Systemic Lupus Erythematosus (SLE)
SLE is a chronic autoimmune disease that affects predominantly young women, with greater prevalence and more severe disease in blacks and Hispanics. There are both genetic and environmental triggers to the disease.
There are two classification criteria for SLE, with manifestations that include the cutaneous, musculoskeletal, serositis, renal, neuropsychiatric, cytopenias, and serological antibodies in the classification for SLE.
Medications may also cause lupus-like symptoms, hydralazine, procainamide, penicillamine, quinidine, minocycline, isoniazid, antitumor necrosis factor inhibitors, diltiazem, interferon-alpha, methyldopa, and chlorpromazine. NSAIDs and thiazide diuretics can trigger a photosensitive rash in SLE patients.
Renal involvement in SLE is divided into six classes, which can be differentiated by renal biopsy.
The ACR has 19 case definitions for neuropsychiatric lupus (NPSLE), including diffuse and focal manifestations. Anti-neuronal antibodies, anti-ribosomal P antibodies, antiphospholipid antibodies, N-methyl-D-aspartate receptor (NMDAR) antibodies, and anti-aquaporin-4 antibodies (neuromyelitis optica) may play a role in the NPSLE.
Cyclophosphamide may decrease fertility in lupus.
Estrogen-containing oral contraceptives are safe in certain populations of SLE patients with no or low-disease activity and those who do not have antiphospholipid antibody syndrome.
Hydroxychloroquine may reduce the risk for SLE flares during pregnancy, and data suggests that it may lessen the risk for neonatal lupus in SSA- or SSB-positive mothers.
KeywordsLupus Systemic lupus erythematosus Rheumatology board exam Rheumatology board questions Rheumatology review Board study
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