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Lupus


Description

Sytemic Lupus Erythematosus (SLE) is a multi-system, autoimmune inflammatory condition characterized by a fluctuating, chronic course.

Lupus is characterized by severe fatigue and butterfly rash across the face; debilitating pain and swelling often occur in the hands, wrists, elbows, knees, ankles, or feet. There may also be morning stiffness in the joints. Other signs and symptoms of lupus include a worsening of the butterfly rash across the face following sun exposure; a pale or blue tinge to the fingers when exposed to cold; and possibly hair loss.



Causes

Most cases are idiopathic.

Drug induced lupus is clinically different from idiopathic SLE

RISK FACTORS include: Race (blacks, Hispanics, Asians, and Native Americans have higher prevalence than whites); Genetic markers (HLA-B8, HLA-DR2, HLA-DR3); and Hereditary complement deficiency especially C2 and C4.



Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.

Conventional Labs

Positive antinuclear antibody (ANA)

Anti-double standard DNA (dsDNA), anti-Sm, false-positive VDRL, or positive LE preparation. These tests have either high sensitivity (ANA, false-positive VDRL) or specificity (anti-dsDNA, anti-Sm and LE preparation) and are included as American Rheumatology Association (ARA) criteria for the diagnosis of SLE along with the clinical features.

Sedimentation rate is nonspecific, but valuable in assessing activity of SLE

Anemia, Leukopenia, Lymphopenia, Thrombocytopenia

Abnormal urinary sediment, Proteinuria, Hypoalbuminuria

Increased prothrombin time

Positive anticardiolipin

Increased serum creatinine

Positive Coombs test

 

 

 

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