SLE

Question 1

What is SLE?

Answer 1

A multysystem autoimmune disease

Question 2

What is the pathophysiological backround of Lupus?

Answer 2

Polychlonal B-cells produce IgG auto-antibodies (e.g. ANA) which lead to a type 3- hypersensitivity reaction

• complement activation and disposition

Question 3

What is the prevalence of SLE?

Answer 3

About 0.2%

Women 9:1 Men

Child baring age

increase in afro-carribian, asian

Question 4

What are risk factors for the development of SLE?

Answer 4

• Female
• 15-45
• Asian/African descent in Europe/US
• Drugs
  
  • tetracyclines
  • and others
• Family history

Question 5

What are the presenting symptoms of SLE?

Answer 5

Depending on organs involved

• Cutaneous
  
  • malar, butterfly rash (not painful)
  • Photosensitive rash (painful)
  • disocid rash
• Systemic
  
  • fatigue
  • weight loss
  • fever
  • aloplecia
• Other
  
  • fibromyalgia
  • oral ulcers
  • Raynaud’s phenomenon
  • Chest pain, SOB
    
    • Pleuritis and Pericarditits + other
  • Thrombosisi
  • Neprhosis

Question 6

What are signs on examnation of SLE?

Answer 6

Depending on system involved

• Malaise, fatigue, myalgia and fever
• Might have unspecific or specitfic symptoms

Question 7

Which investigations would you order in a patient with suspected SLE?

Answer 7

• Blood
  
  • ANA (present in 95%)
  • Anti DSDNA (specific, only in 60% of cases +)
  • Other Antibodies
  • Increased ESR
  • CRP Normal
• Monitor activity
  
  • complement levels
  • monitor kidney function
    *