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Lupus Erythematosus


Presentation

  • To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation.[ncbi.nlm.nih.gov]
  • We present a case of a male black patient with SLE who presented with neurolupus, serositis, skin manifestations and Class IV/V lupus nephritis on histology.[ncbi.nlm.nih.gov]
  • The present paper aimed to report pathological findings and clinical course of the patient.[ncbi.nlm.nih.gov]
  • The patient presented to the Sultan Qaboos University Hospital in Muscat, Oman, in April 2013. The oedema had been present for two years before admission.[platform.almanhal.com]
  • We describe a patient of SLE who presented with ILD as the only manifestation.[sjmms.net]
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]
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]
  • Splenomegaly occurs in 10% of patients. Neurologic symptoms can result from involvement of any part of the central or peripheral nervous system or meninges. Mild cognitive impairment is common.[merckmanuals.com]
Arthralgia
  • 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]
  • The most widely used medications are: Analgesics [1] : These medications are used to control the pain associated with arthralgia, arthritis, and ulcers that are caused by SLE. [3] Non-Steroidal Anti-inflammatory Drugs (NSAIDS): These medications help[physio-pedia.com]
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]
Musculoskeletal Pain
  • Godoy, Differences in Pressure-Pain Threshold Between Healthy Women and Patients with Fibromyalgia Syndrome, Systemic Lupus Erythematosus, and Rheumatoid Arthritis, Journal of Musculoskeletal Pain, 17, 2, (139), (2009). Stephen L.[doi.org]
  • The health care professional should help establish a regimen for adequate relief of both the musculoskeletal pain and chronic fatigue experienced by most patients, encouraging adequate rest.[medical-dictionary.thefreedictionary.com]
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]
  • 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]
  • SLE: Joint radiography Chest radiography and chest CT scanning Echocardiography Brain MRI/MRA Cardiac MRI Procedures Procedures that may be performed in patients with suspected SLE include the following: Arthrocentesis Lumbar puncture Renal biopsy See Workup[emedicine.medscape.com]

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]
  • LESSONS: We report a case of LET converted from DLE with diverse lesions, unusual pathologic findings and slow response to the treatment of corticosteroids combined with hydroxychloroquine.[ncbi.nlm.nih.gov]
  • Treatment by oral prednisolone at 30 mg/day was initiated. Pericardial fluid, pleural effusions, and thickening of the gallbladder wall improved after 3 months of treatment according to computed tomography.[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]
  • Kyttaris, Novel Treatments in Lupus, Frontiers in Immunology, 10.3389/fimmu.2018.02658, 9, (2018).[doi.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]
  • Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med 2006 ; 119: 700 – 706. Google Scholar Medline ISI 9. Flower, C, Hennis, AJ, Hambleton, IR, Nicholson, GD, Liang, MH.[doi.org]
  • Renal changes in systemic lupus erythematosus: The lupus nephritis The lupus nephritis, which occurs in over half of the patients, is crucial for the prognosis of SLE.[lecturio.com]

Etiology

  • […] due to the underlying etiology.[icd10data.com]
  • Etiology The current best estimate is that SLE affects between 5,000 and 10,000 children in the United States.[pedclerk.bsd.uchicago.edu]
  • Etiology of Lupus Causes of the systemic lupus erythematosus The exact etiology of lupus is unknown, but there are certain predisposing genetic factors (e.g., the surface molecules HLA-DR2 and HLA-DR3 ).[lecturio.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]
  • 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]
  • Late-onset systemic lupus erythematosus: Epidemiology, diagnosis and treatment. Drugs Aging 2012 ; 29: 181 – 189. Google Scholar Medline ISI 18. Sato, VA, Marques, ID, Goldenstein, PT.[doi.org]
  • Links: epidemiology pathogenesis clinical features investigations diagnosis differential diagnosis management prognosis co-morbidities in SLE (systemic lupus erythematosus)[gpnotebook.co.uk]
  • 1 History of Lupus, 1 2 Definition and Classification of Lupus and Lupus-Related Disorders, 15 3 The Epidemiology of Lupus, 23 SECTION 2 Pathogenesis 4 Overview of Lupus Pathogenesis, 44 5 Genetics of Human SLE, 54 6 Epigenetics of Lupus, 69 7 The Environment[elsevier.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • 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]
  • This lesson will discuss the complex pathophysiology behind systemic lupus erythematosus. You will learn why it occurs, what may trigger it, and how it can be properly diagnosed, treated, and managed.[study.com]
  • Pathophysiology of Lupus The development of systemic lupus erythematosus The pathological mechanism of lupus is a precipitation of immune complexes at the basal membrane of the cell walls.[lecturio.com]
  • In this Review, Gupta and Kaplan explore the contribution of neutrophils and NETs to the pathophysiology of systemic autoimmune disorders that can affect the kidneys, and discuss neutrophils as novel therapeutic targets for these diseases.[nature.com]

Prevention

  • 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]
  • 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]
  • Prevention Because the cause of SLE is unknown, no one knows how to prevent it.[rheumatology.org]
  • 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]
  • Taking medicine to help prevent osteoporosis caused by corticosteroids. Preventing plaque in the arteries (atherosclerosis) that can be made worse by corticosteroids.[healthy.kaiserpermanente.org]

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