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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
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SLE Diagnostic Criteria: ACR Guidelines need 4 out of 11
- Malar Rash
- Discoid Rash
- Photsensitivity
- Oral Ulcers
- Arthritis (nonerosive)
- Serositis
- Renal Disorder (U/A with 3+ protein or >0.5 g/d)
- Seizures or psychosis
- Hematologic manifestations (Hemolytic Anemia or Leukopenia)
- Immunologic (Anti-DS DNA, anti-Smith, and/or antiphospholipid Abs)
- 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
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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:
- Minimal mesangial glomerulonephritis - favorable prognosis
- Mesangial proliferative glomerulonephritis - favorable prognosis
- Focal proliferative glomerulonephritis - poor prognosis without adequate management
- Diffuse proliferative glomerulonephritis - poor prognosis without adequate management
- Membranous glomerulonephritis - poor prognosis without adequate management
- Advanced sclerosing glomerulonephritis - poor prognosis
Posted 07/12/16 09:29:10 AM by Adam Faye
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Mainstay of Lupus therapy includes hydroxychloroquine. Before initiating therapy:
- Eye Exam (retinal toxicity - deposits in the retina and is dose/accumulation dependent)
- G6PD (hemolytic anemia) - X-linked recessive so more common in males
Posted 07/12/16 02:31:26 PM by Adam Faye
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Complications of SLE:
- Higher CV mortality (5-6x)
- Infectious complications
- Osteoporosis (partly from steroids)
- Thrombosis
Posted 07/12/16 02:35:37 PM by Adam Faye
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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
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For further reading...
Posted 07/12/16 03:04:56 PM by Adam Faye