Presentation
To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation. [ncbi.nlm.nih.gov]
[…] areas (''maculopapular lupus rash'', generalized form); SCLE which presents with red, raised, scaly rash on sun-exposed areas of the body (annular/polycyclic form or papulosquamous form); CCLE which presents either as red to purple, well demarcated, [orpha.net]
Although presentation may be similar in arthralgia and fatigue, patients with DILE are less likely to present with organ damage or dermatologic manifestations. [uspharmacist.com]
Entire Body System
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Swollen Knee
One person with lupus may have swollen knees and fever. Another person may be tired all the time or have kidney trouble. Someone else may have rashes. Lupus can involve the joints, the skin, the kidneys, the lungs, the heart and/or the brain. [medicinenet.com]
Immune System
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Splenomegaly
[…] neuropathies and thromboembolic disease Ophthalmologic manifestations, particularly keratoconjunctivitis sicca as well as more uncommon manifestations Haematologic manifestations, including cytopenias, thrombophilia, thromboembolic disease, lymphadenopathy and splenomegaly [els.net]
Enlargement of the spleen (splenomegaly) occurs in about 10% of people. [msdmanuals.com]
Another new approach is the use of stem cell transplantation for severe disease, which has as a complication graft-versus-host disease. [18] Differential Diagnosis Adult-onset Still disease characterized by arthralgia, fever, lymphadenopathy, and splenomegaly [ncbi.nlm.nih.gov]
Musculoskeletal
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Arthralgia
The most common presenting symptoms are constitutional, such as fatigue, weight loss, and fever without a focal infection, occurring in up to 90% of patients. 9 Other common presenting symptoms include arthralgia and myalgia, which occur in up to 95% [aafp.org]
[…] manifestations, including cutaneous (malar rash, photosensitivity), ocular (keratoconjunctivitis sicca, retinopathy), gastrointestinal (oral ulceration, abdominal pain), cardiac (atherosclerosis, chest pain), pulmonary (serositis, pleurisy), musculoskeletal (arthralgia [orpha.net]
Systemic sclerosis characterizes by decreased joint mobility, arthralgia, myalgia, Raynaud phenomenon, and skin induration. It can distinguish from SLE testing for specific antibodies. [ncbi.nlm.nih.gov]
Patients may be treated symptomatically with nonsteroidal anti- inflammatory drugs (NSAIDs) for the arthralgias, myalgias, fever, and arthritis. Rashes may respond well to antimalarials or topical preparations. [epilepsy.com]
Treatment for patients systemic lupus erythematosus often complicated by the fact that the clinical spectrum of the disease is rather diverse, and patients often present with very vague manifestations (including fever, fatigue, and arthralgia) which can [adcreview.com]
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Joint Swelling
swelling and synovitis hand and wrist manifestation are common (90%) swelling and synovitis of PIPs, MCPs, and carpus ligamentous laxity Raynaud's phenomenon dorsal subluxation of ulna at DRUJ Imaging Studies Radiographs usually no evidence of joint [orthobullets.com]
Common symptoms include: severe fatigue joint pain joint swelling headaches a rash on the cheeks and nose, which is called a “butterfly rash” hair loss anemia blood-clotting problems fingers turning white or blue and tingling when cold, which is known [healthline.com]
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Knee Pain
Multiple bone infarcts in a 26-year-old woman with SLE and left knee pain. (a) Anteroposterior radiograph of the left knee shows sclerosis in the distal femur and proximal tibia. [pubs.rsna.org]
Workup
Systemic Lupus Erythematosus (SLE) Workup. (19 September 2016 updated.) Available online at . Accessed March 27, 2017. Fonti utilizzate nelle precedenti revisioni (2003 August). Handout on Health: Systemic Lupus Erythematosus. [labtestsonline.it]
The focus of this article is ACLE. [2, 3] (See Etiology, History, Physical Examination, and Workup .) Relationship of acute cutaneous lupus erythematosus (ACLE) to systemic disease. LE is lupus erythematosus. [emedicine.medscape.com]
Systemic Lupus Erythematosus (SLE) Workup. (19 September 2016 updated.) Available online at . Accessed March 27, 2017. Sources Used in Previous Reviews (2003 August). Handout on Health: Systemic Lupus Erythematosus. [labtestsonline.org]
HLA Type
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HLA-DR4
