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PHARMACOTHERAPEUTICS-I
SYSTEMIC LUPUS
ERYTHEMATOUS
BY:- MALINI.R
M.PHARMACY- 1st year
PHARMACY PRACTICE
CONTENTS
• Systemic Lupus Erythematous
• Definition
• Causes
• Types of lupus
• Etiology
• Pathophysiology
• Signs and symptoms
• Diagnosis
• complications
• Clinical manifestation
• Treatment
• Prevention
• references
What is Systemic Lupus Erythematosus?
• Systemic lupus erythematosus (SLE) is an autoimmune disease the
immune system attacks its own tissues, causing widespread
inflammation and tissue damage in the affected organs.
• In this disease, the immune system of the body mistakenly attacks
healthy tissue.
• It can affects the joints, skin, brain, lungs, kidneys, and blood vessels.
• There is no cure for lupus, but medical interventions and lifestyle
changes can help control it.
WHAT CAUSES SYSTEMIC LUPUS
ERYTHEMATOSUS?
• The causes of SLE are unknown, but are believed to be linked to
environmental, genetic, and hormonal factors.
• More than 90% of cases of SLE occur in women, frequently starting at
childbearing age.
• Women ages 15 to 44 and certain ethnic groups—including African
American, Asian American, Hispanics/Latino, and Native American—
are at higher risk for developing SLE than the rest of the population.
ETIOLOGY
• ETIOLOGY IS UNKNOWN
• MOST PROBABLE CAUSES:-
GENETIC INFLUENCE
HORMONES
ENVIRONMENTAL FACTORS
CERTAIN MEDICATIONS
PATHOPHYSIOLOGY
Signs and symptoms
• The signs and symptoms of lupus that you experience will depend on
which body systems are affected by the disease.
• The most common signs and symptoms include:
• Fatigue
• Fever
• Joint pain, stiffness
• Butterfly-shaped rash on the face that covers the cheeks and
bridge of the nose or rashes elsewhere on the body.
• Fingers and toes that turn white or blue when exposed to cold
or during stressful periods.
• Shortness of breath
• Chest pain
• Dry eyes
• Headaches, confusion and memory loss.
• Swollen glands.
• Swelling in the legs or around the eyes.
• Pain when breathing deeply or lying down, from inflammation of the
lining around the lungs or heart.
• Headaches, dizziness, depression, confusion, or seizures.
• Abdominal pain.
• Round scaly rashes that can
appear anywhere on the body.
• Sensitivity to the sun that may
cause a rash.
• Hair loss.
• Sores, which are usually
painless, in the nose and mouth
(most often on the roof of the
mouth).
• Change of color in the fingers
and toes – blue-purplish, white,
or red – from cold and
stress.(Raynaud’s
phenomenon).
DIAGNOSIS
• 2019 update of the Joint European League Against Rheumatism and European Renal
Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA)
recommendations for the management of lupus nephritis.
• Laboratory studies used in the diagnosis of SLE are as follows:
• CBC with differential
• Serum creatinine
• Urinalysis with microscopy
• ESR or CRP level
• Complement levels
• Liver function tests
• Creatine kinase assay
• Spot protein/spot creatinine ratio
• Autoantibody tests
• Imaging studies
• The following imaging studies may be used to evaluate patients with suspected
SLE:
• Joint radiography
• Chest radiography and chest CT scanning
• Echocardiography
• Brain MRI/MRA
• Cardiac MRI
• Procedures that may be performed in patients with suspected SLE include the
following:
• Arthrocentesis
• Lumbar puncture
• Kidney biopsy
SEVERITY OF LUPUS
• The severity of lupus varies from
mild to life-threatening. After
many years of having lupus,
patients may develop:
COMPLICATIONS OF LUPUS
• Osteoporosis (especially in those who are treated with corticosteroids)
• hypertension (high blood pressure)
• kidney failure
• atherosclerosis (also known as atherosclerotic cardiovascular disease)
• forms of heart and lung diseases
• In addition, a significant number of lupus patients also have the
antiphospholipid antibody (aPL) associated with antiphospholipid syndrome.
CLINICAL MANIFESTATIONS
• DERMATOLOGIC
• ORAL/NASOPHARY
NGEAL ULCERS
• CUTANEOUS
VASCULAR LESIONS
• ALOPECIA
• BUTTERFLY RASH
MUSCULOSKELETAL
POLY ARTHRALGIA
WITH MORNING
STIFFNESS
SWAN NECK
DEFORMITY
ULNAR DEVIATION
SUB LUXATION
WITH HYPERLAXITY
OF JOINTS
CARDIOPULMONARY
TACHYPNEA
PLEURISY
DYSRHYTHMIAS
PERICARDITIS
NERVOUS SYSTEM
GENERALIZED/
FOCAL SEIZURES
PERIPHERAL
NEUROPATHY
COGNITIVE
DYSFUNCTION
RENAL
• LUPUS NEPHRITIS
PHARMACOLOGICAL TREATMENT
NON-
PHARMACOLOGICAL
TRATMENT
PREVENTION
• No way to prevent lupus.
• But people who smoke may be more prone to get LUPUS.
• AVOID SMOKING and other TOBACCO products to decrease the risk.
