SYSTEMIC LUPUS ERYTHEMATOSUS. OUTLINE. Definition Epidemiology Pathophysiology Classification and diagnosis Clinical Features Lupus related syndromes Treatment Prognosis . DEFINITION.
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SYSTEMIC LUPUS ERYTHEMATOSUS
Malar Rash (butterfly erythema)
Subacute cutaneous LE
Nasal septal perforation
Nailfold capillary changes
Subacute Cutaneous Lupus
Acute Cutaneous: Malar Rash
Note Sparing of Nasolabial Folds
Note Scarring, Hyperpigmentation
Follicular Plugging Livedo Reticularis
SLE - VASCULOPATHY
Jaccoud’s Arthopathy: Nonerosive, Reducible Deformities
Noninfective thrombotic endocarditis involving mitral valve in SLE.
Note nodular vegetations along line of closure and extending onto chordae tendineae.
A)Hemolytic anemia - with reticulocytosis
B)Leukopenia - less than 4,000/mm3 total on 2 or more occasions
C)Lymphopenia - less than 1,500/mm3 on 2 or more occasions
D)Thrombocytopenia - less than 100,000/mm3 in the absence of offending drugs
Nephritis remains the most frequent cause of disease-related death.
Class IIIFocal and segmental proliferative glomerulonephritis
Class IVDiffuse proliferative glomerulonephritis
Class VMembranous glomerulonephritis
Class VIGlomerular sclerosis
1. Malar rash
2. Discoid rash
4. Oral ulcers
7. Renal disease.
> 0.5 g/d proteinuria
≥ 3+ dipstick proteinuria
8. Neurologic disease.
Psychosis (without other cause)
9. Hematologic disorders.
Leukopenia (< 4000/uL)
Lymphopenia (< 1500/uL)
10. Immunologic abnormalities.
Positive LE cell
11. Positive ANA ( 95-100% )
THE 1982 REVISED CRITERIA FOR CLASSIFICATION OF SLE
-Not part of the diagnostic criteria for SLE
-Does NOT warrant ANA if no other clinical evidence to suggest autoimmune disease