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1. Collagen vascular diseases
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2. • Rheumatoid arthritis (RA)Rheumatoid arthritis (RA)
• Reactive arthritis (Reiter's syndrome)Reactive arthritis (Reiter's syndrome)
• Giant cell arthritis (Temporal arthritis)Giant cell arthritis (Temporal arthritis)
• Systemic lupus erythematosus (SLE)Systemic lupus erythematosus (SLE)
• PolymyositisPolymyositis & Dermatomyositis& Dermatomyositis
• SclerodermaScleroderma
• Sjogren's syndromeSjogren's syndrome
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3. Systemic Lupus Erythematosus (SLE)
• Chronic inflammatory disease, Associated withChronic inflammatory disease, Associated with
abnormalities of immune systemabnormalities of immune system
• Results from interactions among genetic, hormonal,Results from interactions among genetic, hormonal,
environmental, immunologic factorsenvironmental, immunologic factors
• Autoimmune reactions directed against constituents ofAutoimmune reactions directed against constituents of
cell nucleus and DNAcell nucleus and DNA
• Ranges from disorders, most commonly affects the skin,Ranges from disorders, most commonly affects the skin,
muscles, joints, lungs, heart, nervous system, andmuscles, joints, lungs, heart, nervous system, and
kidneyskidneys
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4. Immunologic Findings in SLE
- Antinuclear antibodies (Antinuclear antibodies (ANA)ANA)
- Double-stranded DNA antibodies (Anti-dsDNA)Double-stranded DNA antibodies (Anti-dsDNA)
- Anti-RNP antibodiesAnti-RNP antibodies
- Anti-Smith (Anti-Sm) antibodiesAnti-Smith (Anti-Sm) antibodies
- Antiphospholipid antibodiesAntiphospholipid antibodies
- Lupus AnticoagulantsLupus Anticoagulants
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5. Hematologic findings in SLE
- AnemiaAnemia
- LeukopeniaLeukopenia
- ThrombocytopeniaThrombocytopenia
- Elevated ESRElevated ESR && CRPCRP
- Coagulopathy and elevated PTTCoagulopathy and elevated PTT
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6. Clinical Manifestations
• General
– Fever, headache, fatigue, malaise, weight loss, arthritisFever, headache, fatigue, malaise, weight loss, arthritis
• Skin
– Malar “Butterfly” rash, photosensitivity rashMalar “Butterfly” rash, photosensitivity rash
• Renal
– GlomerulonephritisGlomerulonephritis
• Cardiovascular
– Pericarditis, myocarditis, endocarditis, vasculitisPericarditis, myocarditis, endocarditis, vasculitis
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8. Diagnostic Studies
- Complete Blood Count (CBC) with diffComplete Blood Count (CBC) with diff
- U/AU/A
- ESR, CRPESR, CRP
- Complement levelsComplement levels
- Antinuclear antibodies (Antinuclear antibodies (ANA)ANA)
- Anticardiolipin antibody (ACLA)Anticardiolipin antibody (ACLA)
- Lupus anticoagulants (LA)Lupus anticoagulants (LA)
- PTTPTT
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9. Giant cell arthritis (temporal arthritis)
• HeadacheHeadache
• Scalp tendernessScalp tenderness
• Thickened temporal arthritisThickened temporal arthritis
• Jaw claudicationJaw claudication
• Acute visual lossAcute visual loss
• Weight loss, anorexia, fever, night sweats, malaise,Weight loss, anorexia, fever, night sweats, malaise,
depressiondepression
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11. Laboratory Findings
• Complete Blood Count (CBC)Complete Blood Count (CBC)
– Normochromic, Normocytic anemiaNormochromic, Normocytic anemia
– Reactive thrombocytosisReactive thrombocytosis
– WBC is usually normalWBC is usually normal
• Erythrocyte Sedimentation Rate (ESR)Erythrocyte Sedimentation Rate (ESR)
– Significantly elevatedSignificantly elevated
• C-Reactive Protein (CRP)C-Reactive Protein (CRP)
– Significantly elevatedSignificantly elevated
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