Term
| What is the epidemiology of lupus? |
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Definition
| More women than men, less caucasians, usually develops between 20 and 45. |
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Term
| What are the types of lupus? |
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Definition
Systemic - most common. Autoantibodies (IgG) due to a trigger
Drug induced - hydralazine, procainamide, quinidine, isoniazide, methyldopa
Discoid - skin rash only, in 20% of SLE patients. crusty patches on sun exposed areas.
Overlap - SLE + RA |
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Term
| What are triggers for lupus? |
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Definition
Stress, UVB, burns/infection, pregnancy, drugs.
NOT viral.
Low C3/C4 in the complement may indicate active lupus - TEST! |
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Term
| What is the most common test for lupus? |
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Definition
| Test for ANA antibodies - antibodies that bind to and destroy the nucleus. |
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Term
| What is antiphospholipid syndrome? |
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Definition
| In 20% of patients, antibodies to phospholipids cause a narrowing of BVs, leads to clots. |
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Term
| How is lupus clinically presented? |
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Definition
Fever, fatigue, muscle pain.
Dermatological rash - light sensitive. Butterfly rash
Can flare and go into remission
High ANA titers, decreased complement. CBC: low HGb, patelets |
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Term
| What are non-pharmacologic treatments for SLE? |
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Definition
- Rest
-Exercise
- Smoking avoidance
- Limit UV exposure |
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Term
| How are NSAIDs used for SLE? |
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Definition
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Term
| How are antimalarials used for SLE? |
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Definition
Hydroxychloroquine - first line. Good for rash and pain, maintains remission. Need eye exams q6mo. Safe in pregnancy
Decreases T cell activation, PG formation, stabilizes lysosomes |
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Term
| How are steroids used for SLE? |
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Definition
Serious, life-threatening SLE.
Lots of AEs. Can use medrol IV or prednisone orally |
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Term
| How is Cyclophosphamide/Cytoxan used for SLE? |
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Definition
| for moderate-severe cases, inhibits DNA in T/B cells. Must adjust for renal function. Monitor immunosuppression, urinary cystitis/cancer (PO more than IV) |
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Term
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Definition
Resistand discoid lupus
Can cause GI effects, leukopenia |
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Term
| What is cellcept used for in SLE? |
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Definition
| Renal and non-renal symptoms, well tolerated |
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Term
| What is Benlysta used for? |
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Definition
| A new treatment that blocks B cell activation. High risk of infection. Ineffective in african americans. |
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