文档介绍：SystemicLupusErythematosus
DoctorNaLi
BinzhoumedicalcollegeYantaiaffiliatedhospital
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SLE
Autoimmune d can lead to fibrosis and intra-alveolar hemorrhage.
Also pneumothorax and pulmonary HTN can occur
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Serositis – Cardiac
Pericarditis: most common cardiac manifestation and usually responds to NSAIDs.
Myocarditis (rare) and fibrinous endocarditis (Libman-Sacks) may occur. Steroids plus treatment for CHF/arrhythmia or embolic events.
MI due to atherosclerosis can occur in <35 y/o
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Neuro
Cranial or peripheral neuropathy occurs in 10-15%, it is probably secondary to vasculitis in small arteries supplying nerves.
Diffuse CNS dysfunction: memory and reasoning difficulty
Headache: if excruciating, often indicate acute flare
Seizures of any type
Psychosis: must distinguish from steroid-induced psychosis (occurs in 1st weeks of tx at doses ≥40mg prednisone and resolves after several days of reducing or stopping tx)
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Cont.
TIA, Stroke: mostly increased among patients that are APLA positive
50-fold increase in risk of vascular events in women under 45 compared to healthy women
Treatment for clotting event is long-term anticoagulation
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Heme
Anemia: usually Normochromic, normocytic
Leukopenia: almost always consists of lymphopenia, not granulocytopenia
Thrombocytopenia
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Renal
Nephritis: usually asymptomatic, so always check UA if patient has known or suspected SLE
Occurs early in course of disease-if not present w/in 1 yr, probably will not occur.
Histologic classification by renal biopsy is useful to plan therapy
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Histologic Classifications
Class I is minimal mesangial glomerulonephritis which is histologically normal on light microscopy but with mesangial deposits on electron microscopy.
Class II is based on a finding of mesangial proliferative lupus nephritis. This form typically responds completely to treatment with corticosteroids.
Class III is focal