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GMU Nurs 769 CECIL Chapter 81
Systemic Lupus Erythematosus
17
Pathology
Graduate
04/01/2012

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Term
What is Systemic Lupus Erythematosus (SLE)?
Definition
Systemic autoimmune, possibly genetic, inflammatory disease that leads to destruction of healthy tissues/organs. Any, or all, tissues and organs can be affected.
Term
Gender considerations for SLE?
Definition
Primarily affects young women of childbearing age (15-45).
Term
What is the "cure" for SLE?
Definition
There isn't one.
Term
Ethnic considerations for SLE:

More prevalent in whites or non-whites?

Definition
Non-whites.

Compared to whites:

Blacks 3X;

Caribbean blacks 5X;

Asians 2X;

Hispanics > whites.

Blacks and Hispanics have more severe disease and worse prognosis than whites.

Term
Constitutional manifestations of SLE?
Definition
Fatigue;

Fever;

lymphadenopathy;

Generalized arthralgias and myalgias.

Term
Oral manifestations of SLE?
Definition
Oral ulcerations, usually on tongue or palate.
Term
Skin manifestations of SLE?
Definition
Malar (butterfly) rash;

Discoid lesions (permanent scarring and disfigurement);

alopecia (hair loss);

Photosensitivity.

Term
Musculoskeletal manifestations of SLE?
Definition
Arthralgias and inflammatory arthritis, usually non-erosive, very common (>75%).
Term
Cardiopulmonary manifestations of SLE?
Definition
Pericarditis and pleuritis very common (>60%);

Valvular thickening;

Non-infective endocarditis;

Myocarditis;

Pulmonary hemorrhage (is rare, though);

Premature CVD.

Term
Renal manifestations of SLE?
Definition
Nephritis (a major cause of morbidity and mortality).
Term
Describe the malar rash of SLE.
Definition
Fixed erythema, flat or raised, is observed over the malar eminences, tending to spare the nasolabial folds.
Term
Neuropsychiatric manifestations of SLE?
Definition
Sensorimotor neuropathy;

Headache;

Cognitive dysfunction;

Anxiety;

Psychosis;

Cerebrovascular vasculitis (which can be life-threatening);

Transverse myelopathy.

Term
Hematologic manifestations of SLE?
Definition
Leukopenia (primarily lymphopenia, anemia, and thrombocytopenia) very common;

Antiphospholipid and anticardiolipin antibodies which can lead to thrombosis, thrombocyopenia, and recurrent spontaneous miscarriages.

Term
Vascular manifestations of SLE?
Definition
Raynaud phenomenon;

PEs and DVTs;

Vasculitis.

Term
Occular manifestations of SLE?
Definition
Keratoconjunctivitis sicca (inflammation of the cornea and conjunctiva).

The "sicca" indicates that the inflammation is secondary to dryness in these tissues.

Term
What is treatment for SLE?
Definition
1:Education;

Reducing inflammation with glucocorticoids;

Immunosuppression with glucocorticoids and other immunosuppressive agents.

Term
Pregnancy considerations with SLE?
Definition
Higher rates of miscarriage, stillbirth, and preterm delivery.

Pregancy itself can initiate a flare.

Lupus antibodies can cross to fetus (rare).

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