateway to CTD but not specific to SLE
Anti-dsDNA - highly specific to SLE and levels psitivelly correlate with disease activity
In anti-phospholipid syndrome, what autoantibodies are positive?
Anti-cardiolipin (also + in 30% SLE and 5% of healthy population)
lupus anticoagulant activity
What does anti-phospholipid syndrome cause?
Arterial/ venous thrombosis
Responsible for 15% of recurrent foetal loss
Responsible for 20% recurrent thrombosis in YP
Does anti-phospholipid syndrome affect men more than women?
What are other features of anti-phospholipid syndrome?
mild/ moderate thrombocytopaenia
Libman Sachs endocarditis
What treatment is required for anti-phospholipid syndrome?
aspirin and heparin during pregnancy
attention to vascular risk factors
Describe Sjogrens syndrome.
Lymphocyte infiltration of exocrine glands causing xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes)
Which auto-antibodies can be positive in Sjogren's syndrome?
Is Sjogren's syndrome more common in men or women?
What treatment can be given for Sjogren's syndrome?
Pilocarpine (cholinergic agonist)
Steroids and immunosuppression
Attend to CV risk factors and dental hygiene
What auto-antibodies can be positive in systemic sclerosis?
How is systemic sclerosis classified?
Limited or diffuse
What organs can systemic sclerosis involve?
What are the management options available for systemic sclerosis?
ACE inhibitor (HTN)
Bosentan, Sildenafil (pumonary HTN)