Systemic Lupus Erythromatosus (SLE).PPTX

3. • Classification criteria
• Treatment

14. • Causes of death in patients with SLE:

15. 1) Blood investigations :
- CBC : 1) normocytic normochromic anemia
2) thrombocytopenia
3) leukopenia
( pancytopenia )
- ESR: elevated specially with active SLE and infection
2) serology tests :
-specific tests : good positive tests .
1) anti double stranded DNA ( Anti-dsDNA) : Positive in about 60% of SLE patients .
2) anti smith antibodies ( Anti-sm ) : positive in about 30% of the SLE patients .
-sensitive tests: good negative tests .
anti DNA antibodies ADA

16. • 3) Renal investigations :
-Urine analysis : :1) proteinuria 2) hematuria 3) casts : red cell,
granular ( with active nephritis )
-24 h urinary protein : to detect proteinuria
-kidney function test : impaired ( high serum creatinine and urea with renal
affection )
-Renal biopsy : not recommended in all cases ( show membranous GN and
interstitial nephritis )
• Drug induced SLE :( reversable )
(ANA is positive – Anti_dsDNA is negative – serum complements are normal )
• Monitoring of disease activity :
( ANA – Anti_dsDNA –serum complements –ESR –KFT)

17. ( Classification criteria )
-Presence of 4 or more of these criteria-
1. Butterfly (malar) rash on cheeks
2. discoid rash
3. photosensitivity
4. Oral or nasopharyngeal ulcers
5. Joint swelling, stiffness, pain involving two or more joints (arthritis)
6. serositis
7. Nephritis
8. Nervous system problems, such as seizures or psychosis, without known cause
9. Hematological disorders(Cytopenia)
10. Laboratory tests showing increased autoimmune activity (antibodies against normal tissue)
11. Positive antinuclear antibody (ANA) test

18. Diagnostic
classification
of SLE
(EULAR/ACR2019)

19. • Rheumatoid arthritis (erosive arthiritis)
• Mixed connective tissue disease
• Drug-induced SLE (HYdralazine , INH ,alpha methyl dopa)
• Various forms of Dermatitis
• Sarcoidosis
• Neurological disorders such as: epilepsy, multiple sclerosis, psychiatric
disorders
• Infections (parvo B19 ,TB, HIV ,EBV)
• Malignancies (leukemia, lymphoma)
• Thyroid disease