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Systemic Lupus Erythematosus
Who can see the pain within my
heart?
COMPARE……..
Epidemiology
Clinical feature
Manifestation Prevalence(%)
Fatigue/malaise/fever 95
Cutaneous 80
hematologic 85
Neurologic 60
Cardiopulm...
Investigation:
Screening:
ANA
Specific:
Anti-ds DNA
Diasease activity;
Complement, Anti ds DNA, active sediment in
urine
SlICC clinic criteria for
SLE
Clinical manifestation Immunologic manifestation
 Acute cutaneous
 Chronic cutaneous
 Ora...
Treatment
Not life or
organ
threatening
Life or organ
threatening
 High dose
glucocorticoids
Addition of immunosuppressiv...
What about ?
 hydoxychlroquinine
Scleroderma
Definition
 Connective tissue disorder, involve multisystem
 Characterised by skin thickening
Epidemiology
 Female predominant(4.6:1)
 Peak age of onset: 30-50 years
Types of systemic sclerosis
Characterstics Limited cutaneous Diffuse cutaneous
Skin involvement Limited distal to elbow Di...
Clinical features
Raynaud phenomenon
INVESTIGATION
Diagnosis Supportive
ACA: limited cutaneous SSC
Anti-toposisomerase I:
Diffuse cutaneous SS
Full thickness s...
Treatment
Definative supportive
 Disease modifying therapy
 Glucocorticoids:only if
indicated
 Cyclophosphamide:for ILD...
Treatment
 No any treatment to significantly alter the
course the natural history of disease.
Thank you
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Sle

autoimmune disease ,primarily affecting the adult female,great imitator

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Sle

  1. 1. Systemic Lupus Erythematosus
  2. 2. Who can see the pain within my heart?
  3. 3. COMPARE……..
  4. 4. Epidemiology
  5. 5. Clinical feature Manifestation Prevalence(%) Fatigue/malaise/fever 95 Cutaneous 80 hematologic 85 Neurologic 60 Cardiopulmonary 60 Renal 30 Gastrointestinal 40 Thrombosis 15
  6. 6. Investigation: Screening: ANA Specific: Anti-ds DNA Diasease activity; Complement, Anti ds DNA, active sediment in urine
  7. 7. SlICC clinic criteria for SLE Clinical manifestation Immunologic manifestation  Acute cutaneous  Chronic cutaneous  Oral ulcer  Serositis  Alopecia  Synovitis  Renal  Neurologic  Hemolytic anemia  Leucopenia  thromcytopenia  ANA  Anti-ds DNA  Anti-Sm  Antiphospholipid  Low serum complement  Positive DCT 4 CRITERIA AT ALEAST 1 CRITERIA EACH FROM CLINICAL AND IMMUNOLOGICAL BIOPSY PROVEN LUPUS NEPHRITIS+ANA/ANTI DS DNA
  8. 8. Treatment Not life or organ threatening Life or organ threatening  High dose glucocorticoids Addition of immunosuppressive Mycophenolate/cyclophosphamide
  9. 9. What about ?  hydoxychlroquinine
  10. 10. Scleroderma
  11. 11. Definition  Connective tissue disorder, involve multisystem  Characterised by skin thickening
  12. 12. Epidemiology  Female predominant(4.6:1)  Peak age of onset: 30-50 years
  13. 13. Types of systemic sclerosis Characterstics Limited cutaneous Diffuse cutaneous Skin involvement Limited distal to elbow Diffusely involve Raynauds phenomenon Precedes the skin involvement Coincident ILD Mild Common and severe Renal crisis Rare Common Antibodies Anticentromere Ab Anti-topoisomerase Ab.
  14. 14. Clinical features
  15. 15. Raynaud phenomenon
  16. 16. INVESTIGATION Diagnosis Supportive ACA: limited cutaneous SSC Anti-toposisomerase I: Diffuse cutaneous SS Full thickness skin biopsy  ECHO:  PFT:  UGI endoscopy:  Nail cappillaroscopy:
  17. 17. Treatment Definative supportive  Disease modifying therapy  Glucocorticoids:only if indicated  Cyclophosphamide:for ILD  Mehtotrexate/mycophenol ate mofetil:little benefit  Antifibrotic therapy:D- penicillamine  Vascular therapy:Calcium channel blocker  gastrointestinal :  Pulmonary artery hypertension:  Renal crisis:
  18. 18. Treatment  No any treatment to significantly alter the course the natural history of disease.
  19. 19. Thank you

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