Besides patients with HLA-DR4 make anti-Smith antibodies. [ncbi.nlm.nih.gov]
Treatment
We also reviewed published case reports on skin lesions that developed after HCQ treatments, and propose strategies for early cutaneous eruptions after HCQ treatments. [ncbi.nlm.nih.gov]
Limited treatment options Despite enormous efforts in finding real and conclusive answers regarding the etiology and pathogenesis of systemic lupus erythematosus, treatment is still complex and treatment options remain limited. [adcreview.com]
Potent topical steroids and antimalarials are the mainstay of treatment. [jabfm.org]
Prognosis
The Committee on Prognosis Studies in SLE. Arthritis Rheum 1992 ; 35: 630 – 640. Google Scholar Medline 10. Gladman, D, Ginzler, E, Goldsmith, C. [doi.org]
It is known commonly to affect females but has worse prognosis when males or blacks are affected. [ncbi.nlm.nih.gov]
Prognosis • SLE patient prognosis is variable – 5-year survival rate: approx. 82% to 90%; – 20 years survival rate: 63% to 75% – Prognosis depends on which organs are affected and how frequently the disease is reactivated – Common cause of death is renal [slideshare.net]
Certain patient characteristics portend a worse prognosis in SLE: male sex, age (both young and old), low socioeconomic status, and black race. [visualdx.com]
Damage to the kidneys or nervous system is associated with a poor prognosis! [amboss.com]
Etiology
[…] due to the underlying etiology. [icd10data.com]
Etiology Etiology is still elusive but it is thought to be multifactorial, involving a genetic predisposition. [orpha.net]
Etiology The exact etiology is unknown, but several predisposing factors have been identified: Genetic predisposition: HLA-DR2 and HLA-DR3 are commonly present in individuals with SLE Genetic deficiency of classical pathway complement proteins (C1q, C2 [amboss.com]
It is of unknown etiology, but is thought to represent a failure of the regulatory mechanisms of the autoimmune system. [fpnotebook.com]
Epidemiology
Epidemiology of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 2002 ; 16: 847 – 858. Google Scholar Medline ISI 2. Borchers, AT, Keen, CL, Shoenfeld, Y, Gershwin, ME. [doi.org]
SLE Epidemiology: Epidemiologic Subtypes and Risk Factors for Development Pages 1-12 The Immunopathogenesis and Immunopathology of Systemic Lupus Erythematosus Pisetsky, David S., M.D., Ph.D. [springer.com]
Table of Contents Epidemiology and Diagnosis 1. Epidemiology 2. Disease Activity Measures 3. Disease Outcome 4. Quality of Life and Economic Aspects Pathogenesis 1. Overview of the Pathogenesis of SLE 2. Genetics 3. Hormones 4. [elsevier.com]
The Congress will span the disciplines dedicated to improving outcomes in SLE, from basic and translational science through epidemiology and outcomes research. Learn More Here [lupusresearch.org]
Pathophysiology
The pathophysiology of SLE involve injury to the bodies own cells leading damaged cell proteins and DNA. Injured cells can subsequently lead to organ injury. [youtube.com]
Medscape Education Rheumatology, September 2017 Concepts in Systemic Lupus Erythematosus: From Pathophysiology to Practice Five leading experts in lupus research and treatment discuss the latest developments. [medscape.org]
PATHOPHYSIOLOGY OF SLE 8. [slideshare.net]
EDUCATIONAL OBJECTIVES • Describe the pathophysiology and explain the various clinical manifestations of systemic lupus erythematosus (SLE). • Define the differential diagnosis for SLE. • List the elements of the laboratory work-up used in the diagnosis [mdedge.com]
procainamide, hydralazine) [4] References:[1][4] Pathophysiology Hormonal and environmental factors as well as genetic predisposition (see “Etiology” above) loss of self-tolerance production of antibodies against perceived nuclear and cellular antigens [amboss.com]
Prevention
Prevention There is no way to prevent SLE since the cause is not known. [winchesterhospital.org]
Treat flares quickly: This will help prevent serious illness. Prevent a lupus flare: Eat healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. [drugs.com]
Moreover, the effect seemed independent of immune suppression, implying that Plaquenil can directly act to prevent the blood clots. [medicinenet.com]
Prevent or reduce flares. Help the immune system. Reduce or prevent damage to joints. Balance the hormones. Treat problems related to lupus, such as high cholesterol, high blood pressure, or infection. Alternative treatments may improve symptoms. [niams.nih.gov]
If they take corticosteroids, they should be eating foods low in salt to help prevent high blood pressure and low in sugar to help prevent diabetes and weight gain. [printo.it]