Systemic Lupus Erythematosus
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Transcript of Systemic Lupus Erythematosus
SYSTEMIC LUPUS
ERYTHEMATOSUS
By:Izatty Lim0308188
Basic pathogenesis
Clinical featuresInvestigation
SLE
Multisystem auto-immune disorder
Formation of autoantibodies o antinuclear antibodies/ANAso Lead to inflammation and abnormal blood vessels (vasculitis,
immune complex deposition)
Clinically,o Chronico Unpredictableo Remitting & relapsing diseaseo Insidious onseto Many clinical presentation overlap features of other
autoimmune disease.
BASIC PATHOGENESIS
CLINICAL FEATURES
Common in women
CLINICAL FEATURES Dermatologic
o Cutaneous vascular lesiono Butterfly rasho Oral ulcerso Alopeciao Photosensitivity
Musculoskeletalo Arthritis (non-erosive) o Characterized by
tenderness, swelling or effusion.
CLINICAL FEATURES
Cardiopulmonaryo Pleuritis, pericaditis o Libman-Sack endocarditis (less
common)o Coronary artery disease o Interstitial fibrosis (lung)
Renalo Proteinuriao Glomerulonephritis (deposition
of DNA-anti-DNA complexes within glomeruli)
o Renal failure
CLINICAL FEATURES Nervous system
o Often ascribed it is due to vascular lesion
o Cerebral microinfarctso Seizure, psychosis
Hematologico Hemolytic anemia o Leukopeniao Lymphopeniao Thrombocytopenia
INVESTIGATION FANA
o Anti-dsDNA and anti-Sm antibody
Homogeneous pattern: o found with antibodies to chromatin, histones &
double stranded DNA. o seen in lupus and occasionally in other
autoimmune diseases. Speckled pattern:
o found with antibodies to non-DNA nuclear antigens.
o most common immunofluorescent pattern & least specific
Nucleolar pattern (green spots): o found with antibodies to RNA. o systemic sclerosis
Rim or peripheral pattern: o found with antibodies to double-stranded DNA.
This pattern is seen frequently in lupus.
INVESTIGATION ELISA Test
o ds-DNA antibodieso Anti-histone antibodieso Deoxyribonucleoprotein
(DNP)
Ouchterlony Testo Used to determine immunological specificityo Shows the serum does or does not have antinuclear antibodies
Multiplexed immunoassayso support the identification of
multiple autoantibodies from a single determination in the same time.
INVESTIGATION
established by the American Rheumatism Association
INVESTIGATION CBC with differential Serum creatinine Urinalysis with microscopy ESR or CRP results Complement levels Liver function tests (Alanine aminotransferase
(ALT)) Creatine kinase assay (myocarditis, myocardial
infarction) Spot protein/spot creatinine ratio (proteinuria) Autoantibody tests
REFERANCES Robbins Basic Pathology 9th Edition
• By Kumar Abbas Aster
Journal of Clinical Pathologyo http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769989/
Pathology Student. FANA Testing.o http://www.pathologystudent.com/?p=7612
THE END