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Systemic lupus

this topic describes indetail regarding the SYSTEMIC LUPUS ERYTHAMETOSUS (SLE) and its management

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Systemic lupus

  1. 1. Systemic Lupus Erythematosus (SLE) By: Mr. M. Sivananda Reddy
  2. 2. Incidence • About 90% of all cases occur in women • Most cases occur in women of childbearing years • At the age of 30 years the ratio of women to men is 10:1 • African, Asian, Hispanic, and Native Americans three times more likely to develop than whites
  3. 3. Etiology • Auto immune • Etiology is unknown • Most probable causes: – Genetic influence – Hormones – Environmental factors- UV B rays, infections with CMV, HCV, smoking – Certain medications- Trimethoprim, Sulphamethaxozole
  4. 4. Pathophysiology • Autoimmune reactions directed against constituents of cell nucleus, DNA • Antibody response related to B and T cell hyperactivity which is stimulated by the Estrogen • The antigen antibody complexes that are developed will be in the circulation and blocks the microvasculature and the spaces
  5. 5. Clinical Manifestations • Ranges from a relatively mild disorder to rapidly progressing, affecting many body systems • Most commonly affects the skin/muscles, lining of lungs, heart, nervous tissue, and kidneys
  6. 6. • Dermatologic: – Cutaneous vascular lesions – Butterfly rash – Oral/nasopharyngeal ulcers – Alopecia
  7. 7. Butterfly Rash / Malar Rash
  8. 8. • Musculoskeletal –Polyarthralgia with morning stiffness –Arthritis • Swan neck fingers • Ulnar deviation • Subluxation with hyperlaxity of joints
  9. 9. Swan Neck Deformity
  10. 10. Ulnar deviation:
  11. 11. • Cardiopulmonary – Tachypnea – Pleuritis – Dysrhythmias – Accelerated CAD – Pericarditis
  12. 12. • Renal – Lupus nephritis • Ranging from mild proteinuria to glomerulonephritis
  13. 13. • Nervous system – Generalized/focal seizures – Peripheral neuropathy – Cognitive dysfunction • Disorientation • Memory deficits • Psychiatric symptoms
  14. 14. • Hematologic – Formation of antibodies against blood cells – Anemia – Leukopenia – Thrombocytopenia – Coagulopathy – Anti-phospholipid antibody syndrome
  15. 15. • Infection – Increased susceptibility to infections – Fever should be considered serious – Infections such as pneumonia are a common cause of death
  16. 16. Diagnostic Studies
  17. 17. • Antinuclear antibodies – ANA and other antibodies indicate autoimmune disease – Anti-DNA and anti-Smith antibody tests most specific for SLE – ESR & CRP are indicative of inflammatory activity.
  18. 18. • CBC for hematologic problems • Ultrasound Abdomen for lupus nephritis • X-rays of affected joints • Chest x-ray for pulmonary problems • ECG for cardiac problems
  19. 19. Treatment • Drug therapy –NSAIDs- Acetaminophen –Antimalarial drugs- Hydroxychloroquine –Corticosteroids- Prednisone –Immunosuppressive drugs
  20. 20. Nursing Management Nursing Diagnoses • Fatigue • Acute pain • Impaired skin integrity • Ineffective therapeutic regimen management • Body image disturbance
  21. 21. Nursing Interventions – Observe for • Fever pattern • Joint inflammation • Limitation of motion • Location and degree of discomfort • Fatigability
  22. 22. – Monitor weight and I&O – Collect 24-hour urine sample – Assess neurological status – Explain nature of disease – Provide support
  23. 23. • Ambulatory and home care – Reiterate that adherence to treatment does not necessarily halt progression – Minimize exposure to precipitating factors – fatigue, sun, stress, infection, drugs – Teach energy conservation and relaxation exercises – Teach regarding ROM to prevent contractures
  24. 24. • Psychosocial issues – Counsel patient and family that SLE has good prognosis – Physical effects can lead to isolation, self-esteem, and body image disturbances – Assist patient in developing goals

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