REFERENCES
• https://medlineplus.gov/ency/article/000435.htm
• https://emedicine.medscape.com/article/332244-
overview
• https://www.lupus.org/resources/what-is-systemic-
lupus-erythematosus-sle
• https://www.nhs.uk/conditions/lupus/
• https://bestpractice.bmj.com/topics/en-us/103
• https://www.hss.edu/condition-list_lupus-sle.asp
• https://www.mayoclinic.org/diseases-
conditions/lupus/symptoms-causes/syc-20365789
• ttps://www.slideshare.net/GAMANDEEP/sle
-ppt-67364877

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SYSTEMIC LUPUS ERYTHEMATOUS

  • 2. CONTENTS • Systemic Lupus Erythematous • Definition • Causes • Types of lupus • Etiology • Pathophysiology • Signs and symptoms • Diagnosis • complications • Clinical manifestation • Treatment • Prevention • references
  • 3. What is Systemic Lupus Erythematosus? • Systemic lupus erythematosus (SLE) is an autoimmune disease the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. • In this disease, the immune system of the body mistakenly attacks healthy tissue. • It can affects the joints, skin, brain, lungs, kidneys, and blood vessels. • There is no cure for lupus, but medical interventions and lifestyle changes can help control it.
  • 4. WHAT CAUSES SYSTEMIC LUPUS ERYTHEMATOSUS? • The causes of SLE are unknown, but are believed to be linked to environmental, genetic, and hormonal factors. • More than 90% of cases of SLE occur in women, frequently starting at childbearing age. • Women ages 15 to 44 and certain ethnic groups—including African American, Asian American, Hispanics/Latino, and Native American— are at higher risk for developing SLE than the rest of the population.
  • 5.
  • 6. ETIOLOGY • ETIOLOGY IS UNKNOWN • MOST PROBABLE CAUSES:- GENETIC INFLUENCE HORMONES ENVIRONMENTAL FACTORS CERTAIN MEDICATIONS
  • 8. Signs and symptoms • The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. • The most common signs and symptoms include: • Fatigue • Fever • Joint pain, stiffness • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body. • Fingers and toes that turn white or blue when exposed to cold or during stressful periods.
  • 9. • Shortness of breath • Chest pain • Dry eyes • Headaches, confusion and memory loss. • Swollen glands. • Swelling in the legs or around the eyes. • Pain when breathing deeply or lying down, from inflammation of the lining around the lungs or heart. • Headaches, dizziness, depression, confusion, or seizures. • Abdominal pain.
  • 10. • Round scaly rashes that can appear anywhere on the body. • Sensitivity to the sun that may cause a rash. • Hair loss. • Sores, which are usually painless, in the nose and mouth (most often on the roof of the mouth). • Change of color in the fingers and toes – blue-purplish, white, or red – from cold and stress.(Raynaud’s phenomenon).
  • 11.
  • 12. DIAGNOSIS • 2019 update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. • Laboratory studies used in the diagnosis of SLE are as follows: • CBC with differential • Serum creatinine • Urinalysis with microscopy • ESR or CRP level • Complement levels • Liver function tests • Creatine kinase assay • Spot protein/spot creatinine ratio • Autoantibody tests • Imaging studies
  • 13. • The following imaging studies may be used to evaluate patients with suspected SLE: • Joint radiography • Chest radiography and chest CT scanning • Echocardiography • Brain MRI/MRA • Cardiac MRI • Procedures that may be performed in patients with suspected SLE include the following: • Arthrocentesis • Lumbar puncture • Kidney biopsy
  • 14. SEVERITY OF LUPUS • The severity of lupus varies from mild to life-threatening. After many years of having lupus, patients may develop:
  • 15. COMPLICATIONS OF LUPUS • Osteoporosis (especially in those who are treated with corticosteroids) • hypertension (high blood pressure) • kidney failure • atherosclerosis (also known as atherosclerotic cardiovascular disease) • forms of heart and lung diseases • In addition, a significant number of lupus patients also have the antiphospholipid antibody (aPL) associated with antiphospholipid syndrome.
  • 16. CLINICAL MANIFESTATIONS • DERMATOLOGIC • ORAL/NASOPHARY NGEAL ULCERS • CUTANEOUS VASCULAR LESIONS • ALOPECIA • BUTTERFLY RASH
  • 17. MUSCULOSKELETAL POLY ARTHRALGIA WITH MORNING STIFFNESS SWAN NECK DEFORMITY ULNAR DEVIATION SUB LUXATION WITH HYPERLAXITY OF JOINTS
  • 22.
  • 24. PREVENTION • No way to prevent lupus. • But people who smoke may be more prone to get LUPUS. • AVOID SMOKING and other TOBACCO products to decrease the risk.
  • 25. REFERENCES • https://medlineplus.gov/ency/article/000435.htm • https://emedicine.medscape.com/article/332244- overview • https://www.lupus.org/resources/what-is-systemic- lupus-erythematosus-sle • https://www.nhs.uk/conditions/lupus/ • https://bestpractice.bmj.com/topics/en-us/103 • https://www.hss.edu/condition-list_lupus-sle.asp • https://www.mayoclinic.org/diseases- conditions/lupus/symptoms-causes/syc-20365789 • ttps://www.slideshare.net/GAMANDEEP/sle -ppt-67364877