Systemic Lupus Erythematosus (SLE)

SLE Lupus is the latin word for “WOLF” Is an autoimmune disorder characterized by inflammation of almost any body part The disease is chronic SLE occurs when the body produces antibodies against its own cells Resulting antigen and antibody complex damage connective tissues

SLE Is a disease characterized by exacerbations and remissions that may be triggered by genetic, hormonal, and environmental factors SLE is chronic, incurable, and multicausal Increasing evidence suggests that immunological, hormonal, genetic, and possibly viral factors mat contribute to the onset of the disease

SLE Is most prevalent in women of child bearing age Nine times as many women are affected Three times as many African Americans as Caucasions are affected

SLE-Multisystem MUSKOSKELETAL- Inflammation of vessels, tendons, and muscle tissue occurs because of deposits of fibrin. Polyarthralgia and polyarthritis occur in 90-95% of patients

SLE- Multisystem GASTROINTESTINAL- Ulceration occurs on mucosal membranes because of degeneration of collagen tissue, with GI manifestations of hemorrhage, abdominal pain, pancreatitis, cholecystitis, and bowel infarction RENAL-Glomerular sclerosis and glomerularnephritis occur

SLE- Multisystem HEMATOLOGICAL- Cells are destroyed, and interference with coagulation occurs because of circulating antibodies. Anemia, leukopenia, lymphopenia, thrombocytopenia, and elevated erythrocyte sedimentation results

SLE- Multisystem CARDIOVASCULAR- Pericarditis is the most common cardiac manifestation. It is often the first clinical problem the patient manifests. Pericardial rub, commonly associated with pericarditis, can lead to dysrhythmias; vasculitis in the small vessels may occur

SLE- Multisystem PULMONARY- Pleurisy and pleural effusions resulting from inflammation of the pleura are relatively common CUTANEOUS- Classic characteristics include the erythrematous butterfly rash over the bridge of the nose and on the cheeks and linear erythema along the eyelids. Other features may include bullae, patchy areas of purpura, urticaria, and SubQ nodules. Also, alopecia and ulcers of the lip, mouth and nose

SLE- Multisystem NEUROLOGICAL- Mental and neurological signs and symptoms occur in 35% to 40% of patients with SLE. Signs and symptoms relate to the CNS, not to the peripheral nerves. Mental and behavioral changes may occur as well as headaches, seizures, and CVA’s. Patients may also be photosensitive

SLE- Diagnostics Complete history and physical- take note of a butterfly rash on the face and any other physical symptoms as previously noted Blood work- CBC, ESR, PT/PTT, Lupus erythematosus cell preparation, US, CXR, Coomb’s test, DNA antibody, Rheumatoid factor

SLE- Treatment ***Goal is to prevent progression of loss of organ function*** Steroids Non steroidal anti-inflammatory drugs(ASA, Motrin) Antineoplastic agents such as Imuran and Cytoxan Antimalarial drugs- Plaquenil Antiinfective agents Analgesics and diuretics Supportive therapy such as a balanced diet, a balance of rest and activity, and reduction of sun exposure

SLE- Nursing Interventions Educate regarding sunscreen and wearing long- sleeved clothing. Avoid sunlight Symptomatic relief Report abnormal lab values Skin rash is often scaly and itchy. Cool baths and topical agents may relieve symptoms and should be applied as prescribed Help maintain adequate nutrition Provide good mouth care