SLE

Question 1

Most common subtype

Answer 1

Discoid Lupus Erythematous (confined to skin)

Question 2

When does drug-induced lupus resolved?

Answer 2

when drug d/c

Question 3

Symptoms of Neonatal SLE?

Answer 3

• skin rash (transient)
• heart block (permanent)

*newborns of SLE mothers

Question 4

Symptoms of subacute cutaneous SLE?

Answer 4

nonscarring papulosquamous lesions resembling psoriasis or annular-polycyclic lesions with peripheral scale and central clearing

Question 5

Etiology of subacute cutaneous SLE?

Answer 5

1. Induced by drugs: ACEI’s, hydrochlorothiazide, terbinafine and CCB’s
2. Can develop as para-neoplastic syndrome

Question 6

May progress to squamous cell carcinoma

Answer 6

Chronic Cutaneous LE

Question 7

photosensitive lesions that can lead to skin atrophy and scar

Answer 7

Chronic Cutaneous LE

Question 8

Epidemiology of SLE?

Answer 8

AA > white
F > males
Peak incidence in childbearing years
More severe at younger ages

Question 9

Susceptibility genes

Answer 9

HLA-D2
HLA-DR-3
complement C4A deficiency

Question 10

Environmental factors in pathogenesis

Answer 10

UV light

Question 11

Pathogenesis:
What induces cellular apoptosis?
These dying cells release:

Answer 11

genetic predisposition + UV

HMGB1 and Beta defensins (bind and activate TLRs of innate immune system cells)

Question 12

Pathogenesis:
What activates plasmacytoid DC?
What is the function of these cells?

Answer 12

INF-1, produced by macrophages
**central player

Plasmacytoid DC cells take up + present DNA and histones (inefficiently removed apoptosed cells) in lymphoid tissues

Question 13

Pathogenesis:

What causes the breakdown of normal tolerance?

Answer 13

DC»_space; Self-Ag presented to T cells»_space; stimulate B cells to make autoAbs

Question 14

Pathogenesis:

What causes inflammation?

Answer 14

complement activation»_space; neutrophils

Question 15

Clinical presentation?

Answer 15

RASH PAIN O MD:

Renal, arthritis, serositis, hematologic, photosensitivity, ANA +, Immunologic, Neuorologic, Oral Ulcer, Malar Rash, Discoid Rash

Question 16

How is SLE-associated arthritis characterized?

Answer 16

Symmetrical, NON-erosive, deforming, myositis and weakness

Question 17

How is SLE-associated serositis characterized?

Answer 17

pleuritis, pericarditis, inflammation of peritoneal cavity (abd pain)

Question 18

What are possible SLE-associated heme abn?

Answer 18

hemolytic anemia, leukopenia, lymphopenia, thrombocytopenia

Question 19

What are SLE-associated neurologic symptoms?

Answer 19

Depression, psychosis, seizures, MS-like dz, periph neuropathy

Question 20

SLE-associated skin symptoms?

Answer 20

Knuckles spared
Discoid rash
Alopecia (telogen effluvium or alopecia areata)

Question 21

Auto Abs

Answer 21

o Anti-dsDNA
o Anti-smith
o Anti-U1RNP
o Anti-Ro/SSA, La/SSB
o Anti-histone
o Anti-phospholipid

Lauren SHURDs her Pants
Lupus = smith, histone, U1, Ro, dsDNA, phos