Systemic lupus erythematosus SLE

Systemic lupus erythematosusNote the predominance of sun exposed areas
  • Facts:
    Chronic, inflammatory autoimmune disorder
    Antibody mediated cellular attack and deposition of antigen-antibody complexes
  • History / PE:
    Nonspecific symptoms (fever, anorexia, weight loss)
    Painless oral ulcers
  • Diagnosis:
    Anti-dsDNA antibodies
    Anti-Sm antibodies
    Antihistone antibodies (drug induced SLE)
    Anti-Ro antibodies (neonatal SLE)
  • Treatment:
    1) Need to perform kidney biopsy (baseline histology)
    2) NSAIDs (joint pain)
    3) Steroids (acute exacerbations)
  • Complications:
    Lupus nephritis (major cause of M/M)
  • Pneumonic:

    D iscoid rash
    O ral ulcers
    P hotosensitivity
    A rthritis
    M alar rash
    I mmunologic criteria
    N eurologic (lupus cerebritis, seizures)
    E levated ESR

    R enal disease
    A NA positive
    S erositis (pleural/ pericardial effusion )
    H ematologic abnormalities (anti-phospholipid antibody)
  • Notes:
    Pancytopenia (decreased RBCs, WBCs, and platelets) occurs due to the formation of antibodies against blood cells, a form of type 2 hypersensitivity reaction (similar mechanism to that of idiopathic thrombocytopenic purpura )
  • Associated With:
    Libman-Sacks Endocarditis
    Drugs (chlorpromazine, hydralazine, INH, methyldopa, penicillamine, procainamide, and quinidine)
  • Differential Diagnosis:
    Mixed connective tissue disease (anti nRNP)

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August 6th 2010