Difference between revisions of "Systemic lupus erythematosus"

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*'''P'''hotosensitive.
*'''P'''hotosensitive.
*'''A'''rthritis.
*'''A'''rthritis.
*'''S'''erositis (pericardial or pleural).
*[[serositis|'''S'''erositis]] (pericardial or [[Systemic lupus erythematosus pleurisy|pleural]]).
*'''R'''enal dysfunction.
*'''R'''enal dysfunction.
**Proteinuria (>0.5 g/day) or cellular casts.
**Proteinuria (>0.5 g/day) or cellular casts.
Line 31: Line 31:
*[[Thrombosis]].
*[[Thrombosis]].


==Lymph node pathology==
==Microscopic==
{{Main|Lymph_node_pathology#Systemic_lupus_erythematosus_lymphadenopathy}}
===Lymph node pathology===
{{Main|Systemic lupus erythematosus lymphadenopathy}}


==Skin==
===Skin===
:See: ''[[Lupus erythematosus]]''.
:See: ''[[Lupus erythematosus]]''.


==Pancreas==
SLE can have a variety of skin manifestations:
*Vacuolar interface dermatitis ([[lupus erythematosus]]) - classic finding.
*[[Panniculitis]].
*Bullae ([[bullous disease|bullous]] systemic lupus erythematosus).
*Deep and superficial dermal, lymphocyte predominant, inflammation.
 
===Pancreas===
*[[Pancreatitis]].
*[[Pancreatitis]].


==Kidney disease==
===Kidney disease===
{{Main|Medical_kidney_diseases#Lupus_nephritis}}
{{Main|Lupus nephritis}}


==Vasculitis==
===Vasculitis===
{{Main|Vasculitis}}
{{Main|Vasculitis}}


Images:
Images:
*[http://path.upmc.edu/cases/case202.html Vasculitis assoc. with SLE - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case202.html Vasculitis assoc. with SLE - several images (upmc.edu)].
===Joint disease===
:See: ''[[Rheumatic joint disease]]''.
==See also==
*[[Mixed connective tissue disease]].
*[[Sjögren syndrome]].
*[[Scleroderma]].


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Clinical]]
[[Category:Clinical]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 13:41, 9 May 2017

Systemic lupus erythematosus, abbreviated SLE, is a common autoimmune disorder that typically affects multiple organs.

Diagnosis

The diagnosis rests on the evaluation of eleven clinical/laboratory criteria; if four of the eleven criteria are present, the diagnosis is made.[1]

Criteria

Mnemonic DAMP AS RHINO:[2]

  • Discoid rash.
  • ANA +ve
    • Sensitivity ~99%;[3] negative finding essential excludes the diagnosis.
  • Malar rash.
  • Photosensitive.
  • Arthritis.
  • Serositis (pericardial or pleural).
  • Renal dysfunction.
    • Proteinuria (>0.5 g/day) or cellular casts.
  • Hematologic abnormality.
    • Includes: anemia, leukopenia, lymphopenia, thrombocytopenia, hypocomplementemia (low C3 & C4).
  • Immunologic abnormality.
    • Anti-Smith antibody, APLA, VDRL false positive (test for syphilis).
  • Neurologic abnormality, e.g. seizures, psychosis.
  • Oral ulcer or nasal ulcer.

Prognosis

Survival:[4]

  • ~90% @ 10 years.

Mortality (leading causes):[4]

  • Active SLE - esp. kidney involvement.
  • Infections.
  • Thrombosis.

Microscopic

Lymph node pathology

Skin

See: Lupus erythematosus.

SLE can have a variety of skin manifestations:

  • Vacuolar interface dermatitis (lupus erythematosus) - classic finding.
  • Panniculitis.
  • Bullae (bullous systemic lupus erythematosus).
  • Deep and superficial dermal, lymphocyte predominant, inflammation.

Pancreas

Kidney disease

Vasculitis

Images:

Joint disease

See: Rheumatic joint disease.

See also

References

  1. Gill, JM.; Quisel, AM.; Rocca, PV.; Walters, DT. (Dec 2003). "Diagnosis of systemic lupus erythematosus.". Am Fam Physician 68 (11): 2179-86. PMID 14677663.
  2. URL: http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy. Accessed on: 11 September 2011.
  3. Edworthy, SM.; Zatarain, E.; McShane, DJ.; Bloch, DA. (Oct 1988). "Analysis of the 1982 ARA lupus criteria data set by recursive partitioning methodology: new insights into the relative merit of individual criteria.". J Rheumatol 15 (10): 1493-8. PMID 3060613.
  4. 4.0 4.1 Madhok, R.; Wu, O. (Nov 2007). "Systemic lupus erythematosus.". Am Fam Physician 76 (9): 1351-3. PMID 18019880.