SYSTEMIC LUPUS ERYTHEMATOSUS. OUTLINE. Definition Epidemiology Pathophysiology Classification and diagnosis Clinical Features Lupus related syndromes Treatment Prognosis . DEFINITION.
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Malar Rash (butterfly erythema)
Subacute cutaneous LE
Nasal septal perforation
Nailfold capillary changesCLINICAL FEATURES: Mucocutaneous
Note Sparing of Nasolabial Folds
Note Scarring, Hyperpigmentation
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 I Normal
Class II Mesangial
IIA Minimal alteration
IIB Mesangial glomerulitis
Class III Focal and segmental proliferative glomerulonephritis
Class IV Diffuse proliferative glomerulonephritis
Class V Membranous glomerulonephritis
Class VI Glomerular sclerosis
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% )CLASSIFICATION
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