Patients with dangerous proliferative forms of glomerular damage (ISN Ill and IV) usually have microscopic hematuria and proteinuria
(>500 mg per 24 h)
20% of individuals with lupus diffuse proliferative ‘
glomerulonephritis (DPGN) die or develop ESRD within
10 years of dx
Approximately 20% of SLE patients with proteinuria (usually nephrotic) have ____changes without
proliferative changes on renal biopsy
membranous glomerular
For most people with lupus nephritis, ____ becomes important after several years of disease
accelerated atherosclerosis
- most common manifestation of diffuse CNS lupus
- difficulties with memory and reasoning
Cognitive dysfunction
When excruciating, they often indicate SLE flare
Headaches
caused by focal occlusion or by embolization from carotid artery plaque or from fibrinous vegetations
of Libman-Sacks endocarditis
Ischemia in the brain
are primarily manifestations of accelerated atherosclerosis
myocardial infarctions
The increased risk for vascular events is 3-to tenfold overall, and is highest in women aged
<49 years
- most common pulmonary
manifestation of SLE - when mild, may respond to treatment with nonsteroidal
anti-inflammatory drugs (NSAIDs); when more. severe, patients require a brief course of glucocorticoid therapy
Pleuritis w/ or without pleural effusion
Life-threatening pulmonary manifestations include
- interstitial inflammation leading to fibrosis,
- shrinking lung syndrome,
- intraalveolar hemorrhage
- most frequent cardiac manifestation;
- usually responds to anti-inflammatory therapy and infrequently leads to tamponade
Pericarditis
More serious cardiac manifestations
- myocarditis
>fibrinous endocarditis of Libman-Sacks
most frequent hematologic manifestation of SLE
Anemia
can be rapid in onset and severe, requiring high-dose glucocorticoid therapy, which is effective in most patients
Hemolysis
common and almost always consists of npnopenia, not granulocytopenia; lymphopenia rarely predisposes to infections and by itself usually does not require therapy
Leukopenia
- a recurring problem
thrombocytopenia
If the platelet counts are ___ and abnormal bleeding is ___, therapy may not be required
- > 40000/uL
- absent
SLE flare
- Nausea,
- vomiting,
- diarrhea
d/t autoimmune peritonitis or intestinal vasculitis
Diffuse abdominal pain
Gastrointestinal Manifestation that is common when active
Increase in AST and ALT
Intestinal vasculitis — LIFE THREATENING; may lead to:
- ischemia
- bleeding
- sepsis
5 EYE PROBLEMS ASSOCIATED WITH LUPUS
- Dry eye disease
- eyelid disease
- retinal disease
- scleral disease
- nerve disease
MOST IMPORTANT to detect; positive in >95% of patients, usually at the onset of symptoms
ANA
