Systemic Lupus Erythematosus (SLE) is an autoimmune disease where the immune system attacks its own tissues. It most commonly affects women aged 15-40. The exact causes are unknown but genetics, viruses, sunlight, and some drugs may play a role. Symptoms vary but can include rashes, joint pain, fatigue, and organ inflammation. Diagnosis involves blood tests and potentially biopsies. Treatment focuses on rest, sun protection, medications like NSAIDs, antimalarials, corticosteroids, and immunosuppressants to control disease activity and prevent organ damage. Nursing care aims to manage symptoms, prevent infections, and educate patients.

1. Systemic Lupus Erythematosus
Safaa EID
Medical surgical and critical care
department

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. 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. • 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. 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. • 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. 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. • 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. • 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. Secondary sjogren’s syndrome
• Dry eyes
• Dry mouth

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. “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. • Sensitivity to the sun
• Swelling (edema) in legs or around eyes
• Swollen glands
• Extreme fatigue

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. • 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. • Maculopapular
eruption

17. • Vasculitic skin
lesion

18. • Alopecia

19. • Oral ulcer:
• Painless sores in the
nose or mouth need to
be observed and
documented by a
doctor.

20. Different symptoms in different
body systems :
• Kidneys
Inflammation of the kidneys (nephritis)
Lungs
Central nervous system:

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. • 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. • 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. 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. 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. 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. 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. Other therapy
• Plasma exchange
• Intravenous Immunoglobulin
• Stem cell transplantation
• Immune therapy ( anti-IL10, anti-CD20,
and immune tolerance therapy)

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. – 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. Thanks