UNIT 3

MUSCULO-SKELETAL SYSTEMS AND SKIN

3.4 Systemic Lupus Erythematosus (SLE)

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 LEARNING OUTCOME

1. Explain the pathogenesis and pathophysiology of Systemic Lupus

Erythematosus (SLE).

2. Describe the clinical manifestations and diagnostic approaches of Systemic

Lupus Erythematosus (SLE).

3. Explain the therapeutic interventions and care in the management Systemic

Lupus Erythematosus (SLE).

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 DEFINITION

• A chronic inflammatory condition caused by an autoimmune disease.

• An autoimmune disease occurs when the body’s

tissues are attacked by its own immune system.

• Patients with lupus have unusual antibodies in

their blood that are targeted against their own
body tissues.

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 ETIOLOGY

SEX & ENVIRONMENT

GENETICS HORMONES
-family -affect -UV Rays
members women than -certain
men medications
(estrogen)
-viruses
-trauma
-physical or
emotional stress

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 PATHOPHYSIOLOGY

Etilogy / triggering agents.

Abnormal autoimmune response.

Abnormalities in both T-cells and B-cells (overactive).

Production of autoantibodies.

Tissue injuries & damages.

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 CLINICAL MANIFESTATIONS

• Severe fatigue

• Joint pain

• Joint swelling

• Headaches

• A rash on the cheeks and nose, which is called a

“butterfly rash”

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 CLINICAL MANIFESTATIONS

• Anemia

• Blood-clotting problems

• Sun sensitivity

• Hair loss

• Fingers turning white or blue and tingling when

cold, which is known as raynaud’s phenomenon

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 DIFFRENTIAL DIAGNOSIS

Multiple
Vasculitis sclerosis
Mixed (MS)
connective
tissue
disease
Rheumatoid (MCTD)
arthritis
(RA)

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 INVESTIGATION

• No specific test.

• History, physical examinations.

• Laboratory findings:

▪ Tissue biopsy – sign of inflammation.

▪ Blood for Erythrocyte Sedimentation Rate (ESR) – to detect systemic

inflammation.

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 INVESTIGATION

• Laboratory findings:

▪ Blood for Antinuclear antibodies (ANA) – to detect abnormal antibody.

▪ Complete Blood Count (Hb, LFT, RFT, Platelet count) – general information about
health.

▪ Urinalysis – to check protein & cell, possibility kidney damage.

▪ Electrocardiogram (ECG) – to check cardiac problems.

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 MANAGEMENT

NON-STEROIDAL CORTICOSTEROIDS ANTIMALARIAL IMMUNE

ANTI- DRUGS SUPPRESSANTS
INFLAMMATORY • Prednisone • Chloroquine • Cyclophosphamide
DRUGS (NSAIDS) • Prednisolone • Azathioprine
• Hydrocortisone
• Aspirin
• Ibuprofen
• Indomethacin

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 MANAGEMENT

• Topical – steroid cream for rashes.

• Health education;

i. Rest / good sleep.

ii. Avoid stress, sun (use protective clothing / sun block).

iii. Nutrition / Diet.

iv. Prevent infection.

v. Good hygiene.
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 PROGNOSIS

• Early diagnosis with therapy aimed at preventing organ damage, monitoring and
screening patients for cardiovascular disease and infections with early
intervention may improve these outcomes.

• Sle patients suffer from significant morbidity and carry a high mortality.

• Survival rates are 85% to 90% during the first 10 years.

• Mortality include cardiovascular disease, infections, and renal disease.

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REFERENCES

• Innes, J. A. (2016). Davidson’s Essentials of Medicine. (2nd ed.). Edinburgh: Churchill Livingstone.
• Kumar, P. & Clark, M. (2016). Clinical Medicine. (9th ed.). Edinburgh: Elsevier.
• Longmore, M, Willkinson, I. Baldwin, A. & Wallin, E. (2014). Oxford Handbook of Clinical Medicine.
(9th ed.). Oxford: Oxford University Press.
• Hinkle, J.L. & Cheever, K.H. (2013). Brunner & Suddarth's Textbook of Medical-Surgical Nursing.
(13 th ed.). Washington: Wolters Kluwer.
• Soo, H.H. (2011). Sarawak Handbook of Medical Emergencies. (3rd ed.). Kuching: C.E. Publishing.
• Medical Assistant Board. (2006). Standard Operating Procedures For Medical Assistants In
Cardiology. Putrajaya: Ministry Of Health, Malaysia.

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