Systemic Lupus Erythematosus

1Presented by: J. Yeban & A. Arante

2Presented by: J. Yeban & A. Arante

Systemic Lupus Erythematosus

- A multisystem disease of autoimmune origin. It is a complex disorder of multifactorial origin resulting from interactions among genetic, hormonal, environmental and immunologic factors.

3Presented by: J. Yeban & A. Arante

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.

4Presented by: J. Yeban & A. Arante

SLE affects:

5Presented by: J. Yeban & A. Arante

Signs and Symptoms

• skin rash• pain and swelling in

joints• muscle aches• fatigue• weight loss• hair loss• loss of appetite

6Presented by: J. Yeban & A. Arante

• 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)

7Presented by: J. Yeban & A. Arante

8Presented 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.

Etiology and Pathophysiology

9Presented by: J. Yeban & A. Arante

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.

10Presented by: J. Yeban & A. Arante

Therapeutic Interventions

Corticosteroids and analgesic to reduce pain and inflammation.

Supportive therapy as the major organ become affected (heart, kidneys, CNS, GI tract).

11Presented by: J. Yeban & A. Arante

Diagnostic Tests

History and physical examination Antibodies

Anti-DNA antibodyAnti-Sm antibody Antinuclear antibody (ANA)Complete Blood Cell CountLE cell prep.UrinalysisX-ray of affected jointsChest x-rayECG to determine extra articular involvement

12Presented by: J. Yeban & A. Arante

Treatment

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

13Presented by: J. Yeban & A. Arante

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

14Presented by: J. Yeban & A. Arante

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.

Surgery

15Presented by: J. Yeban & A. Arante

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.

16Presented by: J. Yeban & A. Arante

Nursing Interventions

• 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.

17Presented by: J. Yeban & A. Arante

Sources: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

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Presented by: Jay-Ann M. Yeban

Arjo M. Arante