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17335204
Salma with facial rash
Description
Mind Map on Salma with facial rash, created by Alya Almualla on 18/03/2019.
Mind Map by
Alya Almualla
, updated more than 1 year ago
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Created by
Alya Almualla
over 5 years ago
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Resource summary
Salma with facial rash
Due to
Systemic Lupus Erythematosus
Epidemiology
Prevalence and incidence
More in black than white
More in women than men
More in Hispanics
More in Indians/Alaska Natives
US
Prevalence is 20-150/100,000 people
White women "Prevalence is 164/100,000 people"
African American women "Prevalence is 406/100,000 people"
In Europe & North America "Prevalence is 24/100,000 people"
In North America, South America, Europe, & Asia "Incidence is 1-25/100,000 people"
UAE "2012"
Incidence was 2.1/100,000 people
Prevalence was 103/100,000 people
Death rates
Connective Tissue Disorder
Rheumatoid arthritis
Symmetric joint involvement
Joints of the hands, feet, wrists, elbows, knees and ankles
Morning stiffness lasting > 1 hour
Women (30 - 60 years)
Sjögren's syndrome
Destruction of the salivary and lacrimal glands
Women (40 to 60 years)
Type 4 hypersensitivity
Scleroderma \ Systemic sclerosis
Fibroblast activation and excess collagen deposition
Polymyositis
Progressive symmetric proximal muscle weakness
Dermatomyositis
Gottron’s sign
Symmetric erythematous eruption over knuckles
Heliotrope rash
Reddish eruption on upper eyelids
Shawl sign
Erythematous rash over neck, upper chest and shoulders
Mixed connective tissue disease
Autoimmune mediated tissue damage with mixed features of SLE, scleroderma, polymyositis
Psoriatic arthritis
Joint inflammation in patients with psoriasis
HLA-B27 & environmental factors
Risk factors
Gender "Women"
Age "15 - 44"
Race or ethnicity
Family history "5% - 13% chance"
Genetic factors
Pathogenesis
Failure to maintain self-tolerance
Tissue injury due to immune complex deposition
Autoantibodies "Type II hypersensitivity"
Immunofluorescence "IgG"
Deposits of immunoglobulin
Granular pattern "Kidney"
Differential Diagnosis
Adult-onset Still disease
Behcet syndrome
Chronic fatigue syndrome
Endocarditis
Fibromyalgia
HIV infection
Inflammatory bowel disease
Lyme disease
Reactive arthritis
Sarcoidosis
Thyroid disease
Clinical manifestation
Tachypnea
Cough
Photosensitivity
Pleuritis/ Pleural effusion
Weight loss
Fatigue
Fever & Increase infection
Arthritis
Emotional lability
Hematological disorder
Neurologic disorder
Raynaud’s phenomenon
Pericarditis
Vasculitis
Rash
Erythematous
Butterfly
Lupus nephritis
Proteinuria
Hematuria
Types
Drug induced
Anti-histone antibodies
No involvement of kidney or brain
Sulfasalazine, Hydralazine, Isoniazid, Procainamide / Phenytoin, Statins
Symptoms: Arthralgia - myalgia - Fatigue - Serositis
Neonatal lupus
In fetus with mothers that have
Anti Ro\SSA - anti La\SSB - anti U1RNP
Placental transmission of maternal IgG abs
Rash resembling Subcutaneous cutaneous lupus erythematosus
Cutaneous lupus
Acute
Butterfly rash
Subacute
Annular or psoriasiform plaques
Chronic
Related to photosensitivity
Chronic Discoid Lupus Erythematosus
Red inflamed, coin-shaped patches of skin with a scaling and crusty appearance
ANA
Investigations
CBC & differential
Activated PTT
BUN & electrolytes
ESR & CRP
Antinuclear antibodies, (ds) DNA, smith antigen
Urinalysis
Chest x-ray
ECG
C3, C4, CH50
Anti-ro & anti-La abs
Thyroglobulin abs & Thyroid peroxidase abs
IgG
Management
Immunosuppressants
General Mechanisms of Action
Mono- and polyclonal antibodies that block T-cell surface molecules
Antilymphocyte and antithymocyte Globulins
Basiliximab
Daclizumab
Belimumab (B-cells)
Rituximab (B-cells)
Interference with cytokine production or action
Disruption of cell metabolism, preventing lymphocyte proliferation
Corticosteroids
Mechanisms of action
Hydroxychloroquine
Decreases T-cell activation
Antibodies
Complications
Blood clots / Vasculitis
Pericarditis / Heart attack
Stroke / Memory changes / Behavioral changes / Seizures
Pleuritis
Kidney inflammation / Decreased kidney function / Kidney failure
Pregnancy complications & miscarriage
Prognosis
Clinically unpredictable
5-year survival rate (90%)
10-year survival rate (80%)
Media attachments
Ds (binary/octet-stream)
Dea (binary/octet-stream)
Screen Shot 2019 03 12 At 14.18.26 (binary/octet-stream)
Pat (binary/octet-stream)
Kid (binary/octet-stream)
Ig (binary/octet-stream)
Gvfds (binary/octet-stream)
Mos (binary/octet-stream)
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