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18 Cards in this Set
- Front
- Back
What is Systemic Lupus Erythematosus
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Chronic autoimmune disease
As occurs in other autoimmune diseases, the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage |
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What systems can SLE affect?
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Inflammation caused by lupus can affect many different body systems, including joints, skin, kidneys, blood cells, heart and lungs
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Predominant age of SLE development
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Female to Male Ratio: 7:1
Predominant Age: 20-45 (childbearing years |
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Four Types of Lupus
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Systemic lupus erythematosus
Discoid lupus erythematosus Drug-induced lupus erythematosus Neonatal lupus |
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Systemic lupus erythematosus
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can affect nearly any part of the body. Body systems most commonly involved include the skin, joints, lungs, kidneys and blood. When people talk about lupus, they're usually referring to systemic lupus erythematosus
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Discoid lupus erythematosus
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affects only the skin. People with discoid lupus, also called cutaneous lupus, experience a circular rash on the face, neck and scalp. A small number of people with discoid lupus may develop systemic lupus erythematosus, though it isn't possible to predict who will develop the more serious form of lupus.
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Drug-induced lupus erythematosus
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occurs after taking certain prescription medications. Not everyone who takes these medications develops lupus. Drug-induced lupus affects a wide variety of body systems. Signs and symptoms usually go away when the medication is stopped
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Neonatal lupus
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is a rare form of lupus that affects newborn babies. A mother with certain antibodies that are linked to autoimmune diseases can pass them to the developing fetus — even if the mother has no signs or symptoms of an autoimmune disease. The antibodies can cause neonatal lupus. A baby with neonatal lupus may experience a rash in the weeks following birth. Neonatal lupus may last about six months before disappearing
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Risk Factors for SLE
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Sex: more common in women
Age: most often diagnosed between 20-45 Race: more common in African Americans and Asians Sunlight Exposure Certain Medications: chlorpromazine, hydralazine, isoniazid, procainimide EBV Exposure to Chemicals: mercury and silica |
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Symptoms of SLE
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No two cases of lupus are exactly alike
Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent Most people with lupus experience episodes called "flares" of worsening signs and symptoms that eventually improve or even disappear completely for a time |
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Skin Symptoms of SLE
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Erythematous rash over the malar eminences, generally with sparing of the nasolabial folds (butterfly rash)
Alopecia Skin lesions that appear or worsen with sun exposure Raised erythematous patches with subsequent edematous plaques and adherent scales (discoid lupus) Leg, nasal or oropharyngeal ulcerations Livedo reticularis: pallor from anemia Petechiae (from thrombocytopenia) |
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Joint Symptoms of SLE
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Tenderness
Swelling Effusions, generally involving the peripheral joints |
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Cardiac Symptoms in SLE
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Pericardial rub (in patients with pericarditis)
Heart murmurs (if endocarditis or valvular thickening or dysfunction) Chest pain |
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Generalized symptoms of SLE
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Fever
Conjunctivitis Dry eyes Dry mouth (sicca syndrome) Oral ulcers Abdominal tenderness Decreased breath sounds (from pleural effusions) Weight loss or gain Raynaud’s syndrome Shortness of breath Easy bruising Anxiety Depression Memory loss |
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Diagnosis of Lupus according to the American Rheumatism Association
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Diagnosis can be made by the presence of any four of the following criteria:
Butterfly rash Discoid rash Photosensitivity Oral ulcers Arthritis Serositis (pleuritis, pericarditis) Renal disorder Neurologic disorder (seizures, psychosis) Hematologic disorders (hemolytic anemia; leukopenia; lymphopenia; thrombocytopenia) Immunologic disorder (positive SLE cell preparation; Anti-DNA; Anti-SM; false positive STS known to be positive for 6 months Abnormal ANA |
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Laboratory Tests for dx SLE
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Immunologic: ANA; Anti-DNA antibody; anti-SM antibody; ESR
CBC with diff Platelet Count (Coomb’s Test if anemia detected) Urinalysis (24 hour for protein if proteinuria detected) PTT and anticardiolipin antibodies in patients with thrombotic events Renal panel to evaluate function |
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Imaging Studies for SLE
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CXR: for evaluation of pulmonary involvement like pleural effusions or infiltrates
EKG: eval causes of chest pain Echocardiogram: screen for significant valvular heart disease (present in 18% of SLE patients); can pick up valvular thickening and dysfunction |
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Leading cause of death in persons with SLE
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Infection and
kidney failure |