Скачать или смотреть SLE (Systemic Lupus Erythematosus)

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Complications of SLE

Renal Complications
Lupus nephritis occurs due to immune complex deposition in the kidneys.
Common symptoms: proteinuria, hematuria, and reduced kidney function.
Classification includes six classes, from minimal mesangial to sclerotic nephritis.
Early treatment with immunosuppressants can prevent progression to renal failure.
Black patients often experience more severe renal complications compared to White patients.

Treatment for Lupus Nephritis
Cyclophosphamide and corticosteroids are the mainstay treatments.
Emerging therapies include biologics targeting specific immune pathways.
Long-term immunosuppressive therapy carries risks like bone marrow suppression.
Early and targeted intervention improves outcomes.

Cardiovascular Complications
Pericarditis and myocarditis are common heart-related issues in SLE.
Libman-Sacks endocarditis affects heart valves, often linked to antiphospholipid antibodies.
Accelerated atherosclerosis increases the risk of heart attacks and strokes.
Regular cardiovascular monitoring is crucial for SLE patients.

Neuropsychiatric Complications
Central nervous system issues include seizures, psychosis, and anxiety.
Peripheral nervous system involvement may lead to neuropathies like myasthenia gravis.
Autoantibodies and vascular damage are major contributors to these symptoms.
Neuropsychiatric complications require a multidisciplinary approach for management.

Pulmonary Complications
Pleural effusions are the most common lung issue in SLE.
Pulmonary hypertension results from damage to lung blood vessels.
Severe cases include lupus pneumonitis and alveolar hemorrhage.
Prompt diagnosis and treatment improve lung function and quality of life.

Osteoarticular Complications
Arthritis in SLE resembles rheumatoid arthritis but is non-erosive.
Jaccoud arthropathy causes deformities like swan-neck fingers.
Osteoporosis is common due to corticosteroid use and chronic inflammation.
Fracture risk can be reduced with calcium, vitamin D, and weight-bearing exercises.

Gastrointestinal Complications
SLE can cause mesenteric vasculitis, peritonitis, and pancreatitis.
Symptoms include abdominal pain, nausea, and vomiting.
Antiphospholipid antibodies can lead to intestinal ischemia or thrombosis.
Early treatment prevents severe gastrointestinal complications.

Muscular Complications
Myalgia and muscle weakness are common in SLE.
Lupus myositis involves inflammation causing pain and elevated muscle enzymes.
Severe cases require immunosuppressive therapy and physiotherapy.
Regular monitoring ensures optimal muscle function.

Anti-Phospholipid Syndrome (APS)
APS is associated with recurrent blood clots and pregnancy complications.
Common renal issues include thrombotic microangiopathy and renal vein thrombosis.
APS nephropathy leads to hypertension and kidney damage.
Management includes anticoagulation therapy to prevent clot formation.

Summary and Key Takeaways
SLE is a complex autoimmune disease with multi-system complications.
Renal, cardiovascular, and neuropsychiatric complications are among the most severe.
Early diagnosis and targeted treatments are essential for improving outcomes.
Multidisciplinary care ensures comprehensive management of SLE patients.