Systemic Lupus Erythematosus Ch. 50

The diagnosis of SLE can be complicated and difficult. There are _____(number) criteria to be considered. If a person has at least ______ of these ______ criteria, the individual has SLE

11 4;11

SLE occurs between the ages of

15-44, and appears to have a genetic component

______ and ______ are among the most commonly occurring early symptoms of SLE

Arthralgias (joint pain) and arthritis (joint inflammation) -Approximately 90% of all people with the disease complain of joint pain, and this is often the symptom that they present with. -The polyarthritis of SLE initially can be confused with other forms of arthritis, especially RA, because of the symmetric arthropathy.

People with SLE appear to have ____-cell hyperreactivity and increased production of antibodies against self and non-self antigens

B-cell

genes involved in the expression of SLE

HLA-DR and HLA-DQ loci in the MHC class II molecules

________ also may occur in many people with SLE and is evidence of systemic disease

Lymphadenopathy

_____ is the most common of the cardiac manifestation, and is often accompanied by pleural effusions

Pericarditis

_______ occurs in approximately 1/3 of people with SLE

Photosensitivity

definition of SLE

SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. There is no cure for lupus, but medical interventions and lifestyle changes can help control it. It is a major rheumatic disease type 3 hypersensitivity reaction

__________(hormone) appear to protect against the development of SLE, whereas _______ (hormone) seem to favor its development.

androgens; estrogens

The _____ antibody test is more specific for the diagnosis of SLE.

anti-DNA

SLE is characterized by the formation of

autoantibodies and immune complexes

Skin manifestations of SLE

butterfly rash on the nose and cheeks

SLE is more common in (males/females)

females

The most common laboratory test performed is the _________ test for _______. Ninety-five percent of people with untreated SLE have high ______ levels.

immunofluorescence test for ANA. high ANA levels.

SLE has been called the great imitator because

it has the capacity for affecting many different body systems, including the musculoskeletal system, skin, cardiovascular system, lungs, kidneys, central nervous system (CNS), and red blood cells and platelets

treatment of SLE focuses on

managing the acute and chronic symptoms of the disease

types of lupus

systemic (most common) cutaneous drug induced neonatal

the autoantibodies can directly damage...

tissues or combine with corresponding antigens to form tissue-damaging component

renal involvement in SLE

-Renal involvement occurs in close to 50% of people with SLE. -Several forms of glomerulonephritis may occur, including mesangial, focal proliferative, diffuse proliferative, and membranous. Of these, diffuse proliferative has the worst prognosis and presents with hypertension and, in up to 50% of cases, can lead to end-stage renal disease (ESRD) or death, -Interstitial nephritis also may occur. Nephrotic syndrome causes proteinuria with resultant edema in the legs and abdomen, and around the eyes. Kidney biopsy is the best determinant of renal damage and the extent of treatment needed.

possible environmental triggers for SLE

-UV light (specifically UVB) -chemicals -foods -infectious agents

What are some autoantibodies that have been identified in SLE

-antinuclear antibodies (ANA) -anti-DNA antibodies -antiphospholipid antibodies -anti-Smith (Sm) antibodies In addition to ANAs, people with lupus have a host of other self-autoantibodies including those directed against elements of the blood (red cells, platelets, lymphocytes) and plasma proteins (clotting and complement factors).

pulmonary involvement in SLE

-manifested primarily by pleural effusions or pleuritis. -Less frequently occurring pulmonary problems include acute pneumonitis, pulmonary hemorrhage, chronic interstitial lung disease, and pulmonary embolism.