Systemic Lupus Erythematosus Management

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Questions and Answers

What is a significant benefit of using aspirin in patients with systemic lupus erythematosus (SLE)?

It prevents thrombosis due to its antiplatelet effects. (correct)

It eliminates the need for corticosteroids.

It improves immune system function.

It reduces liver toxicity.

Which type of medication is recommended for treating skin lesions in SLE?

Topical corticosteroids (correct)

High-dose IV corticosteroids

Antimalarial drugs

Oral contraceptives

What is the primary concern that necessitates regular vision examinations for patients taking hydroxychloroquine?

Potential liver damage.

Increased risk of cataracts.

Accelerated osteoporosis.

Retinal toxicity and possible irreversible blindness. (correct)

When treating severe SLE, what is the initial dosage range of prednisone typically prescribed?

40 to 60 mg per day Signup and view all the answers

Which of the following side effects is NOT associated with long-term corticosteroid therapy?

Improved adrenal hormone production. Signup and view all the answers

What is the purpose of belimumab (Benlysta) in the treatment of SLE?

Decreasing the activity of B lymphocytes. Signup and view all the answers

Which lifestyle recommendation is advised for patients with SLE to mitigate cardiovascular risks?

Consuming a healthy diet rich in omega-3 fatty acids. Signup and view all the answers

Which of the following factors has been linked to exacerbations of systemic lupus erythematosus?

Increased stress. Signup and view all the answers

What kind of therapy is recommended for patients experiencing severe manifestations of SLE?

High-dose IV corticosteroids and cytotoxic therapy. Signup and view all the answers

Which of the following statements about corticosteroid therapy is TRUE?

Patients using corticosteroids are at risk for osteoporosis. Signup and view all the answers

What is the primary reason for collaboration among healthcare team members in the management of SLE?

To provide comprehensive care that includes nutrition and exercise plans Signup and view all the answers

Which diagnostic test is considered the most specific for confirming SLE?

Anti-DNA antibody testing Signup and view all the answers

Which laboratory finding is commonly associated with SLE in patients?

Elevated erythrocyte sedimentation rate Signup and view all the answers

What type of therapy may be needed for patients with mild or remittent SLE?

Supportive care with minimal therapy Signup and view all the answers

In the context of renal involvement in SLE, what findings might be present in a urinalysis?

Mild proteinuria and hematuria Signup and view all the answers

What role do referrals to counselors play in the management of SLE?

They help manage stress for patients and caregivers. Signup and view all the answers

Why might a kidney biopsy be performed in SLE patients?

To assess the severity of renal lesions Signup and view all the answers

What condition is particularly concerning for patients with SLE in relation to renal health?

End-stage renal disease Signup and view all the answers

What common laboratory finding might indicate severe complications in SLE affecting blood cell counts?

Thrombocytopenia Signup and view all the answers

Which of the following is NOT typically involved in the healthcare team for managing SLE?

Cardiologists Signup and view all the answers

Study Notes

Systemic Lupus Erythematosus (SLE) Management

Collaboration is crucial for SLE management, involving patients and healthcare teams. Nurses may collaborate with dietitians and physical therapists for patients with severe manifestations. Counselors can also help patients and caregivers manage stress.

Diagnosis

SLE diagnosis relies on patient history, physical assessment, and lab studies.
No single test confirms SLE in all cases.
Autoantibodies cause abnormalities in lab tests.

Diagnostic Tests

Anti-DNA antibody testing: Highly specific for SLE.
Erythrocyte sedimentation rate (ESR): Typically elevated, potentially above 100 mm/hr.
Serum complement levels: Usually decreased due to antigen-antibody complex formation.
Complete Blood Count (CBC) abnormalities: Potential for anemia, leukopenia, lymphocytopenia, and thrombocytopenia.
Urinalysis: May show proteinuria, hematuria, and blood cell casts during kidney involvement exacerbations.
Renal function tests: (serum creatinine and blood urea nitrogen) assess renal disease extent.
Kidney biopsy: May be performed for assess renal lesion severity and guide treatment.

Surgery

No surgery for treating SLE directly.
SLE may cause kidney damage, leading to end-stage renal disease requiring hemodialysis, peritoneal dialysis, or kidney transplant.

Pharmacologic Therapy

Mild or remitting SLE: Often requires supportive care only. Aspirin or NSAIDs may manage symptoms like arthralgia, arthritis, inflammation, fever, fatigue. (Consider potential liver toxicity with aspirin). Low-dose corticosteroids (like prednisone) may also be beneficial.
Topical corticosteroids: For skin lesions
Oral contraceptives: Potentially trigger acute episodes, so may be avoided.
Antimalarial drugs (e.g., hydroxychloroquine): Treat skin and arthritic manifestations. Reduce acute SLE episodes in mild to inactive disease. Use adjunctively in lupus nephritis. Monitor for retinal toxicity (6-month eye exams).
Severe SLE: High-dose corticosteroid therapy (40-60 mg prednisone daily), tapered as tolerated. Long-term use possible. Monitor for various side effects (cushingoid effects, weight gain, hypertension, infection, osteoporosis, hypokalemia) and discuss the need for long-term management options.
Severe manifestations requiring emergency management: (severe neurologic involvement, systemic vasculitis, thrombocytopenia, glomerulonephritis, or alveolar hemorrhage) may need high-dose IV corticosteroids and cytotoxic therapy.
Belimumab (Benlysta): First FDA-approved SLE drug. Reduces B lymphocyte activity. Given intravenously or subcutaneously.
Immunosuppressive agents: Increased risk of infection, malignancy, bone marrow depression and drug-specific toxicities

Nonpharmacologic Therapy

Smoking cessation: crucial, as it exacerbates cardiovascular risks and increases infection susceptibility.
Consult HCP: Before immunizations during infection/suspected infection.
Healthy diet: Encouraged. Oily fish may offer cardiovascular protection.
Herbal supplements and vitamins: Consult HCP before adding to diet, as some can have undesirable or lupus flare-up effects.
Stress reduction: Important for managing SLE symptoms and overall quality of life. Peer mentoring can be helpful.

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Description

This quiz covers the management and diagnosis of Systemic Lupus Erythematosus (SLE). It emphasizes the importance of collaboration among healthcare teams and discusses various diagnostic tests used to identify SLE. Test your knowledge on the specific symptoms, laboratory findings, and treatment approaches for this complex autoimmune disorder.