-IBIS-1.5.0-
tx
immune system
systemic lupus erythematosus
diagnoses
definition and etiology
definition: An inflammatory autoimmune connective tissue disorder.
etiology: The cause is unknown. SLE is seen mainly in young women aged 20-40 (90% of cases), but in 10% of the cases the patient is a child or a senior citizen.
signs and symptoms
SLE may have an acute or gradual onset.
Skin: "Butterfly rash" plus other discoid skin lesions; worse sunlight; oral lesions/ulcers.
Fatigue, malaise, fever, anorexia, nausea, weight loss.
Arthralgias and/or myalgias.
Anemia, leukopenia, lymphopenia.
Pleurisy, pericarditis.
Proteinuria, cellular casts.
Ascites.
Many other possible symptoms based on the organ system involved (which may be any).
lab findings:
(+) LE cells (60%)
(+) ANA (FANA detects 95%, best test)
(+) Anti-DNA antibodies in 40-80% of cases
Increased ESR reflecting disease activity
false (+) VDRL
(+) anti-ENA (anti-RNP, anti-Sm)
(+) lupus band test done on skin biopsy
anemia of chronic disease, or occasionally hemolytic
leukocytopenia reflects disease activity
decreased C3C4 (complement fractions) and C1q binding
circulating immune complexes reflect disease activity
course and prognosis
The prognosis varies with organs involved and degree of severity. Patients with kidney or cardiac involvement have a poorer prognosis that those whose condition is limited to joints, skin, and serous membranes. SLE is characterized by exacerbations and remissions, although long-lasting remissions are only seen in 10% of patients. The mortality rate is 5%/year.
differential diagnosis
Discoid LE.
Other connective tissue or auto-immune diseases.
Systemic nodular panniculitis.
footnotes