systemic lupus erythematosus SLE

huh,tajuk xleh nk gempak lagi ? pernah dgr psl SLE? Dulu pernah kena tnye what is SLE? mase tu cek x blaja lg ape bnda binatang SLE ni...sekarang ni baru thu ape tu SLE ...bunyi mcm simple just sekadar S L E ..tp penyakit ni seriously,memang bahaya.. jgn judge nme penyakit cm pendek tp x teruk..cm HIV jgk,3 huruf,pendek je,tapi boleh bw maut...

TANDA2 SLE :

• malar rash - sejenis ruam dkt muka,bentuk seakan2 butterfly ( eryhematous rash over the cheek and nasal bridge ,sparing of the nasolabial fold)
• discoid rash- plaque like lesion,eryhematous base,scales,scarring,pigmentations,telangctasia)
• photosensitivity - sensitif dgn cahaya matahari (macular or diffusely erythematous rash in sun exposed areas)
• oral ulcers - 
• arthritis (sakit sendi ) non erosive 2 or more joints affected
• serositis - pleuritis or pericarditis
• renal disorder- proteinuria,cellular cast (ade protein dlm urine)
• neurological disorder- seizures,psychosis
• hematologic disorder- hemolytic anemia,leucopenia,lymphopenia or thrombocytopenia
• immunologic disorder- positive LE cells
•                                 - antidsDNA
•                                 -ant-sm
•                                 -false positive VDRL
• antinuclear antibody ANA

at least,ade 4 dari sume tanda2 ni,diagnostic utk seseorang tu ade SLE 

saje je letak tanda2 SLE ni dulu sbb nk bg korg cek korg ade x tanda2 ni..mnta dijauhkan la yea..sbb SLE ni penyakit autoimmune,dimana kita sendiri tak tahu kenapa boleh jd camtu..

autoimmune ni sejenis proses dlm badan kita yang kita tak minta pun die jd cmtu,die jadi tiba2 tanpa punca die pun kita tak tahu.. maksudnye camni.. 

dalam badan kita ada antibody utk lawan kuman2,nk pastikan badan kita ni sihat..tapi dlm kes autoimmune ni,antibody yg baik tu serang badan kita instead sepatutnye die bunuh kuman,tp slowly die bunuh badan kita sendiri..tu secara simple jelah..byk lg proses autoimmune ni,tp cukup la tu je utk memahamkn korg.

What is SLE ? SLE is an autoimmune disorders that involve multi-system microvascular inflammation with generation of auto-antibodies.common in young female (15-30years old) ratio 9:1 to male

causes- genetic,environment ( infections,sun exposure,drugs - SLE like condition--> INH,Hydralazine,Procainamide,ppt attack of SLE - sulphadiazine,tetracycline,OCP,penicillamine STOP !,immune disturbances- positive LE cells,autoantibodies,endocrinal disorders- increase during 1st trimester and post partum,OCP and ovulation inhibitor

ok,point2 yang akan ditulis selepas ini adalah untuk saya sendiri yg bace yea.nak test diri sendiri dah igt belum ape yg dibace..klu x fhm,try search sendiri klu teringin nak tahu..sy nk hafal ni :) 

 

clinical picture of SLE

3S + body systems ( infection and thrombosis) from above-downward

S- systemic : low grade fever,weakness,tachycardia,weight loss,anorexia,malaise

S- skeletal : arthralgia>arthritis ,affect small joint of the hands and wrist-knee,but NO deformity (if deformity occur - Jaccouds artropathy -chronis arthritis and tendonitis (non-erosive hand deformities 10%), fibromyalgia -generalised widespread pain,arthralgia and myalgia,aseptic necrosis of head of femur,osteoporosis) myalgia

S- skin - R- raynauds phenomenon (blue,white,red colour change at Distal digital tips)

               M- malar rash

               A- alopecia (temporal regions or patchy patterns)

               D- discoid rash

               Vitiligo

               photosensitivity

              fingers- ulcers,peri ungual erythema

              purpura

body systems - from above to downward

CNS - ASEPTIC MENINGITIS,FOCAL NEUROLOGICAL DEFICIT,TIA

EYE- SJOGREN SYNDROME,CONJUNCTIVITIS,CYSTOID BODIES,RETINAL INFARCTION

CHEST- PULM HTN,PULM.INFARCTION,SEROSITIS,DYPSNEA

CVS- PERICARDITIS,PERICARDIAL EFFUSION,ASEPTIC ENDOCARDITIS,IHD&THROMBOSIS

GIT- ABD PAIN,PERITONITIS,PANCREATITIS,MASENTRIC VASCULITIS,BOWEL INFARCTION,JAUNDICE,painless mouth ulcer,DIARHHEA,BLEEDING PER RECTUM

RENAL- LUPUS NEPHRITIS,LUPUS NEPHROPATHY

HEMATOLOGICAL- LEUCOPENIA,LYMPOPENIA,ANEMIA,THROMBOCYTOPENIA,ANTIPHOSPHOLIPIDS-ABORTION,THROMBOSIS

RES- HSM,PAINLESS GENERALISED LYMPHADENOPATHY

INVESTIGATIONS-  

1. lab- blood picture-pancy,bicyto,monocytopenia
2. increased ESR
3. increased bleeding time and coagulation time
4. decreased C3,C4
5. RH, factor +ve 15%
6. LE cells 85%
7. immunological -  diagnostic - ANA, antidsDNA,anti-sm
8.                           - Ab aginst blood-  anticardiolipin,anti-cell AB,anticoagulation fx antibody,+ve Coombs test
9.                           other- false +ve sor syphilis,anti-thyroid Ab
10. others - urine analysis,ECG,xray,joint xray,biosy-renal wire loop appearance

TREATMENT :

• PROPHYLAXIS - AVOID DRUGS,AVOID PSORALIN RICH DIET,EMOTIONAL SUPPORT
• NSAIDS- PAINS RELIEF FOR SEROSITIS,ARTHALGIA,FEVER
• CORTICOSTEROIDS- TOPICAL N SYSTEMICS, PREDNISONE 1-2MG/KG/DAY,METHYL PREDNISOLONE 1GM/D FOR 3 DAYS OR 0.5GM/D FOR 5 DAYS (SEVERE LUPUS)
• IMMUNOSUPPRESANT- CYCLOPHOSPHAMIDE,METHOTREXATE,AZATHIOPRINE ( SEVERE CASES AND REFRACTORY TO STEROID
• CHLOROQUINE - PREVENT AND TREAT LUPUS SKIN RASHES,ARTRALGIA AND ARTHRITIS
• COMPLICATION TTT- HTN,INFECTION
• PLASMAPHORESIS- NEPHRITIS AND ENCEPHALITIS (REMOVE IMMUNE COMPLEXES FROM PATIENT BLOOD BY REPLACING IT WITH FRSH FROZEN PLASMA OR ALBUMIN

ok,alhamdulillah..selesai dah notes SLE sy...semoga igt yea aisyah ! ok,nak tidur dulu..nite... :)