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Systemic Lupus Erythematosus (SLE)

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by

Emily Carrillo

on 27 January 2013

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Transcript of Systemic Lupus Erythematosus (SLE)

Pathology/Etiology Clinical Manifestations Medications Diagnostic Labs - Type III hypersensitivity that is caused by viruses, hormones, genetics or drugs
- Involves adaptive and innate immune responses
- Chronic SLE results from the presence of persistent antigen-antibody binding which creates inflammation The organs Lupus usually affects:
- Skin
- Musculoskeletal
- Kidney Systemic Lupus Erythematosus (SLE) - Medications cannot cure lupus, but they are able to control the symptoms and can prevent or slow organ damage
- Principle drugs used are anti-inflammatory drugs, disease modifying anti-rheumatoid drugs (DMARD), anti-malarials, and immunosuppressive drugs
- Choice of drugs depends on the type and severity of the lupus symptoms, the person's response to treatment, and the risks of the drug's side effects Group 1: 6 Pack - Mostly affects connective
tissue of the musculoskeletal
system
- Affects the cardiovascular
or renal system Anti-Inflammatory Drugs - Relieve the symptoms by reducing the inflammation response and treat symptoms like fever, arthritis, or pleurisy
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are used for arthritis, arthralgia, joint stiffness or pain, fever and chest pain from mild pleurisy, and pericarditis (inflammation of the sac around the heart)
- Celebrex and Bextra
- Corticosteroids Disease Modifying Anti-rheumatoid Drugs (DMARD) - Antiinflammatory, antiarthritic, and immunomodulating
- Much more toxic than NSAIDs
- Has a slower onset (several weeks)
- Methotrexate, leflunomide, etanercept Anti-Malarial Drugs - Hydroxychloroquine is commonly used
- Effective in treating lupus arthritis, skin rashes, and mouth ulcers
- Reduces the risk of blood clots and lowers cholesterol levels Immunosuppressive Drugs - Azathioprine and methotrexate are commonly used
- Reserved for people with more serious manifestations: lupus kidney disease (nephritis) or acute neurologic complications disease
- These drugs are used if corticosteroids have failed The organs Lupus sometimes affects:
- Neurologic
- Pulmonary
- Cardiac Usual Signs and Symptoms:
- Fatigue
- Joint pain/ swelling
- Pericardial effusion
- Pleural effusion
- Skin rashes Not one single test can diagnose
Lupus. A combination of blood and urine tests, physical and history, and signs and symptoms are used. Complete Blood Count Measures the number of RBCs, WBCs, platelets and amount of hemoglobin. With lupus this test will usually show anemia, which is common in lupus patients. A low WBC or platelet count may show up as well. Erythrocyte Sedimentation Rate Determines the rate that RBCs settle to the bottom of a tube within one hour. An elevated sedimentation rate may be indicative of lupus. (the sedimentation rate isn’t a specific diagnostic test, an elevated rate may also indicate other inflammatory conditions, cancer, or infections). Kidney & Liver Assessment and Urinalysis If lupus has affected the kidneys, it is possible to have an increased protein level in the urine as well as RBCs in the urine. Chest X-ray If lupus is affecting the heart or lungs, a chest x-ray may be used to detect any inflammation. Antibody Tests - Antinuclear Antibody Test (ANA) - Implications: identifies presence of autoantibodies
- Anti-DNA antibody test - Implications: Immunoglobulin specific against DNA; highly specific test for lupus and associated with serious organ-threatening disease
- Anti - SSB test - Implications: Particular test for immunoglobins specifically in neonatal
- Antiphospholipid antibody test - Implications: autoantibodies that react with phospholipids in Lupus patients THE END!
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