Systemic Lupus Erythematosus

Systemic Lupus Erythematosus = SLE = Lupus

A rheumatic disease of unknown cause, is characterized by autoantibodies directed against self-antigens and resulting inflammatory damage to target organs :

the kidneys

blood cells

the central nervous system (CNS)

Etiology :

unknown

hallmark : autoantibody production against self-antigens

Clinical manifestations :

fever

musculoskeletal : arthralgia, arthritis, tendinitis, myositis

rash : butterfly rash

include nasal bridge

thickened epidermis

photosensitive

mucous membrane : vasculitic erythema – ulcers

serositis : pleural, pericardial, peritoneal surfaces

hepatosplenomegaly

GI manifestations : pain, diarrhea, melena, hepatitis

neurologic manifestations

renal disease : hypertension, nephrosis,

acute renal failure

Laboratory findings

antinuclear antibodies (ANA) : excellent screening

anti-double-stranded DNA : specific for lupus

CH50, C3, C4 : decreased in active disease

Treatment

Non farmakologis :

Education

social & psikologis support

Bed rest

Sun block

Follow up

Farmakologis :

Mild : sun block (Parasol)

Corticosteroid (control symptoms and autoantibody product) :

Prednison : 1-2 mg/kg/24hr — divided doses, and when complement levels rise to within the normal range, the dose is carefully tapered over 2-3 yr to the lowest effective dose

Severe disease — cytotoxic therapy :

Cyclophosphamide (multi organ involvment)

(Lupus Nefritis & neuropsychiatric)

Azathioprine

Immunoglobulin

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