22. Causes of STROKE in lupus
ABNORMAL ANTIBODIES:
Antiphospholipid antibodies
(APA)
Anticardiolipin antibodies
Lupus anticoagulant
ATTACK the blood vessel
initiates the formation of BLOOD CLOTS
EMBOLIC
STROKE
“Sticky Blood
Syndrome”
23. Antiphospholipid Antibody Syndrome
(APAS): “sticky blood syndrome”
Twenty to 35% of women with SLE develop
APAS
APAS occurs for the most part in young
women of fertile age
CRITERIA:
Vascular thrombosis
pregnancy morbidity
24. Antiphospholipid Antibody Syndrome
(APAS): “sticky blood syndrome”
CRITERIA:
Vascular thrombosis
In any tissue or organ
pregnancy morbidity
1 or more unexplained
fetal death at 10 wks
or beyond OR
1 or more premature birth
at or before 34thwk AOG OR
– 3 or more consecutive spontaneous
abortions
Anticardiolipin antibodies
Lupus anticoagulant
25. Causes of STROKE in lupus
VASCULITIS:
Antibodies ATTACK the blood vessel
INFLAMMATION
DECREASES blood flow
26. Causes of STROKE in lupus
ATHEROSCLEROSIS:
ARTERIES are NARROWED by plaque
DECREASES blood flow
27. TRANSIENT ISCHEMIC ATTACK
A mini-stroke
Symptoms last a few minutes or hours
Never ignore a TIA !
It is often a sign that a more damaging stroke is on the way
28. WARNING SIGNS OF STROKE
weakness on one side of the body
loss of speech or trouble understanding speech
loss of vision, particularly on one eye or
double vision
dizziness and loss of balance
numbness/tingling in the face/arm/leg
slurring of speech
severe and unusual headache
SUDDEN….
29. What to do in case of Stroke ?
the signs of stroke
Do not wait. Go to the nearest ER or
hospital with facilities for
stroke care
30.
31. Seek help right away !
0 - 3 hours treatments most effective
Clot lysis with IV rtPAClot
33. REDUCING OUR CHANCE of stroke
Have regular medical checkups.
know our:
• blood pressure
• blood sugar
• cholesterol level
…SLE might not have a cure, but it's a
highly treatable condition.
Take our medications
34. Lifestyle Changes for Lupus
Eat a healthy diet.
Exercise.
Rest.
Reduce stress.
35. Remember..
“ Work with our doctors.. because lupus is
always unpredictable and our symptoms are
likely to fluctuate over time even with good
treatment.”
“ But with patience -- and the help of our health
care team -- the odds are good that we'll find a
lupus treatment plan that works for us.”
36. 80% to 90% of people with lupus can expect a
normal lifespan with good
treatment.
Lupus Foundation of America,
Many people with lupus are unusually sensitive to the sun and other forms of ultraviolet light. A day at the beach may trigger a skin rash in areas exposed to sunlight and may worsen other lupus symptoms. Certain medications can make people with lupus even more sensitive to UV light. more than half of all people with lupus are light sensitive. More importantly, 40% to 70% of people with lupus experience an increase in lupus symptoms after being exposed to ultraviolet (UV) rays, either from the sun or from artificial light. Sunlight may cause also a lupus flare, resulting in fever, joint pain, or even organ inflammation.
Joint and muscle pain is often the first sign of lupus. This pain tends to occur on both sides of the body at the same time, particularly in the joints of the wrists, hands, fingers, and knees. The joints may look inflamed and feel warm to the touch. But unlike rheumatoid arthritis, lupus usually does not cause permanent joint damage.
A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple rash on various parts of the body, including the face, neck, and arms. Some people also develop mouth sores.
Lupus can cause the nails to crack or fall off. They may be discolored with blue or reddish spots at the base. These spots are actually in the nail bed, the result of inflamed small blood vessels. Swelling may also make the skin around the base of the nail look red and puffy.
Most people with lupus experience some degree of fatigue. In many cases, it is severe enough to interfere with exercise and other daily activities. Most patients also run a low-grade fever from time to time. This unexplained fever may be the only warning sign in some people.
Some people with lupus develop a condition called Raynaud's phenomenon. Their fingers and toes become painful, numb, and tingly in response to cold temperatures or emotional stress. This happens when small blood vessels spasm and restrict blood flow to the area. During an attack, the fingers and toes may turn white or blue. People can also have Raynaud's without having lupus or any serious health complications.
The symptoms of lupus tend to come and go, and this includes hair loss. Patients may go through periods where their hair falls out in patches or becomes thinner all across the scalp. Once the flare-up is over, new hair is likely to grow back.
it affects women 10 times more often than men. Aside from being female, your odds of getting the disease are higher if you are:
African-American, Latino, or Asian
Between the ages of 20 and 40
Related to someone with lupus…in short.. Anyone can get lupus.
Up to three out of four people with lupus can develop kidney problems. These problems may not cause symptoms, though some people notice swelling in their legs or ankles. Most patients only learn about their kidney trouble when a urine test reveals blood or abnormal protein levels.
The most common heart problem linked to lupus is an inflammation of the sac around the heart. This may cause severe pain in the left side of the chest. People with lupus are also more likely to develop plaques that narrow or clog the arteries. This can lead to coronary artery disease. Other complications include heart valve disease and inflammation of the heart muscle. Call 911 immediately for chest pain, rather than trying figure out the cause yourself.
Lupus and the medications used to treat it can contribute to anemia in some patients. This means the body has too few red blood cells, because it is not making enough, or red blood cells are being destroyed more quickly than they can be replaced. Symptoms include fatigue and shortness of breath.
And today we are going to focus our discussion on one of the most important complications of lupus.. STROKE
For a brief overview..
Stroke is a medical emergency .It occurs when a blood vessel in the brain bursts or, more commonly, when a blockage develops. Without treatment, cells in the brain quickly begin to die. The result can be serious disability or death.
As ive mentioned before, in lupus, our bodies produce abnormal ANTIBODIES.
One of the abnormal ab produced is an ANTIPHOSPHOLIPID ANTIBODY (APA).
1. APA attack membranes of the cells that line the inside of the blood vessel which initiates the formation of blood clots.. This could happen in the diff parts of the body ( deep veins of the legs, the heart and the head)
Sometimes these blood clots can travel to the brain and cause embolic strokes.
The incidence of stroke, heart attacks and TIAs are increase in pxs with SLE but are not exclusive to pxs with APAS.
2. In lupus, ANTIBODIES that attack our healthy tissues also cause inflammation inside the walls of blood vessels know as VASCULITIS. Sometimes the inflammation is so severe that blood flow is completely prevented. If this happens in the BRAIN…IT CAN LEAD TO STROKE.
Atherosclerosis also contributes to stroke where arteries are narrowed by plaque. Plaques can also be dislodged and cause embolism which can eventually lead to stroke.
Blood flow is temporarily impaired to part of the brain, causing symptoms similar to an actual stroke. When the blood flows again, the symptoms disappear. A TIA is a warning sign that a stroke may happen soon.
Even with good treatment, your symptoms are likely to fluctuate over time. Lupus is always unpredictable. That's why careful monitoring and regular check-ups are so important
