Lupus (SLE) defined Correct Answer-Chronic inflammatory, multi-
system disorder of connective tissue
- autoimmune origin
- genetic influence
- environmental factor
- drug induces
- flare ups & remission (may not go back to baseline)
- no way to predict its progression
- variable
Lupus (SLE) environmental factors Correct Answer-- physical/mental
stress
- streptococcal/viral infections
- exposure to sunlight or ultraviolet light (vacay)
- pregnancy (after - hormones drop)
- estrogen -> lupus
Lupus (SLE) drug induced factors Correct Answer-- icillin
- oral contraceptive
- thyroid meds
- INH
- some biologic response modifiers
- anticonvulsant (Dilantin)
,- Hydralazine (Apresoline)
- Procainamide (Pronestyl)
Lupus (SLE) patho Correct Answer-production of large variety of
autoantibodies which results from hyperactivity of B-cells (protect from
non-self) as a result of a disordered T-cell function - antibodies form
immune complexes which are deposited into CT which then prompt
inflammatory response leading to local tissue damage
Lupus (SLE) leading causes of death Correct Answer-1. Renal failure
2. Cardiac failure
3. Neuro
Lupus (SLE) risk factors Correct Answer-- genetic influence (HLA
genes)
- women childbearing age (high estrogen)
- first symptoms seen at menarche
- more common in African Americans, Asians & Hispanic
- environmental factors (EBV: mono)
- drug induced
Lupus (SLE) clinical manifestations Correct Answer-- extremely
variable in severity
- recurring remission & exacerbation
- no characteristic pattern of organ involvement
,- most commonly affects: skin, muscle, kidney, lining of lungs, gut,
heart, nervous tissue
Generally: fever, weight loss, anorexia, malaise, excessive fatigue may
proceed exacerbation - usually feel 10x when an exacerbation is coming
- exacerbations more common in spring & summer (pollen & vacay)
Lupus: musculoskeletal problem Correct Answer-- arthritis,
polyarthralgia
- osteoporosis
- joint & muscle swelling, pain/stiffness
Lupus: gastrointestinal problems Correct Answer-- abdominal pain
- diarrhea
- oral/nasopharyngeal ulcerations
- anorexia, heartburn, wt loss
- enlarged liver, splenomegaly
Lupus: cardiopulmonary problems Correct Answer--
pericarditis/endocarditic/myocarditis
- tachypnea & cough (restrict lung dx)
- pleurisy (pain with coughing)/pleuritis/pleural effusion
- dysrhythmias (d/t fibrosis (unhealthy tissue) so SA & AV nodes)
- HTN
- hypercholesteremia
, - vasculitis/increased risk atherosclerosis
- thrombic events (TIA, CVA, MI)
Raynaud's phenomenon
2ND LEADING CAUSE OF DEATH
- teach - smoking cessation, prevent obesity/hyperlipidemia, decrease
salt, fat and cholesterol intake
Lupus: ocular problems Correct Answer-- transient blindness: due to
retinal vasculitis
- photophobia (painful to look at light)
- conjunctivitis
Lupus: renal problems Correct Answer-- nephritis
- renal failure
treated with corticosteroids, cytoxic agents (Cytoxan) &
immunosuppressive agents (Imuran, cyclosporin)
Lupus: nervous system problems Correct Answer-- generalize or focal
seizures
- peripheral neuropathy; cranial nerve palsies
- CVA
- headache/irritability
- aseptic meningitis
- psychosis/depression