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Systemic lupus erythematosus

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Systemic Lupus Erythematosus
Systemic Lupus Erythematosus
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Systemic lupus erythematosus

  1. 1. Systemic Lupus Erythematosus Safaa EID Medical surgical and critical care department
  2. 2. Definition • is an autoimmune disease of the body's connective tissues. • Autoimmune means that the immune system attacks the tissues of the body. • attacks parts of the cell nucleus. • between the ages of 15 and 40, although it can show up at any age.
  3. 3. Pathogenesis • A healthy immune system produces proteins called antibodies and specific cells called lymphocytes. • that help fight and destroy viruses, bacteria, and other foreign substances that invade the body.
  4. 4. • In lupus, the immune system produces antibodies against the body's healthy cells and tissues. • These antibodies, contribute to the inflammation of various parts of the body and can cause damage to organs and tissues. • Lupus can affect -joints, skin, kidneys, heart, lungs, blood vessels, and brain.
  5. 5. Causes • The exact causes is not known. • Inherited genes, viruses, ultraviolet light, and drugs may all play some role. • Genetic factors increase the tendency of developing autoimmune diseases
  6. 6. • female hormones play an important role in the expression of SLE. • a key enzyme's failure to dispose of dying cells may contribute the development of SLE. • a genetic mutation • Drug-induced lupus. ( hydralazine, beta- blokers, isoniazid) .
  7. 7. There are several kinds of lupus: • Discoid lupus erythematosus is • a chronic skin disorder • red, raised rash appears on the face, scalp, or elsewhere • The rash may last for days or years .
  8. 8. • Sub acute cutaneous lupus erythematosus refers to skin lesions that appear on parts of the body exposed to sun. The lesions do not cause scarring. • Drug-induced lupus is a form of lupus caused by medications. Many different drugs can cause drug- induced lupus • Neonatal lupus is a rare disease that can occur in newborn babies of women with SLE
  9. 9. • Sjögren's syndrome is an autoimmune disorder in which immune cells attack and destroy the excroin glands that produce tears and saliva. • Sjögren's syndrome is also associated with rheumatic disorders such as rheumatoid arthritis
  10. 10. Secondary sjogren’s syndrome • Dry eyes • Dry mouth
  11. 11. Clinical manifestations • The symptoms of SLE come on in waves, called flares or flare-ups. In between flares, patients may have almost no symptoms. • general discomfort, extreme fatigue, fever, and weight loss at some point.
  12. 12. “Common Symptoms of Lupus • Painful or swollen joints and muscle pain • Unexplained fever • Red rashes, most commonly on the face • Chest pain upon deep breathing • Unusual loss of hair • Pale or purple fingers or toes from cold or stress .
  13. 13. • Sensitivity to the sun • Swelling (edema) in legs or around eyes • Swollen glands • Extreme fatigue
  14. 14. • Malar rash: • This is a "butterfly- shaped" red rash over the cheeks below the eyes and across the bridge of the nose. • It may be a flat or a raised rash. • The rashes are made worse by sun exposure.
  15. 15. • Raynaud’s phenomenon • is commonly found in lupus. • reaction of distal digits to cold or emotion, in which the skin colour changes from white to blue to red)
  16. 16. • Maculopapular eruption
  17. 17. • Vasculitic skin lesion
  18. 18. • Alopecia
  19. 19. • Oral ulcer: • Painless sores in the nose or mouth need to be observed and documented by a doctor.
  20. 20. Different symptoms in different body systems : • Kidneys Inflammation of the kidneys (nephritis) Lungs Central nervous system:
  21. 21. • Blood vessels: • Blood vessels may become inflamed (vasculitis) • Muscles and Bones: • joint pain or inflammation. • The pain can come and go, or it can be long lasting.
  22. 22. • Blood: • anemia, leucopenia (a decreased number of white blood cells), or thrombocytopenia (a decrease in the number of platelets in the blood, which assist in clotting). • Heart: • (myocarditis and endocarditis) or the membrane that surrounds it (pericarditis).
  23. 23. • Digestive System: • Symptoms include abdominal pain, loss of appetite, nausea, and sometimes vomiting. • psychological and emotional effects • such as grief, depression, and anger, depression • Pregnancy. • However, the chances of miscarriage, premature birth, and death of the baby in the uterus are high.
  24. 24. Diagnostic studies – Complete blood count (CBC) – Erythrocyte sedimentation rate (ESR) – Urinalysis – Blood chemistries – Antinuclear antibody test (ANA) – Other autoantibody tests (anti-DNA) • Skin biopsy • Kidney biopsy
  25. 25. Treatment • A conservative regimen of physical and emotional rest is required • protection from direct sunlight • a healthful diet • prompt treatment of infections • pregnancy must be planned for times when the disease is under control, and the patient is on allowable medications.
  26. 26. Medications 1-NSAIDs: • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. 2- Antimalarials: • (Plaquenil). It may be used alone or in combination with other drugs 3- Corticosteroids:
  27. 27. 4- Immunosuppressives: For some patients whose kidneys or central nervous system are affected by lupus, such as cyclophosphamide (Cytoxan) - restrain the overactive immune system by blocking the production of immune cells.
  28. 28. Other therapy • Plasma exchange • Intravenous Immunoglobulin • Stem cell transplantation • Immune therapy ( anti-IL10, anti-CD20, and immune tolerance therapy)
  29. 29. Nursing care • Minimize appearance of lesions. • Alleviate discomfort • Minimize fatigue. • Maintain weight at optimal range • Teach the patient to recognize fever and signs and symptoms of infection. • Maintain joint function and increase muscle strength.
  30. 30. – Recognize anemia and develop a plan of care – Minimize episodes of bleeding. – Minimize incidence of infection. – Educate the patient about immunizations – Educate patient nutritional status.
  31. 31. Thanks

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