Systemic Lupus Erythematosus (SLE) Basics

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8 Questions

What is the approximate prevalence of systemic lupus erythematosus (SLE) worldwide?

1 in 2,000 people

What is the primary mechanism of tissue damage in SLE?

Immune system mistakenly attacks healthy tissues

Which of the following is NOT a clinical feature of SLE?

Gastrointestinal symptoms

What is the female-to-male ratio of SLE prevalence?

9:1

Which of the following is a diagnostic criterion for SLE?

Malar rash

What is the role of cytokines in SLE?

Promoting inflammation

Which of the following is a common hematological feature of SLE?

Anemia

How many of the 11 diagnostic criteria must be present to diagnose SLE?

At least 4

Study Notes

Definition and Epidemiology

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems.
  • It is characterized by the production of autoantibodies against nuclear and cytoplasmic antigens.
  • SLE affects approximately 1 in 2,000 people worldwide, with a higher prevalence in women (9:1 female-to-male ratio) and certain ethnic groups (African Americans, Hispanics, and Asians).

Pathophysiology

  • The immune system mistakenly attacks healthy tissues, leading to inflammation and damage to organs such as the skin, joints, kidneys, and nervous system.
  • Autoantibodies against double-stranded DNA, histones, and other nuclear antigens contribute to the disease process.
  • Cytokines, such as TNF-α and IL-1β, play a role in promoting inflammation and tissue damage.

Clinical Features

  • Mucocutaneous: butterfly rash (malar rash), discoid lupus, oral ulcers, and photosensitivity
  • Musculoskeletal: arthritis, arthralgia, and myalgia
  • Renal: glomerulonephritis, proteinuria, and nephrotic syndrome
  • Neurological: seizures, psychosis, and peripheral neuropathy
  • Cardiovascular: pericarditis, myocarditis, and premature atherosclerosis
  • Hematological: anemia, leukopenia, lymphopenia, and thrombocytopenia

Diagnosis

  • Diagnostic criteria: at least 4 of the following 11 criteria:
    1. Malar rash
    2. Discoid rash
    3. Photosensitivity
    4. Oral ulcers
    5. Arthritis
    6. Serositis (pleuritis or pericarditis)
    7. Renal disorder (proteinuria or cellular casts)
    8. Neurological disorder (seizures, psychosis, or mononeuropathy)
    9. Hematological disorder (anemia, leukopenia, lymphopenia, or thrombocytopenia)
    10. Immunological disorder (anti-dsDNA, anti-Sm, or antiphospholipid antibodies)
    11. Antinuclear antibody (ANA) positivity
  • Laboratory tests: complete blood count, erythrocyte sedimentation rate, ANA, anti-dsDNA, and complement levels

Treatment and Management

  • Medications: NSAIDs, corticosteroids, immunosuppressants (e.g., hydroxychloroquine, azathioprine), and biologics (e.g., belimumab)
  • Lifestyle modifications: sun protection, stress management, and regular exercise
  • Monitoring: regular check-ups, laboratory tests, and disease activity scores (e.g., SLEDAI)

Definition and Epidemiology

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems.
  • SLE is characterized by the production of autoantibodies against nuclear and cytoplasmic antigens.
  • The disease affects approximately 1 in 2,000 people worldwide.
  • SLE has a higher prevalence in women (9:1 female-to-male ratio) and certain ethnic groups (African Americans, Hispanics, and Asians).

Pathophysiology

  • The immune system mistakenly attacks healthy tissues, leading to inflammation and damage to organs.
  • Autoantibodies against double-stranded DNA, histones, and other nuclear antigens contribute to the disease process.
  • Cytokines, such as TNF-α and IL-1β, play a role in promoting inflammation and tissue damage.

Clinical Features

  • Mucocutaneous manifestations include butterfly rash, discoid lupus, oral ulcers, and photosensitivity.
  • Musculoskeletal manifestations include arthritis, arthralgia, and myalgia.
  • Renal manifestations include glomerulonephritis, proteinuria, and nephrotic syndrome.
  • Neurological manifestations include seizures, psychosis, and peripheral neuropathy.
  • Cardiovascular manifestations include pericarditis, myocarditis, and premature atherosclerosis.
  • Hematological manifestations include anemia, leukopenia, lymphopenia, and thrombocytopenia.

Diagnosis

  • Diagnosis is based on at least 4 of the 11 criteria, including malar rash, discoid rash, photosensitivity, and more.
  • Laboratory tests include complete blood count, erythrocyte sedimentation rate, ANA, anti-dsDNA, and complement levels.

Treatment and Management

  • Medications used to treat SLE include NSAIDs, corticosteroids, immunosuppressants, and biologics.
  • Lifestyle modifications include sun protection, stress management, and regular exercise.
  • Regular monitoring is necessary, including check-ups, laboratory tests, and disease activity scores (e.g., SLEDAI).

Learn about the definition, epidemiology, and pathophysiology of Systemic Lupus Erythematosus, a chronic autoimmune disease that affects multiple organs and systems.

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