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Systemic Lupus Erythematosus
SLE Lecture PART ONE
43
Other
Not Applicable
11/03/2012

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Term
Results from a triphasic reaction of distal digits to cold or emotion, in which the skin color changes from white to blue to red
Definition
Rayaud's phenomenon
Term
most common skin sign of lupus
Definition
Butterfly rash
Term
bilateral arthritis without joint deformity; swelling and tenderness must be present
Definition
Musculoskeletal clinical sign of lupus
Term
Caused by disruption of blood flow to bone and prednisone therapy
Definition
Bone necrosis
Term
Hematuria, Proteinuria, Casts
Definition
Kidney clinical signs of lupus
Term
clot formation in a critical vessel that supplies blood to the spinal cord
Definition
rare clinical presentation in lupus
Term
normocytic anemia
Definition
frequent in lupus from chronic inflammation or medication-related hemorrhage
Term
appears to be mediated by anti-platelet antibodies and/or antiphospholipid antibodies
Definition
Thrombocytopenia
Term
Disease and medication (immunosuppressants) related
Definition
Leucopenia
Term
most common manifestation of pulmonary involvement
Definition
Pleurisy
Term
seen in SLE patients with nephritic syndrome, infection, and/or cardiac failure
Definition
Pleural effusions
Term
fever, dyspnea, cough w/ scanty sputum, hemoptysis, tachypnea and pleuritic chest pain
Definition
Acute pneumonitis
Term
most common CV clinical presentation in lupus
Definition
Paricarditis
Term
very similar features to viral myocarditis
Definition
Myocarditis clinical presentation in SLE
Term
many flat reddish-tan vetations spreading overal mitral valve and chordate
Definition
Liman-Sacks Endocarditis
Term
Esophagitis, dysphagia, nausea, vomiting
Definition
most cases are medication related
Term
some GI/Liver Clinical Presentations of SLE
Definition
Chronist intestinal pseudo-obstruction, mesenteric vasculitis, protein-losing enteropathy, pancreatitis, lupus hepatitis
Term
must be screened every 6 months if taking the antimalarial medications
Definition
Eyes
Term
dry eyes and/or mouth due to exocrine glands infiltrated with lymphocytes
Definition
Comorbid Sogren's Syndrome
Term
Recurrent arterial and/or venous thrombosis, fetal loss and thrombocytopenia
Definition
Antiphospholipid Syndrome (APS)
Term
Speckled pattern, 97% of patients
Definition
Antinuclear Antibody (ANA)
Term
75% of SLE patients
Definition
Anti-dsDNA
Term
44% of SLE patients
Definition
Anticardiolipin
Term
33% of SLE patietns
Definition
Anti-Smith and Anti-Ro (SSA)
Term
25% of SLE patients
Definition
Anti-La (SSB)
Term
15% of SLE patients
Definition
Anti-ribonucleoprotein
Term
nonspecific but in combo with positive ANA --> suspect SLE
Definition
Low compliment (C3 or C4) lab test
Term
echinachea and excessive zinc supplmementation
Definition
avoid in SLE
Term
daily multivitamin
Definition
OK in SLE
Term
licorice products
Definition
avoid in SLE (unless deglycerided)
Term
Used for patients on chronic NSAIDs
Definition
Proton Pump Inhibitors
Term
used for mild disease (arthritis)
Definition
NSAID + PPI
Term
used for skin and joint manifestations
Definition
Anti-malarial (hydroxychloroquine)
Term
used for skin and localized discoid lesions
Definition
topical/intralesional corticosteroids
Term
used for life-threatening or multisystemic organ-threatening manifestations
Definition
Oral or IV corticosteroids
Term
Standard of practice for lupus nephritis
Definition
High dose IV corticosteroids
Term
Immunosuppressant primarily used as adjunct therapy to corticosteroids; reduces the number of SLE flares
Definition
Azathioprine
Term
Azathioprine
Definition
Useful as a steroid sparing agent in nonrenal disease
Term
Mycophenolate mofetil
Definition
For renal and nonrenal symptoms
Term
DMARD to manage arthritis, skin rashes below the neck that are in refractory to topical corticosteroids, endo-/pericarditis, and constitutional symptoms
Definition
Methotrexate
Term
Methotrexate
Definition
use with caution in patients with renal disease (medication is eliminated via the kidneys)
Term
B-lymphocyte stimulator-specific inhibitor
Definition
Belimumab
Term
Plasmaphoresis, IV immunoglobulin, stem cell transplants, immune therapy
Definition
reserved for poor responders with severe disease
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