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Duke PA Systemic Lupus Erythematosus

with SLE any __ can be involved organ system
cells and organs damaged by __ and immune complexes autoantibodies
__% of all patients with SLE are women 90
in the US the highest incidence of SLE is in African American females
ultraviolet light: triggers photosensitivity, rashes, drugs: sulfonamides, cigarette smoking, infections: EBV, ?parvo B-19, hormones environmental factors for SLE
systemic/constitutional clinical manifestations of SLE fatigue, malaise
cardiopulmonary clinical manifestations of SLE pleuritis/pleural effusion, pericarditis/pericardial effusions
neuropsychiatric clinical manifestations of SLE cognitive impairment
gastrointestinal clinical manifestations of SLE hepatitis, pancreatitis
dermatologic clinical manifestations of SLE photosensitivity, malar rash, discoid lesions, alopecia
most serious manifestation of SLE Renal (nephritis)
__% of patients with SLE develop nephrotic syndrome as well 50
in SLE, untreated nephritis can lead to ESRD in __ years 2
classical arthritis presentation of SLE polyarthritis similar distribution to RA
Fixed erythema, flat or raised over the malar eminences Malar rash
Raised patches with scaling, follicular plugging; scarring of older lesions discoid rash
Unusual rash triggered by sunlight; by history or observation Photosensitivity
Oral or nasopharyngeal; usually painless oral ulcers with SLE
Non-erosive involving ≥2 or more peripheral joints; + tenderness, ± effusion arthritis with SLE
Persistent proteinuria (>0.5g/d or 3+)OR cellular casts renal disorder with SLE
Seizures or psychosis (no other known causes of either) neurologic disorder with SLE
Hemolytic anemia OR leukopenia OR lymphopenia hematologic disorder with SLE
Anti-DNA OR anti-Sm OR+ antiphospholipid antibodies immunologic disorder with SLE
+ ANA titer in the absence of any drug known to be associated with drug-induced lupus syndromes antinuclear antibody
order first; best screening test for SLE. 98% prevalence ANA-antinuclear antibodies
high titers diagnostic; may correlate with disease activity. 70% prevalence dsDNA-double stranded DNA
causative drugs: many= antiarrhythmics, antihypertensives, antibiotics, anticonvulsants: hydralazine, procainamide, quinidine, isoniazid, diltiazem, minocycline Drug-induced Lupus Erythematosus (DILE)
Syndrome of + ANA associated with constellation of symptoms including malaise, fever, arthritis (± myalgias), rash, serositis, autoimmune-mediated response more common in Caucasians, renal/CNS symptoms are rare Drug-induced Lupus Erythematosus (DILE)
cimetidine, hydralazine, HCTZ, penicillin, sulfonamides, terbinafine (lamisil) drugs that precipitate flares of SLE for those that already have it
__ occur almost universally in SLE patients skin lesions
annular or papulosquamous subacute cutaneous lupus
discoid lupus chronic cutaneous lupus
Patients with DLE have a __% risk of developing SLE which tends to be mild 10-15
common sites for Discoid Lupus face, neck, scalp
__ are mainstay treatment of life-threatening manifestations Systemic glucocorticoids
__ used for cutaneous and mild-mod musculoskeletal symptoms Anti-malarials (mostly hydroxychloroquinine)
Created by: bwyche
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