Systemic Lupus Erythematosus (SLE) Flashcards Preview

Rheumatology > Systemic Lupus Erythematosus (SLE) > Flashcards

Flashcards in Systemic Lupus Erythematosus (SLE) Deck (8)
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1
Q

What is SLE?

A
  • Multi-systemic autoimmune disease
  • Characterised by presence of anti-nuclear antibodies
  • Type 3 hypersensitivity reaction
2
Q

What are the risk factors of SLE?

A
  • Gender (female)
  • Age - 15 to 45
  • Ethnicity
  • Family History
  • Smoking
  • Drugs
  • Sun exposure
3
Q

What are the possible causes of SLE?

A
  • Genetics (associated with HLA B8, DR2, DR3)
  • Sex hormone status
  • UV light
  • Drugs (Procainamide, Hydralzine, Isoniazid, Minocycline, Phenytoin) - Drug induced lupus associated with antihistone antibodies
  • EBV
4
Q

What are the clinical features of SLE?

A

=> General features:

  • Fatigue
  • Fever
  • Mouth ulcers
  • Lymphadenoapthy

=> Skin:

  • Butterfly rash
  • Alopecia
  • Photosensitivity
  • Livedo reticularis
  • Raynaud’s phenomenon

=> MSK:

  • Arthralgia
  • Non erosive arthritis

=> CVS:

  • Pericarditis
  • Myocarditis

=> Respiratory:

  • Pleurisy
  • Fibrosing alveolitis

=> Renal:

  • Protenuria
  • Glomerulonephritis

=> Neuropsychiatric:

  • Anxiety and depression
  • Psychosis
  • Seizures
5
Q

What is the pathophysiology of SLE?

A
  • Autoimmune condition where the body makes antibodies against its own DNA
  • Dead cells and cell fragments are cleared up ineffectively by phagocytes
  • Immune complexes travel to lymphoid tissue, where they encounter APC
  • Autoantibodies form
  • Inappropriate clearance of these immune complexes lead to inflammation and damage
6
Q

What are the investigations in suspected SLE?

A
=> Bloods - ESR, CRP FBC
FBC reveals pancytopenia 
ESR raised 
CRP NORMAL 
RAISED ESR + NORMAL CRP = SUSPECT SLE
=> Serum autoantibodies 
Anti-dsDNA raised
Anti-Smith raised
C3 and C4 reduced
RF may be raised
Antiphospholipid levels raised 

=> ENA panel test

7
Q

What is the management of SLE?

A

=> Conservative manegement

  • Avoid sunlight
  • Use high factor sun block (Hydrochloroquine)
  • Topical steroids

=> Mild flares

  • Hydrochloroquine or low dose steroids
  • Steroid sparing

=> Moderate flares
- DMARDs

=> Severe flares

  • Mycophenolate
  • Rituximab
  • Cyclophosphamide
8
Q

What is antiphopholipid syndrome and its features?

A

Acquired disorder characterised by predisposition to venous and arterial thrombosis, recurrent fetal loss and thrombocytopenia

=> Features:

  • Venous/arterial thrombosis
  • Recurrent fetal loss
  • Thrombocytopenia
  • Prolonged APTT (paradoxical)
  • Liverdo reticularis
  • Pulmonary hypertension, pre-eclampsia