SYSTEMIC AND DISSEMINATED
LUPUS ERYTHEMATOSUS
HAEMATOLOGY PRESENTATION
PRESENTED BY:
S. MA. LYDIA YAA SARPONG,RVM
REFERENCES:
Haematology by: Rodak et Al
: Henry's Clinical Diagnostics
: Center For Disease Control Journal
: Google Images
MARCH 17, 2022
Clinical Presentation
SYSTEMIC AND DISSEMINATED
LUPUS
ERYTHEMATOSUS
OBJECTIVES
At the end of the Presentation:
We will be able to;1. Describe the etiology, pathogenesis and pathophysiology of SLE.
2. Correlate Laboratory Diagnosis with Clinical Symptoms.
3. Analyze the impact of SLE on an Individual, Environment and System.
…… Cognitively, affectively and Practically….
SYSTEMIC
LUPUS
ERYTHEMATOSUS (SLE)
DISSEMINATED
LUPUS
ERYTHEMATOSUS (DLE)
AUTOIMMUNE DISEASE
AUTOIMMUNE DISEASE
…Immune System Attacks its own tissues…
1. Inflammation
2. Tissue damage in organs
…… NOTE: There is no cure, only medical interventions……
SYSTEMIC
LUPUS
ERYTHEMATOSUS (SLE)
Chronic autoimmune inflammatory disease manifested
by severe vasculitis, renal involvement, and lesions of
the skin and nervous system.
…… NOTE: There is no cure, only medical interventions……
DISSEMINATED
LUPUS
ERYTHEMATOSUS (DLE)
Is a distinctive cutaneous eruption forming part
of a systemic disorder that usually includes also
characteristic clinical and anatomic evidence of
visceral damage.
ETIOLOGY (CAUSES )- UNKNOWN
PATHOGENESIS
PATHOPHYSIOLOGY OF
SIGNS AND SYMPTOMS
●FLARE
●REMISSION
SIGNS AND SYMPTOMS
(Malar rash)
COMPLICATIONS
● Poor access to care
● Late diagnosis
● Less effective treatments
● Poor adherence to therapeutic regimes
(eg.Pregnancy= "HIGH RISK
PREGNANCY")
DIAGNOSIS
● Symptoms assessments
● Physical Examination
● X-rays
● Laboratory Tests
*****Rheumatologist *****
LABORATORY ASSESSMENT
● Hematology assessments
A. Hemolytic Anemia with reticulocytosis.
B. Leukopenia,Lymphopenia,Thrombocytopenia
.
LABORATORY ASSESSMENT
● Hematology assessments
● Thrombocytopenia also is noted in 14% to 26% of
patients with systemic lupus erythematosus.
● NOTE:- (The diagnosis of ITP or systemic lupus erythematosus in the mother
is a prerequisite for the diagnosis of neonatal autoimmune thrombocytopenia.
Neonatal autoimmune thrombocytopenia is due to passive transplacental
transfer of antibodies from a mother with ITP or, occasionally, systemic lupus
erythematosus).
LABORATORY ASSESSMENT
● Hematology assessments
A. Presence of LE cells in serous fluids.
LABORATORY ASSESSMENT
● Renal Disorder
• Persistent Proeteinurea
• Cellular Casts (Red cell,
hemoglobin, granular, tubular or
mixed)
FINE
CASTS IN THE URINE
COARSE
LABORATORY ASSESSMENT
● Immunologic
• Anti-DNA
• Anti-Sm
• Positive Antiphospholipid antibodies (IgG or
IgM anticardiolipin antibodies, Positive test
for Lupus anticoagulant, false positive
Treponemal antibody test.
• Positive ANA(antinuclear antibody)
LABORATORY ASSESSMENT
● 50% of patients with systemic lupus erythematosus
have autoimmune APL antibodies.
LABORATORY ASSESSMENT
Immunologic
● Lupus anticoagulant
• The two most commonly recommended test
systems are the dilute Russell viper venom
time (DRVVT) and the silica-based partial
thromboplastin time (PTT)
• Two older systems:- kaolin clotting time (KCT) and the dilute
thromboplastin time (DTT, also named tissue thromboplastin
inhibitor test, TTI)
LABORATORY ASSESSMENT
Immunologic
● Lupus anticoagulant
• Lupus anticoagulant (LA, LAC) Autoantibody to phospholipidbinding proteins such as b2-glycoprotein I, annexin, and
prothrombin. May be present as a primary condition or secondary
to a collagen disorder such as systemic lupus erythematosus,
Sjögren syndrome, or rheumatoid arthritis.
• Chronic lupus anticoagulant is associated with venous and arterial
thrombosis and spontaneous abortion.
● Women
Risk
● Africans /African Americans
● Asians
● Hispanics
● Indians
Societal concern
● Women
● Pregnant women
● Weakness
● Other painful episodes
● Laboratory worker
SUMMARY
CBC
• Finding leukopenia and/or thrombocytopenia in idiopathic
vasculitides is rare and suggests alternative diagnoses such as
systemic lupus erythematosus (SLE), neoplasm, bone marrow
disorders, lympho- matoid granulomatosis, or hypersplenism
(Mandell, 1994).
• Leukocyte counts greater than 10,000/μL, and often greater
than 50,000/μL, are characteristic of crystalinduced arthritis
(e.g., gout, pseu dogout), chronic in ammatory arthritis (e.g.,
rheumatoid arthritis, sys temic lupus erythematosus,
ankylosing spondylitis), and septic arthritis (Kjeldsberg, 1993)
RESEARCH JOURNALS TIP-BITS
DIAGNOSTICALLY
• The 1982 revised criteria for classification of SLE included 11
categories, adding (1) abnormal titer of antinuclear antibody by
immunofluorescence or an equivalent assay, and (2) antibody
to native DNA and/or Sm antigen. In contrast to the 1971
criteria, the 1982 criteria removed Raynaud’s phenomenon and
alopecia because of their lack of sensitivity and specificity.
• The presence of antinuclear antibodies was detected in female
laboratory workers with varying degrees of exposure to blood
SUMMARY
• An autoimmune disease of concern since
etiology is not known.
• Proper Laboratory investigations ought to be
done to help with early diagnosis to avoid
complications especially in pregnant women.
• Laboratory professionals among many others
are at risk.