Presentation
A number of patients will present with a cluster of features suggestive of an autoimmune rheumatic disease, though at initial presentation the final diagnosis appears unclear. [ojrd.biomedcentral.com]
How can SLE present? SLE can present in several ways depending on the type of autoantibodies present. [rheumatology.uw.edu]
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% of [aafp.org]
To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation. [ncbi.nlm.nih.gov]
Immune System
- 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]
[…] numbers of special red blood cells (platelets) that assist in blood clotting functions (thrombocytopenia), low levels of other circulating red blood cells (anemia), low levels of certain white blood cells (neutropenia), and abnormally large spleen (splenomegaly [rarediseases.org]
Entire Body System
- 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]
Musculoskeletal
- Arthralgia
Arthralgia, arthritis, osteonecrosis (avascular necrosis of bone), and myopathy are the principal manifestations. Arthritis and arthralgias have been noted in up to 95 percent of patients with SLE (11). [ncbi.nlm.nih.gov]
Arthralgias are usually controlled with NSAIDs. [msdmanuals.com]
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]
- Joint Swelling
[…] common in patients taking glucocorticoids Raynaud's phenomenon Presentation Symptoms fever pain in multiple joints hip pain (osteonecrosis) Physical exam butterfly malar rash large joint swelling and synovitis hand and wrist manifestation are common [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]
- 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 http://emedicine.medscape.com/article/332244-workup. Accessed March 27, 2017. Fonti utilizzate nelle precedenti revisioni (2003 August). [labtestsonline.it]
Systemic Lupus Erythematosus (SLE) Workup. (19 September 2016 updated.) Available online at http://emedicine.medscape.com/article/332244-workup. Accessed March 27, 2017. Sources Used in Previous Reviews (2003 August). [labtestsonline.org]
EULAR/ACR criteria have a sensitivity of 96.1% and a specificity of 93.4%.41 Diagnostic workup for SLE is detailed in Table 4. [rheumatologyadvisor.com]
Treatment
Medical treatment for lupus affecting the skin begins with creams or ointments and an oral medication called hydroxychloroquine. If your skin lupus is still active after using these treatments, your physician may consider other medications. [jamanetwork.com]
Patients with increased disease activity, complications, or adverse effects from treatment should be referred to a rheumatologist. [aafp.org]
Effective treatments are available for lupus The aim of lupus treatments is to reduce inflammation in tissues and improve quality of life. Treatment must be individualised, taking account of the severity of the disease. [allergy.org.au]
The goal of treatment is to ease symptoms. Treatment can vary depending on how severe your symptoms are and which parts of your body SLE affects. [healthline.com]
Prognosis
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]
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]
Damage to the kidneys or nervous system is associated with a poor prognosis! [amboss.com]
Certain patient characteristics portend a worse prognosis in SLE: male sex, age (both young and old), low socioeconomic status, and black race. [visualdx.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]
Systemic lupus erythematosus is a chronic, multisystem, inflammatory disorder of autoimmune etiology, occurring predominantly in young women. [msdmanuals.com]
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]
The etiology and pathology of many diseases have been cleared up and the way leading to the elucidation of many mooted questions pointed out. [jamanetwork.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]
Epidemiology Sex: ♀ >> ♂ (10:1) Peak incidence: women aged 20–40 years; no particular age of manifestation in men US prevalence: highest in African-American, Hispanic, and Asian populations References:[1] Epidemiological data refers to the US, unless [amboss.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]
[3] Environmental factors: UV light;, stimulation of immune cells through infection with bacteria and viruses (in particular EBV;, which causes disease flares following infection), medications (e.g., procainamide, hydralazine) [4] References:[1][4] Pathophysiology [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. How can I help 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]
NYU Langone experts are part of a Centers for Disease Control and Prevention initiative to better understand the impact of systemic lupus erythematosus, and our doctors offer access to clinical trials for new therapies at the Lupus Center. [nyulangone.org]
Hydroxychloroquine was used in the past to prevent and treat malaria. It is also used to treat lupus-related arthritis, fatigue, rashes, and mouth sores, as well as prevent flares. [rheumatology.org]
A medicine used to prevent and treat malaria can help ease some lupus symptoms. It can treat fatigue, rashes, joint pain, and mouth sores. The medicine may also help prevent blood clots. Corticosteroid medicines. [urmc.rochester.edu]