autoimmune dieases

1. Systemic Lupus Erythematosus

2. 1. Clinical features.
2. THE MORPHOLOGIC CHANGES IN SLE:-
• Vasculitis
• Kidney
• Skin
• Joints
• CNS
• Pericarditis with other serosal cavity
involvement-
• CVS
• Spleen

3. • SLE is a multisystem
disease that is highly
variable in clinical
presentation.
• Its diagnosis relies on
combination of clinical,
serological and
morphological changes.
Clinical signs and symptom

4. Clinical and pathologic
manifestation of
systemic lupus
erythematosus

5. THE MORPHOLOGIC CHANGES IN SLE
.
An acute necrotizing
vasculitis involving
capillaries, small arteries,
and arterioles may be
present in any tissue.
The arteritis leads to
fibrinoid necrosis of the
vessel walls. In
chronic stages, vessels

6. • Kidney involvement is one of the
most important clinical features
of SLE, with renal failure. being
the most common cause of
death.
• A kidney biopsy is essential in
the renal assessment of patients
with SLE and is indicated in all
patients having abnormalities of
urine sediment or abnormal
renal function
• The pathologic findings of lupus
Classification of lupus nephritis 2004

7. .

8. • The skin is involved in a
majority of patients
• A characteristic
erythematous or
maculopapular eruption over
the malar eminences and
bridge of the nose ("butterfly
pattern") is observed in
approximately half of the
cases.
• Exposure to sunlight (UV

9. Skin
• Histopathologic
findings include
liquefactive
degeneration of the
basal layer of the
epidermis
• Edema at the
dermoepidermal
junction, and

10. • It consists of swelling and
a nonspecific
mononuclear cell
infiltration in the synovial
membranes
• Erosion of the membranes
and destruction of articular
cartilage, such as in RA,
are exceedingly rare.

11. • CNS disease often is ascribed to
vascular lesions causing
ischemia or multifocal cerebral
micro infarcts.
• Small vessel angiopathy with
noninflammatory intimal
proliferation is the most
• frequent pathological lesion; frank
vasculitis is uncommon. The
angiopathy may result from

12. • Pericardium and
pleura, in particular,
are serosal
membranes that
show a variety of
inflammatory
changes in SLE
ranging (in the acute
phase) from serous
effusions to fibrinous
exudates
Recurrent Lupus
Pericarditis

13. .
• Involvement of the heart
is manifested
• primarily in the form of
Pericarditis. Myocarditis
(in the form of a
nonspecific mononuclear
cell infiltrate) and valvular
lesions (called Libman-
Sacks endocarditis) also
occur but are less
common in the current
era of aggressive
corticosteroid therapy
• Moreover, glucocorticoid
Libman-Sacks
endocarditis of the mitral
valve in lupus
erythematosus

14. • The spleen may be
moderately enlarged.
• Capsular fibrous
thickening is common,
as is follicular
hyperplasia with
numerous plasma cells
in the red pulp
• Central penicilliary
arteries