65.& 66. lupus eritematoso sistemico

Lupus Eritematoso Sistémico (LES) M32.9 Dr. José Leonardo Piscoya - Arbañil Emeritus Member, American College of Rheumatology N º 15143 Fellow American College of Physicians N° 046247 Lima, 26 de Enero del 2006

LES : Hitos históricos ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES : Epidemiología* ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* Lupus 2002, 11:528

LES : Definición ,[object Object]

LES : Inmunopatología ,[object Object],[object Object],[object Object]

LES : Inmunopatogénesis de AAN ,[object Object],[object Object],[object Object],[object Object]

LES : Principales AAN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Antígeno blanco ds DNA ss DNA H1,H2A,H2O,H3,H4 Sn RNP Sn RNP 60 y 52-kDA prot 48 kDA Función Inf.genét Inf.genét Est.nucleosoma Proc RNA Proc RNA Desconocida Regulac RNA % LES 40 70 70 30 32 35 15

LES : Determinante de susceptibilidad enf. ,[object Object],[object Object],[object Object],[object Object],[object Object]

Genética de LES murino ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES : eventos desencadenantes ,[object Object],[object Object],[object Object]

LES : rasgos clínicos ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LES : sistema múculoesquelético ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES : Enfermedad renal ,[object Object],[object Object],[object Object],[object Object],[object Object],* Am J Kidney Dis 2000, 35:904

Nefritis lúpica : OMS ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES y Contracepción ,[object Object],[object Object],[object Object],[object Object],* NEJM Dec 15, 2006 353 Nº 24 2539-49

Lupus Neonatal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LES : M. Neuropsiquiátricas Cefalea Convulsiones ACV Neuropatía craneal Neuropatía periférica S. Org.Cereb. Psicosis Al inicio 12% 4% 2% 2 2 7 2 Evolutivo 36% 10% 4% 4 14 15 5

LES : M. Pleuropulmonares ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES : Organos < comprometidos ,[object Object],[object Object],[object Object],[object Object]

LES : Hallazgos laboratorio ,[object Object],[object Object],[object Object]

LES : Importancia de Autoanticuerpos ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* Ann Rheum Dis 2004 63:386

LES, Anticuerpos y Diagnóstico ,[object Object],[object Object],[object Object],[object Object],* Internal Medicine Journal 2004, 34: 338-347

LES y Embarazo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lupus Neonatal ,[object Object],[object Object],[object Object],[object Object]

Lupus inducido por drogas ,[object Object],[object Object],[object Object],[object Object]

LES e INFECCIONES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* BP &RCR Vol16, Nº2 281-191 2002

LES y Tuberculosis* ,[object Object],[object Object],[object Object],* Lupus 2004 (13) 274-278

Criterios para la clasificación de LES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LES : Manejo ,[object Object],[object Object],[object Object],[object Object]

LES : Manejo general ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES :Manejo Farmacológico ,[object Object],[object Object],[object Object],[object Object],* Internal Medicine Journal 2004, 34: 338-347

LES : Uso de AINE ,[object Object],[object Object],[object Object],[object Object]

LES : Uso de Esteroides ,[object Object],[object Object],[object Object],[object Object],[object Object]

LES : Uso de Antimalásicos ,[object Object],[object Object],[object Object],[object Object]

LES : Uso de Azatioprina ,[object Object],[object Object],[object Object],[object Object]

LES : Uso de Ciclofosfamida ,[object Object],[object Object],[object Object],[object Object]

LES : Uso de Metrotexate ,[object Object],[object Object],[object Object]

LES : Medicamentos varios ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LES y terapia biológica ,[object Object],[object Object],[object Object],[object Object],* Merrill JT. Lupus Now: State-of-the-Art Approaches from the Experts ; October 29, 2005; New York, NY.

LES : Opciones terapéuticas ,[object Object],[object Object],[object Object],[object Object]

LES : Curso Clínico y Pronóstico ,[object Object],[object Object],[object Object],[object Object],* Arthritis Rheum. 1992; 35 : 630-40

[object Object],[object Object],Ç

65.& 66. lupus eritematoso sistemico

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65.& 66. lupus eritematoso sistemico