This document discusses systemic lupus erythematosus (SLE), a chronic autoimmune disease characterized by the formation of autoantibodies. SLE can affect many parts of the body including the skin, joints, heart, lungs, kidneys, and nervous system. Diagnosis involves detecting antinuclear antibodies (ANAs) and other autoantibodies in the blood through tests like the fluorescent antinuclear antibody (FANA) test. FANA testing can identify different antibody patterns that may indicate SLE or other autoimmune conditions. Laboratory tests are also used to monitor disease activity and screen for organ involvement.

1.  By:
Izatty Lim
0308188

2.  Multisystem auto-immune disorder
 Formation of autoantibodies
o antinuclear antibodies/ANAs
o Lead to inflammation and abnormal blood vessels (vasculitis,
immune complex deposition)
 Clinically,
o Chronic
o Unpredictable
o Remitting & relapsing disease
o Insidious onset
o Many clinical presentation overlap features of other
autoimmune disease.

5.  Dermatologic
o Cutaneous vascular lesion
o Butterfly rash
o Oral ulcers
o Alopecia
o Photosensitivity
 Musculoskeletal
o Arthritis (non-erosive)
o Characterized by
tenderness, swelling or
effusion.

6.  Cardiopulmonary
o Pleuritis, pericaditis
o Libman-Sack endocarditis (less
common)
o Coronary artery disease
o Interstitial fibrosis (lung)
 Renal
o Proteinuria
o Glomerulonephritis (deposition of
DNA-anti-DNA complexes within
glomeruli)
o Renal failure

7.  Nervous system
o Often ascribed it is due to vascular
lesion
o Cerebral microinfarcts
o Seizure, psychosis
 Hematologic
o Hemolytic anemia
o Leukopenia
o Lymphopenia
o Thrombocytopenia

8.  FANA
o Anti-dsDNA and anti-Sm antibody
 Homogeneous pattern:
o found with antibodies to chromatin, histones &
double stranded DNA.
o seen in lupus and occasionally in other
autoimmune diseases.
 Speckled pattern:
o found with antibodies to non-DNA nuclear antigens.
o most common immunofluorescent pattern & least
specific
 Nucleolar pattern (green spots):
o found with antibodies to RNA.
o systemic sclerosis
 Rim or peripheral pattern:
o found with antibodies to double-stranded DNA.
This pattern is seen frequently in lupus.

9.  ELISA Test
o ds-DNA antibodies
o Anti-histone antibodies
o Deoxyribonucleoprotein
(DNP)
 Ouchterlony Test
o Used to determine immunological
specificity
o Shows the serum does or does
not have antinuclear antibodies
 Multiplexed
immunoassays
o support the identification of
multiple autoantibodies
from a single determination
in the same time.

10. established by the American Rheumatism Association

11.  CBC with differential
 Serum creatinine
 Urinalysis with microscopy
 ESR or CRP results
 Complement levels
 Liver function tests (Alanine aminotransferase (ALT))
 Creatine kinase assay (myocarditis, myocardial
infarction)
 Spot protein/spot creatinine ratio (proteinuria)
 Autoantibody tests

12.  Robbins Basic Pathology 9th Edition
• By Kumar Abbas Aster
 Journal of Clinical Pathology
o http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769989/
 Pathology Student. FANA Testing.
o http://www.pathologystudent.com/?p=7612