Скачать или смотреть Systemic lupus erythematosus SLE; autoimmune disease, immune system attacks healthy tissues

Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune disease in which the body’s immune system mistakenly attacks its own tissues, leading to widespread inflammation and tissue damage. It is known as the “great imitator” because it can affect multiple organ systems and mimic many other conditions.

Key Features
Autoimmune basis: Production of autoantibodies (especially anti-dsDNA, anti-Smith) against nuclear components.

Multisystem involvement: Can affect skin, joints, kidneys, heart, lungs, nervous system, and blood.

Course: Characterized by relapses (flares) and remissions.

Clinical Manifestations
General: Fatigue, fever, weight loss.

Skin:

Malar rash (butterfly-shaped rash across cheeks and nose).

Photosensitivity.

Discoid rash.

Musculoskeletal:

Non-erosive arthritis (painful, swollen joints).

Renal:

Lupus nephritis (proteinuria, hematuria, hypertension).

Cardiopulmonary:

Pericarditis, pleuritis, myocarditis.

Neurological:

Seizures, psychosis, cognitive dysfunction.

Hematological:

Anemia, leukopenia, thrombocytopenia.

Diagnosis
Clinical criteria + laboratory findings:

ANA (antinuclear antibody) – highly sensitive but not specific.

Anti-dsDNA and anti-Smith antibodies – highly specific.

Complement levels (C3, C4) often low during active disease.

Classification criteria: ACR/EULAR guidelines combine clinical and immunological features.

Management
General principles:

Tailored to disease severity and organ involvement.

Aim: control inflammation, prevent flares, minimize organ damage.

Medications:

NSAIDs for mild joint/serosal symptoms.

Corticosteroids for acute flares.

Hydroxychloroquine (cornerstone for long-term management).

Immunosuppressants (azathioprine, mycophenolate, cyclophosphamide) for severe organ involvement.

Biologics (belimumab, rituximab) in refractory cases.



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