Systemic, inflammatory, autoimmune disease of the connective tissues - Inflammation reduced blood supply and can cause ischemia to tissues and organs
Associated with exacerbations and remissions; No cure but can be managed - potentially fatal
What is the pathophysiology associated with SLE?
Kidney failure (most common)
Cardiac disease
CNS disease
What are the leading causes of death associated with SLE?
Genetic
Hormonal
Environmental (sunlight, burns)
Meds - Hydralazine, procaninmide, isoniazid, chlorpromazine, phenytoin (If meds are the cause, symptoms disappear once meds are stopped)
Name factors that may contribute to the onset of SLE
Discoid Lupus Erythematosus - form of lupus that only affects the skin (inflammatory)
What is DLE/Discord?
Dryness, scaliness
Butterfly/Malar rash (50%)
Sun sensitivity
Oral ulcers
Hair loss
Name s/s of lupus relating to the skin
Arthritis (90%)
Myalgias
Joint inflammation, Arthralgia
Pain and atrophy
Name s/s of lupus relating to the musculoskeletal system
Lupus Nephritis
Changes in glomeruli
Decreased UO
Proteinuria, hematuria
Fluid retention
Name s/s of lupus relating to the kidneys
Pneumonitis
PE
Pleural effusions
Dyspnea
Hypoventilation
Name s/s of lupus relating to the respiratory system
Pericarditis
Myocarditis
Endocarditis
Vasculitis
Hypertension
Atherosclerosis
Raynaud's Disease
Name s/s of lupus relating to the cardiovascular system
Abdominal pain
Mesenteric arteritis
Peritonitis
Pancreatitis
Ulcers
Liver enlargement
Splenomegaly
Name s/s of lupus relating to the GI tract
Psychoses
Seizures
Headaches, strokes
Peripheral neuropathy
Name s/s of lupus relating to the Nervous system
Fever (often the 1st sign of an exacerbation)
Generalized weakness
Fatigue
Anorexia
Weight loss
Name systemic s/s of lupus
Pancytopenia - thrombocytopenia
Leukocytopenia or leukocytosis
Blood clots
Name s/s of lupus relating to the blood
Pain
Fatigue/weakness
Decreased desire
Name s/s of lupus relating to sexual dysfunction
No single test is a definitive diagnosis!
CBC, Lyte panel, coag studies
Liver & cardiac enzymes
Anticardiolipin antibodies
Serum ANA,ESR, immunglobulins
Lupus cell (LE prep)
Labs that would be of concern during a Lupus flare up would be those that may ind
What tests may be used to help diagnose SLE or confirm an exacerbation?
Skin Biopsy (is a confirmational diagnosis)
What test is used to diagnose DLE?
Steroids - Topical, enteral and parenteral (mainstay)
NSAIDS
Antimalarials - Hydroxychloroquine (Plaquenil), chloroquiine (Aralen)
Immunosuppressants - Azathioprine (Imuran), Cyclophosphamide (Cytoxan), Methotrexate, Cyclosporine (Neoral, Sandimmune)
Name meds commonly used in the management of SLE
Avoid sunlight
Mild soaps
Cosmetic cover-ups
Daily inspection
Mild shampoos with no chemicals
Name ways to manage skin irritation and hair loss in patients with SLE
Plasmapheresis (removes autoantibodies)
Renal transplant if renal failure occurs
Stem cell transplant (last ditch effort - risky!)
Name treatments used for refractory disease in patients with SLE
May need repeated hospitalizations
Recognize signs of exacerbation
Coping strategies, psychosocial care
Need for continued medical follow-up
Healthy lifestyles, Energy conservation
Lupus support group www.lupus.org
Sexual counseling
Pregnancy aggravates t
Name important areas of client education for patients with SLE
Weight gain
Hirsuitism in females
Mood swings
Name side effects of steroids that may negatively effect patients with SLE