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