SLE - ANSWER a chronic, multisystem, inflammatory disease
associated with abnormalities of the immune system
affects the skin, joints, serous membranes (pleural and pericardium),
renal, hematologic, and neurological systems
etiology of SLE - ANSWER unknown cause through genetics: HLAs
(DR3)
hormones play a role: most occur in women in their childbearing years
environmental factors: sun exposure, burns, infectious agents
medications (Pronestyl, Apresoline, anti-seizure meds)
what happens with the immune system in SLE? - ANSWER it does not
distinguish self from non-self antigens and autoantibodies are developed
that bind to their specific antigens with complement activation occurring
where are the immune complexes deposited? - ANSWER in the kidneys,
heart, skin, brain, and joints and are too small to be removed by
phagocytosis
what type of response is SLE and why? - ANSWER humoral immunity
type III
the fixation of the complement and the release of chemotactic factors
lead to inflammation and destruction of the involved tissue
what are the autoantibiodies created against? - ANSWER nucleic acids,
erythrocytes, coagulation proteins, lymphocytes, platelets, and many
other self-proteins
what are generalized complaints of SLE? - ANSWER fever, weight loss,
arthralgia, and excessive fatigue
, clinical manifestations of SLE:
skin - ANSWER alopecia, butterfly rash (seen in 50%), discoid erythema,
palmar erythema, mucosal ulcers
clinical manifestations of SLE:
cardopulmonary - ANSWER endocarditis, myocarditis, pericarditis,
pleural effusion, pneumonitis, Raynaud's phenomenon
CAD and HTN are accelerated: hypercholesterolemia must be treated
aggressively
arrhythmias caused by fibrosis of the SA and AV nodes
clinical manifestations of SLE:
urinary - ANSWER glomerulonephritis (40%), hematuria, proteinuria
all SLE patients have some renal changes
clinical manifestations of SLE:
musculoskeletal - ANSWER arthritis (90%), myositis, synovitis
arthritis is normally non-erosive but may cause deformities
clinical manifestations of SLE:
neurologic - ANSWER stroke, seizures (15%), peripheral neuropathy,
psychosis, cognitive impairment
organic brain syndrome from immune complexes deposited within brain
tissue
clinical manifestations of SLE:
hematologic - ANSWER anemia, leukopenia, lymphadenopathy,
splenomegaly, thrombocytopenia
antiphospholipid syndrome (APS) is a hyper coagulability condition and
is treated with warfarin
what can APS lead to? - ANSWER leads to clots in the arteries and
veins with associated risk of stroke, gangrene, and heart attack
clinical manifestations of SLE:
GI - ANSWER abdominal pain, diarrhea, dysphagia, NV
clinical manifestations of SLE: