• SLE Demographics:
  • Adults - 9:1, Female:Male ratio vs. Adolescents - 5:1, Female:Male ratio
  • Hispanic, African American individuals - 2:1 ratio
  
  

  Posted 07/12/16 09:12:43 AM by Adam Faye

• SLE Diagnostic Criteria: ACR Guidelines need 4 out of 11
  1.  Malar Rash
  2. Discoid Rash
  3. Photsensitivity
  4. Oral Ulcers
  5. Arthritis (nonerosive)
  6. Serositis
  7. Renal Disorder (U/A with 3+ protein or >0.5 g/d)
  8. Seizures or psychosis
  9. Hematologic manifestations (Hemolytic Anemia or Leukopenia)
  10. Immunologic (Anti-DS DNA, anti-Smith, and/or antiphospholipid Abs)
  11. ANA 
  
  
  Other criteria --> 2012 SLICC SLE Criteria: need at least 4 criteria (at least one clinical and 1 laboratory)
  
  

  Posted 07/12/16 09:20:03 AM by Adam Faye

• Lupus Nephritis: (Kidney disease affects 50-75% patients with SLE)
  • Immune Complex-mediated
  • Early signs are proteinuria, hematuria, and cellular casts
  • Biopsy is usually indicated for diagnostic/prognostic information
  
  Classes:
  1. Minimal mesangial glomerulonephritis - favorable prognosis
  2. Mesangial proliferative glomerulonephritis - favorable prognosis
  3. Focal proliferative glomerulonephritis - poor prognosis without adequate management
  4. Diffuse proliferative glomerulonephritis - poor prognosis without adequate management
  5. Membranous glomerulonephritis - poor prognosis without adequate management
  6. Advanced sclerosing glomerulonephritis - poor prognosis
  
  
  
  

  Posted 07/12/16 09:29:10 AM by Adam Faye

• Mainstay of Lupus therapy includes hydroxychloroquine. Before initiating therapy:
  1. Eye Exam (retinal toxicity - deposits in the retina and is dose/accumulation dependent)
  2. G6PD (hemolytic anemia) - X-linked recessive so more common in males
  
  

  Posted 07/12/16 02:31:26 PM by Adam Faye

• Complications of SLE:
  1. Higher CV mortality (5-6x)
  2. Infectious complications
  3. Osteoporosis (partly from steroids)
  4. Thrombosis
  
  

  Posted 07/12/16 02:35:37 PM by Adam Faye

• SLE:
  Arthralgias can be treated with NSAIDs
  Low-dose corticosteroids are used for mild rash or joint symptoms
  Kidney or nervous sytem involvement require additional immunosupresseion
  
  

  Posted 07/12/16 02:53:49 PM by Adam Faye

• For further reading...

  SLE pathophysiology
  
  

  Posted 07/12/16 03:04:56 PM by Adam Faye

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