Systemic Lupus Erythematosus Presented by: J. Yeban & A. Arante 1 Presented by: J. Yeban & A. Arante 2 - A multisystem disease of autoimmune origin. It is a complex disorder of multifactorial origin resulting from interactions among genetic, hormonal, environmental and immunologic factors. Presented by: J. Yeban & A. Arante 3 Systemic lupus erythematosus (SLE) is the most common form of lupus. "Systemic" means it can affect several parts of the body. A subtype of SLE is drug-induced lupus. Some medications uncommonly used for high blood pressure, heart disease and tuberculosis can cause this condition. Presented by: J. Yeban & A. Arante 4 Presented by: J. Yeban & A. Arante 5 • • • • • • • skin rash pain and swelling in joints muscle aches fatigue weight loss hair loss loss of appetite Presented by: J. Yeban & A. Arante 6 • lesions over the bridge of the nose and cheeks, and sometimes on the scalp. Lesions dry into scales that fall off the body, leaving scars (DLE only) • Raynaud's syndrome (a condition in which a sudden, severe reduction in blood flow causes fingers to turn waxy, white and blue and painfully cold) Presented by: J. Yeban & A. Arante 7 8 Presented by: J. Yeban & A. Arante 1. It is unknown; affects the connective tissue and is thought to be due to a defect in the body’s immunologic mechanisms, genetic predisposition, or environmental stimuli. 2. Immune complex deposits in blood vessels, among collagen fibers, and on organs. Presented by: J. Yeban & A. Arante 9 3. Necrosis of the glomerular capillaries, inflammatory of the cerebral and ocular blood vessels, necrosis of the lymph nodes, vasculitis of the GI tract and pleura, and degeneration of the basal layer of the skin. 4. More common in females aged 13-40 years. Presented by: J. Yeban & A. Arante 10 Corticosteroids and analgesic to reduce pain and inflammation. Supportive therapy as the major organ become affected (heart, kidneys, CNS, GI tract). Presented by: J. Yeban & A. Arante 11 History and physical examination Antibodies Anti-DNA antibody Anti-Sm antibody Antinuclear antibody (ANA) Complete Blood Cell Count LE cell prep. Urinalysis X-ray of affected joints Chest x-ray ECG to determine extra articular involvement Presented by: J. Yeban & A. Arante 12 Treatments may include: rest exercise physical therapy for muscle weakness avoiding sun exposure medications such as: anti-inflammatory drugs such as aspirin for symptomatic relief Presented by: J. Yeban & A. Arante 13 corticosteroid drugs such as prednisolone for inflammation antimalarial drugs such as chloroquine phosphate or hydroxychloroquine for rashes, arthritis and malaise immunosuppressive and cytotoxic drugs such as Immuran (azathioprine) and Cytoxan (cycyclophosphamide) are prescribed with vital organs are involved and/or corticosteroids aren't effective Presented by: J. Yeban & A. Arante 14 Surgery Surgery is not used to treat mild or moderate symptoms of lupus(systemic lupus erythematosus, or SLE). Surgery may be considered for people with lupus who have permanent, life-threatening kidney damage. A kidney transplant or kidney dialysis may be done instead of continuing long-term treatment with high doses of medicines that have serious side effects. Presented by: J. Yeban & A. Arante 15 If kidney disease from lupus does not respond to high-dose corticosteroids and other immunosuppressive medicines, kidney dialysis or transplant are reasonable options. For unknown reasons, overall lupus disease activity is often less severe during dialysis and after kidney transplant. Presented by: J. Yeban & A. Arante 16 • Minimize fatigue • Maintain weight at optimal range. • Teach the patient to recognize fever and signs and symptoms of infection. • Assist the patient in adjusting to physical and lifestyle changes • Recognize the signs and symptoms of depression and initiate a plan of care. Presented by: J. Yeban & A. Arante 17 Brunner and Suddarth’s textbook of: Medical Surgical Nursing (volume 2) Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved. http://www.medicinenet.com/systemic_lupus/article.htm Presented by: Jay-Ann M. Yeban Arjo M. Arante 18