Systemic Lupus Erythmatosus (SLE)

 

 

  • A chronic inflammatory disease that may affect any organ system including musculoskeletal.
  • Prevalence of 1/2000 individuals
  • Female predominance of 10:1, shifts to 30:1 during childbearing years
  • Ethnicity: more prevalent in African americans, Hispanics and Asians than Caucasians

 

Etiology

  • idiopathic
  • Characterized by autoantibody and immunocomplex formation
  • B cell hyper-reactivity and heightened self antigen productions

 

autoantibody formation etiology:

  1. genetics – seen in twins, 4 genes involved
  2. hormones – imbalance in sex hormones, androgens protect against developing
  3. immunologic factors
  4. environmental factors – UV

 

Manifestations,

  • Onset may be acute or insidious
  • exacerbation and remissions

 

  1. Arthritis
  2. Arthralgia
  3. flexion contractures
  4. hyperextension of interphalangeal joints
  5. subluxation of carpometacarpal joints
  6. tenosynovitis
  7. skin lesions – butterfly mask on face
  8. erythema
  9. photosensitivity
  10. glomerulonephritis in 50%
  11. pleural effusions or pleuritis
  12. Pericarditis
  13. hemolytic anemia

 

Diagnostics:

  • Immunofluorescence Antinuclear Antibody (ANA) test
  • tests to rule out other disorders

 

Treatment and management.

  • Managing acute and chronic symptoms
  • prevention of progressive organ functioning loss
  • anti-inflammatories
  • antimalarial drugs for cutaneous and musculoskeletal manifestations
  • high dose corticosteroids for acute symptoms
  • immunosuppressants
  • cycolphosphamide
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