Type of Immune cells Mechanism of Onset Example of

Hypersensitivity involved activation Reaction

(Mediators)
TYPE I IgE antibody An anaphylactic Type I or Extrinsic asthma,
Mast cell reaction is anaphylactic allergic rhinitis,
Antigen characterized by hypersensitivity is systemic
eosinophilia vasodilation, an immediate anaphylaxis and
increased reaction reactions to insect
capillary beginning within stings.
permeability, minutes of
smooth muscle exposure to an
contraction, and antigen
eosinophilia.

TYPE II IgG or IgM A cytotoxic Type II Myasthenia gravis,

antibody reaction, which hypersensivity Goodpasture
Complement, involves binding occurs when the syndrome,
phagocytes either the IgG or system mistakenly pernicious
K cells IgM antibody to a identifies a anemia, hemolytic
cell-bound normal disease of the
antigen, may lead constituent of the newborn,
to eventual cell body as foreign. transfusion
and tissue reaction and
damage. thrombocytopenia

TYPE III PMN leukocytes antibodies bind to Type III, or Systemic Lupus
IgG and IgM antigens to form immune complex, Erythematosus,
antibodies immune hypersensitivity Post-streptococcal
neutrophils complexes in the involves immune Glomerulonephriti
circulation. These complexes that s, Drug Induced
complexes travel are formed when Serum Sickness,
through the blood antigens bind to Farmer’s
stream and get antibodies. Lung and Bird
deposited in fancier’s disease
various
susceptible
tissues.

TYPE IV Lymphokines when a sub-  appears 48-72 Erythema and

Macrophages population of CD4 hours after itching are
Lysozymes Th1 cells antigen exposure, common; a few
T lymphocytes encounter certain from an examples include
type of antigens, immediate hypers contact dermatitis,
they produce ensitivity respons graft-versus-host
cytokines which e, which generally disease,
induce a localized appears within 12 Hashimoto’s
inflammatory minutes of an thyroiditis and
reaction mediated antigen challenge sarcoidosis.
by non-specific
inflammatory cells
most prominently
marcrophages.
1. What are the different types of lupus? Describe each.

Systemic Lupus Erythematosus - This type of lupus affects the internal organs and is
the most serious type.  It is an autoimmune disease in which the immune system
attacks its own tissues, causing widespread inflammation and tissue damage in the
affected organs. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels.

Discoid Lupus Erythematosus - is an autoimmune skin condition on the lupus

erythematosus spectrum of illnesses. It presents with red, inflamed, coin-shaped
patches of skin with a scaling and crusty appearance, most often on the scalp,
cheeks, and ears.

Subacute Cutaneous Lupus Erythematosus - is a nonscarring, non–atrophy-

producing, photosensitive dermatosis. SCLE commonly develops in sun-exposed
areas, including the upper back, shoulders, extensor arms, neck, and upper torso,
while the face is often spared. These skin lesions can appear as either
papulosquamous (psoriasiform) or annular lesions.

Drug-Induced Lupus - This type of lupus occurs as a result of an overreaction to

certain medications such as Apresoline (hydralazine) or quinidine and Pronestyl
(procainamide). It is similar to SLE.

2. What are the factors that cause SLE?

The causes of SLE are unknown, but are believed to be linked to environmental,
genetic, and hormonal factors.

3. What are the cardinal signs of SLE?

The cardinal signs of SLE are:
- fatigue
- skin rashes
- fevers
- pain or swelling in the joints

4. Interpret requested investigation appropriately including CBC, renal profile

electrolytes, ECG and ABG. Provide relevant management.

5. What is the cause of anaemia in SLE?

Impaired erythropoietin response and presence of antibodies against erythropoietin may
contribute to the pathogenesis of this type of anaemia. Patients with autoimmune
haemolytic anaemia usually belong to a distinct category, which is associated with
anticardiolipin antibodies, thrombosis, thrombocytopenia, and renal disease, often in the
context of secondary antiphospholipid syndrome. Autoantibodies, T lymphocytes, and
deregulation of the cytokine network can affect bone marrow erythropoiesis, leading to
anaemia.
6. What are the sign and symptoms of multisystem involvement of SLE?
Central Nervous system – seizures or psychosis
Oral system– oral ulcers
Dermatologic system– malar rash, discoid rash
Cardiopulmonary system– serositis, pleural effusion, pericardial effusion
Renal system– persistent protein or cellular casts in the urine
Hematologic system – certain types of anemia (low red blood cell count), leukopenia
(low white blood cell count) or thrombocytopenia (low platelet count)
Musculoskeletal system – arthritis

7. Outline principles of therapy of SLE.

- Detailed assessment of patient and exclusion of disorders that could mimic
active lupus
- Therapy directed at specific disease manifestations that are active rather
than irreversible damage
- Severity of disease manifestation determines the intensity of management
- Treatment for the shortest time and at lowest dose possible to avoid toxicity

8. What is an advisable diet for SLE?

Patient with SLE  should try to eat a nutritious, well-balanced, and varied diet that
contains plenty of fresh fruits and vegetables, whole grains and moderate
amounts of meats, poultry, and fish.

9. Health Teachings you can provide related to skin care for Lupus
 Wear protective eyewear.

 Wear a wide-brimmed hat and carry an umbrella.

 Wear maximum protection sunscreen (SPF 15 or
above) in the sun. Sunbathing is contraindicated.
 Avoid ultraviolet ray.
 The sun can exacerbate a skin rash or precipitate a
disease flare. Special lotions, glasses, and other
items may be required to protect the skin from
sunlight exposure.
 Inform the client of the availability of
special makeup (at large department stores) to
cover rashes, especially facial rashes.
 Introduce or reinforce information about the use
of hydroxychloroquine.
10. What recommendations can you give to help alleviate the mental effects of the
Lupus Disease Process?

Participation in support groups, which can provide disease information, daily

management tips and social support from family, friends and loved ones.