Systemic Lupus Erythematosus - PowerPoint PPT Presentation

Loading...

PPT – Systemic Lupus Erythematosus PowerPoint presentation | free to view - id: 4c5845-MGIyN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Systemic Lupus Erythematosus

Description:

Systemic Lupus Erythematosus Case: A 17-year-old girl was admitted with a chief complaint of recurrent fever for three ... – PowerPoint PPT presentation

Number of Views:567
Avg rating:3.0/5.0
Slides: 27
Provided by: lc11
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Systemic Lupus Erythematosus


1
Systemic Lupus Erythematosus
?? ??? ?? ?? ??? ??
2
Case
  • A 17-year-old girl was admitted with a chief
    complaint of recurrent fever for three years, a
    rash for 2 months, and abdominal pain for 5 days.
    She had suffered from recurrent high grade fever
    since 1998, accompanied by necrotic
    lymphadenitis. Her condition had improved with
    prednisone. Two months earlier, she began to
    notice fevers, dark-red maculopapules(???),
    Raynauds pheno-menon(?????), and severe
    alopecia. At the time, laboratory tests showed
    ANA 1320 (homogeneous pattern), negative
    anti-dsDNA, and anti-SSA 164. She was diagnosed
    with SLE .

Butterfly-erythema (????)
3
What is SLE?
  • SLE is the prototypic autoimmune disease
    belonging to a family of diseases often referred
    to as "connective tissue diseases" a term
    deriving from the observation that the connective
    tissues of multiple organs were abnormal in these
    diseases in the absence of obvious infection or
    neoplasm.

4
  • Cultural diversity
  • SLE strikes women 10 times as often as men,
    increasing to 15 times as often during
    childbearing years(???). It occurs worldwide but
    is most prevalent among people of Asian,
    Hispanic, or African origin
  • Population studies have shown an incidence
    ranging from 2 to 50 cases/100,000 with clear
    variation according to ethnic group.

5
Causes
  • The exact cause of SLE remains a mystery, but
    available evidence points to interrelated
    immunologic, environmental, hormonal, and genetic
    factors.

6
Genetic factors
  • There is an increased frequency of SLE and
    asymptomatic immunologic abnormalities in close
    relatives of SLE patients.
  • Monozygotic twins(?????).
  • Ethnic differences .
  • Certain histocompatibility(?????) antigens (HLA)
    (e.g. HLA- DR2, DR3)

7
Environmental factors
  • Drug induced lupus
  • procainamide(?????), chlorpromazine(???? )
  • Diet
  • Nutritional factors may modify disease but this
    has not been adequately studied.
  • Infectious
  • Viral and other infectious etiologies.

??????????
8
  • Certain related factors
  • UV radiation(?????)
  • Hairdye(???)

Hairdye
Sunshine
9
UV light
infection
Drugs
Self Ag
Skin cell
APC
External Ag
T cell
T cell
APC
AB
IC
B cell
target
IC
Ab
Detective IC clearance and regulatory circuits
Overview of the pathogenesis of SLE
10
Immune System
Genes
Loss self-tolerance (certain antigen)
Exogenous factor
SLE pathogenesis mechanism
Endogenous factor
Androgen
Estrogen
Humoral Immunity
Cellular Immunity
T suppressor ?
B cells
Cytokines(IL-10)
T help?
Increased Ab production to auto-antigen
Auto-antibodies
Immune complex formation
Genes C1?RBC CR1?MPS phagocytosis?
Poor immune complex clearance
Excess immune complex deposition
Inflammation
Pathology
11
Pathophysiology
  • Autoimmunity is believed to be the prime
    mechanism involved with SLE. The body produces
    antibodies against components of its own cells,
    such as the antinuclear antibody (ANA), and
    immune complex disease follows.
  • Patients with SLE may produce antibodies against
    many different tissue components, such as red
    blood cells, neutrophils, platelets, lymphocytes,
    or almost any organ or tissue in the body.

12
Characteristic pathology change ???????
  • Hematoxylin corpuscle(?????)_at_
  • Onionskin(????) change, spleen central artery
    and other arteriescentripetal textile fiber
    proliferation(???????)_at_
  • verrucous endocarditis(??????)_at_
  • glomerulus fluorescent staining(????) appears the
    full house to be bright(???)_at_

13
Main symptoms
  • Weakness
  • Fever
  • more than 80 of the patients have a fever.
  • Skin and mucosal damage
  • 75 -80 of the patients skin or mucosal
    damage.
  • Photosensitivity(???)
  • Cheek erythema(????)
  • Bullous lupus erythematosus(??????? )
  • Alopecia (??)

14
  • Cheek erythema(????)
  • First in cheek, suddenly appeared for the
    small light red, bright red or purple spots,
    gradually expanded to bridge of the nose, and
    linked into such as butterflies like grouper.
    Recurrence of this plaque can happen again.

15
SLE CLINIC FEATURES(1)
  • GENERAL
  • Lethargy
  • Fever
  • Weight loss
  • Lymphadenopathy
  • DERMATOLOGICAL
  • Vasculitis
  • Alopecia
  • Discoid
  • Panniculitis
  • Photosensitivity
  • MUSCULOSKELETAL
  • Arthralgia/Arthritis
  • Myalgia/Myositis
  • Tenosynovitis
  • GASTROINTESTINAL
  • Anorexia
  • Nausea
  • Abdominal pain
  • Hepato/splenomegaly

16
SLE CLINIC FEATURES (2)
  • RENAL_at_
  • Proteinuria
  • Haematuria
  • Casts
  • Nephrotic syndrome
  • CARDIOPULMONARY
  • Shortness of breath
  • Pleurisy
  • Pleural effusion
  • Cardiomegaly
  • Pericarditis
  • CEREBRAL
  • Migraine
  • Anxiety/depression
  • Psychosis
  • Seizures
  • Cranial/Peripheral
  • HEMATOLOGICAL
  • Anemia-iron deficient
  • Anemia-haemolytic
  • Lymphopenia
  • Thrombocytopenia

17
(No Transcript)
18
Diagnosis
  • Test results that may indicate SLE include
  • complete blood count with differential possibly
    showing anemia and a decreased white blood cell
    count
  • platelet count, which may be decreased
  • erythrocyte sedimentation rate, which is often
    elevated
  • serum electrophoresis, which may show
    hypergammaglobulinemia.

19
Drugs for SLE
  • Corticosteroids(?????)
  • most commonly used. It can suppress
    inflammation and are commonly used in controlling
    SLE.
  • Immunosuppressive Drugs(?????)
  • CTX(????), AZA(????)
  • IVIG(?????)

?????
20
Thank you!
21
LE cell(????)_at_
22
?????????_at_
23
????????_at_
24
?????????_at_
25
?????_at_
26
?????(???)
?????(??)_at_
About PowerShow.com