Overview Systemic lupus erythematosus (SLE) is an autoimmune disease. SLE is a chronic multi-system disorder that most commonly affects women during their reproductive years. The pathophysiology of SLE involve many vital organs and tissues such as the brain, blood, and the kidney, the vast majority affecting women of childbearing age. Immune-system aberrations, as well as heritable, hormonal, and environmental factors, contribute to the expression of organ damage. Immune complexes, autoantibodies, autoreactive lymphocytes, dendritic cells, and local factors are all involved in clinical manifestations of SLE. Earlier diagnosis and better management have resulted in a lower prevalence of life-threatening disease.
| Definition Systemic lupus erythematosus (SLE): Complex clinical syndrome characterized by autoimmune-mediated, systemic inflammation that can affect multiple organs. |
Epidemiology
Precipitating factors
| Side note Precipitating factors are factors that exacerbate and cause acute SLE reactions |
SLE is 10–20 times more common in women than men, and most likely to develop between the ages of 15–40 years.
Constitutional symptoms
Specific Organ involvement
| Keratoconjunctivitis sicca also known as dry eye is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation; it causes damage to the interpalpebral ocular surface and is associated with a variety of symptoms reflecting ocular discomfort |
| Libman Sacks endocarditis |
Non-inflammatory Arthritis
Inflammatory Arthritis
| Side note Antiphospholipid antibodies are present in up to one-third of patients with SLE (antiphospholipid syndrome) |
| Sjögren syndrome is a systemic autoimmune disease characterized by dry eyes and dry mouth. Other organ systems are affected in many patients. Sjögren syndrome is classified as primary or secondary. In primary disease, Sjögren syndrome is a solitary process, whereas secondary disease accompanies another autoimmune disease—often rheumatoid arthritis |
| Remember check renal function in SLE as nephritis is a common complication |
Diagnosis a SLE flare
Production of autoantibodies causing multi-organ in ammation. Multi-factorial aetiology:
Please watch video for a better idea of the pathophysiology of video: CLICK HERE
General
Medical Treatment - aim to induce remission
| Hydroxychloroquine is an antimalarial, is immunodulatory and not immunosupressive. Main side effect is retinal toxicity. |
Acute SLE Characterised by haemolytic anaemia, nephritis, severe pericarditis or central nervous system involvement
Complications
Prognosis
The antiphospholipid syndrome (APS) was first described in the 1980s and comprises arterial and venous thrombosis with or without pregnancy morbidity in the presence of anticardiolipin (ACL) antibodies or the lupus anticoagulant (LAC). It can be primary, or secondary to other autoimmune diseases, most commonly systemic lupus erythematosus (SLE).
Clinical features - CLOTS
