Download Systemic lupus erythematosus (SLE)

Systemic
Lupus Erythematosus
Presented by: J. Yeban & A. Arante
1
Presented by: J. Yeban & A. Arante
2
- A multisystem disease of autoimmune origin. It
is a complex disorder of multifactorial origin
resulting from interactions among genetic,
hormonal, environmental and immunologic
factors.
Presented by: J. Yeban & A. Arante
3
Systemic lupus erythematosus (SLE) is the most
common form of lupus. "Systemic" means it can
affect several parts of the body. A subtype of SLE is
drug-induced
lupus.
Some
medications
uncommonly used for high blood pressure, heart
disease and tuberculosis can cause this condition.
Presented by: J. Yeban & A. Arante
4
Presented by: J. Yeban & A. Arante
5
•
•
•
•
•
•
•
skin rash
pain and swelling in joints
muscle aches
fatigue
weight loss
hair loss
loss of appetite
Presented by: J. Yeban & A. Arante
6
• lesions over the bridge of the nose and cheeks, and
sometimes on the scalp. Lesions dry into scales that fall
off the body, leaving scars (DLE only)
• Raynaud's syndrome (a condition in which a sudden,
severe reduction in blood flow causes fingers to turn
waxy, white and blue and painfully cold)
Presented by: J. Yeban & A. Arante
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8
Presented by: J. Yeban & A. Arante
1. It is unknown; affects the connective tissue and is
thought to be due to a defect in the body’s
immunologic mechanisms, genetic predisposition,
or environmental stimuli.
2. Immune complex deposits in blood vessels,
among collagen fibers, and on organs.
Presented by: J. Yeban & A. Arante
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3. Necrosis of the glomerular capillaries, inflammatory
of the cerebral and ocular blood vessels, necrosis of the
lymph nodes, vasculitis of the GI tract and pleura, and
degeneration of the basal layer of the skin.
4. More common in females aged 13-40 years.
Presented by: J. Yeban & A. Arante
10
Corticosteroids and analgesic to reduce pain and
inflammation.
Supportive therapy as the major organ become
affected (heart, kidneys, CNS, GI tract).
Presented by: J. Yeban & A. Arante
11
 History and physical examination
 Antibodies
Anti-DNA antibody
Anti-Sm antibody
Antinuclear antibody (ANA)
Complete Blood Cell Count
LE cell prep.
Urinalysis
X-ray of affected joints
Chest x-ray
ECG to determine extra articular involvement
Presented by: J. Yeban & A. Arante
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Treatments may include:




rest
exercise
physical therapy for muscle weakness
avoiding sun exposure
medications such as:
 anti-inflammatory drugs such as aspirin
for symptomatic relief
Presented by: J. Yeban & A. Arante
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 corticosteroid drugs such as prednisolone for inflammation
 antimalarial drugs such as chloroquine phosphate or
hydroxychloroquine for rashes, arthritis and malaise
 immunosuppressive and cytotoxic drugs such as Immuran
(azathioprine) and Cytoxan (cycyclophosphamide) are prescribed
with vital organs are involved and/or corticosteroids aren't
effective
Presented by: J. Yeban & A. Arante
14
Surgery
Surgery is not used to treat mild or moderate symptoms
of lupus(systemic lupus erythematosus, or SLE). Surgery
may be considered for people with lupus who have
permanent, life-threatening kidney damage. A kidney
transplant or kidney dialysis may be done instead of
continuing long-term treatment with high doses of
medicines that have serious side effects.
Presented by: J. Yeban & A. Arante
15
 If kidney disease from lupus does not respond to
high-dose
corticosteroids
and
other
immunosuppressive medicines, kidney dialysis or
transplant are reasonable options.
 For unknown reasons, overall lupus disease activity
is often less severe during dialysis and after kidney
transplant.
Presented by: J. Yeban & A. Arante
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• Minimize fatigue
• Maintain weight at optimal range.
• Teach the patient to recognize fever and signs and
symptoms of infection.
• Assist the patient in adjusting to physical and lifestyle
changes
• Recognize the signs and symptoms of depression and
initiate a plan of care.
Presented by: J. Yeban & A. Arante
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 Brunner and Suddarth’s textbook of: Medical Surgical Nursing
(volume 2)
 Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft
Corporation. All rights reserved.
 http://www.medicinenet.com/systemic_lupus/article.htm
Presented by:
Jay-Ann M. Yeban
Arjo M. Arante
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