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Systemic Lupus Erythematosus - Coggle Diagram
Systemic Lupus Erythematosus
pathophysiology
caused by
genetic susceptibility
prevalence
appears between ages 15-44
more common in women than men
10-1
hormonal
environmental triggers
dysregulation of immunity
adaptive
apoptotic and damaged cell-derived antigens
triggers abnormal T-cell activation
dysregulated gene expression
impaired regulatory T-cell function
innate
TLR7 and TLR9
type I interferon production
impaired neutrophil clearance and apoptotic debris
persistent source of autoantigens
fuels antibody production
immune complex formation
manifestations
generally
come in waves
different for everyone
commonly include
pain of joints
headaches
rashes
fever
hair loss
fatigue
blood clots
complications
light sensitivity
dry eye
seizures
depression
anemia
osteoporosis
heart disease
kidney disease
Renaud's syndrome
diagnostic criteria
1997 ACR criteria
malar rash
discoid rash
photosensitivity
alopecia
Raynaud phenomena
nasal and oral ulcers
nonerosive arthritis in 2 or more joints
serositis
renal disease
proteinuria >500mg/d
cellular cast
granular
erythrocyte
tubular
mixed
hematologic disease
hemolytic anemia with reticulocytosis
leukopenia <4000/mm^3 2 or more times
lymphopenia <1500/mm^3 2 or more times
thrombocytopenia <100,000/mm^3 in the absence of medication
neurologic disease
seizures
psychosis
diagnosis based on
signs and symptoms
Laboratory findings
positive ANA results
low complement C3 and C4 levels
elevated C-reactice protein
elevated sedimentation rate
synovial fluid aspiration
reveals mild inflammatory joint effusion
CBC
urinalysis
liver and renal function tests
imaging
joint radiographs show
periarticular osteopenia
deformities
subluxation
chest radiographs or CT scans show
pulmonary infiltrates
pleural effusions
histopathology
renal biopsy
tissue biopsy
treatment
focuses on
decreased activity of disease
organ protection
treatments for different systems
hydroxychloroquine
improve fatigue
reduce rash
improve arthralgias and arthritis
confer a mortality benefit
reduces flares
topical cortical steroids
NSAIDs
diet changes
ensure adequate vitamin D
protection from sun
clothing
sunscreen