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. | ||
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==Microscopic== | ==Microscopic== | ||
===Lymph node pathology=== | ===Lymph node pathology=== | ||
{{Main| | {{Main|Systemic lupus erythematosus lymphadenopathy}} | ||
===Skin=== | ===Skin=== | ||
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===Kidney disease=== | ===Kidney disease=== | ||
{{Main| | {{Main|Lupus nephritis}} | ||
===Vasculitis=== | ===Vasculitis=== | ||
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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== | ==See also== | ||
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.
- 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
Main article: Systemic lupus erythematosus lymphadenopathy
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
Main article: Lupus nephritis
Vasculitis
Main article: Vasculitis
Images:
Joint disease
- See: Rheumatic joint disease.
See also
References
- ↑ Gill, JM.; Quisel, AM.; Rocca, PV.; Walters, DT. (Dec 2003). "Diagnosis of systemic lupus erythematosus.". Am Fam Physician 68 (11): 2179-86. PMID 14677663.
- ↑ URL: http://www.medicalmnemonics.com/cgi-bin/return_browse.cfm?browse=1&discipline=Rheumatology%20%2F%20Allergy. Accessed on: 11 September 2011.
- ↑ 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.
- ↑ 4.0 4.1 Madhok, R.; Wu, O. (Nov 2007). "Systemic lupus erythematosus.". Am Fam Physician 76 (9): 1351-3. PMID 18019880.