|
|
| (52 intermediate revisions by 11 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| | {| class="infobox" style="float:right;" |
| | |- |
| | | [[File:Siren.gif|link=SLE resident survival guide|41x41px]]|| <br> || <br> |
| | | [[SLE resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] |
| | |} |
| {{Infobox_Disease | | {{Infobox_Disease |
| |Name = Lupus Erythematosus | | |Name = Lupus Erythematosus |
| |Image = Lupus facial rash.jpg | | |Image = Lupus facial rash.jpg |
| |Caption = Typical "butterfly"-like rash over the cheeks in lupus | | |Caption = Typical "butterfly"-like rash over the cheeks in lupus |
| |ICD10 = {{ICD10|L|93||l|80}}, {{ICD10|M|32||m|30}}
| |
| |ICD9 = {{ICD9|710.0}}
| |
| |DiseasesDB = 12782
| |
| |ICDO =
| |
| |OMIM = 152700
| |
| |MedlinePlus = 000435
| |
| |MeshID = D008180
| |
| }} | | }} |
| [[Image:Discoid lupus erythematosus.JPG|thumb|[[Discoid lupus erythematosus]] [[lesion]] of the face]]
| | {{Systemic lupus erythematosus}} |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
|
| |
|
| ===Click [[The Heart in Systemic Lupus Erythematosus (SLE)|here]] for The heart in Systemic Lupus Erythematosus===
| | {{CMG}}; {{AE}} {{MIR}}, {{CZ}}, {{RT}} |
|
| |
|
| {{Systemic lupus erythematosus}} | | {{SK}} SLE, Lupus erythematosus, Systemic lupus, Lupus, Disseminated lupus erythematosus, Discoid lupus, Cutaneous lupus erythematosus |
| | ==[[Systemic lupus erythematosus overview|Overview]]== |
|
| |
|
| {{CMG}}; {{AE}} {{CZ}} {{RT}}
| | == [[Systemic lupus erythematosus historical perspective|Historical perspective]] == |
|
| |
|
| {{SK}} SLE, lupus erythematosus
| | == [[Systemic lupus erythematosus classification scheme|Classification]] == |
| | |
| ==[[Systemic lupus erythematosus overview|Overview]]== | |
|
| |
|
| ==[[Systemic lupus erythematosus pathophysiology|Pathophysiology]]== | | ==[[Systemic lupus erythematosus pathophysiology|Pathophysiology]]== |
|
| |
|
| ==[[Systemic lupus erythematosus causes|Causes]]== | | ==[[Systemic lupus erythematosus causes|Causes]]== |
| [[Systemic lupus erythematosus causes#Common causes|Common Causes]] | [[Systemic lupus erythematosus causes#System based|System based]] | [[Systemic lupus erythematosus causes#alphabetical order|Alphabetical Order]] | | |
| | ==[[Differentiating systemic lupus erythematosus from other diseases|Differentiating Systemic Lupus Erythematosus from Other Diseases]]== |
|
| |
|
| ==[[Systemic lupus erythematosus epidemiology and demographics|Epidemiology and Demographics]]== | | ==[[Systemic lupus erythematosus epidemiology and demographics|Epidemiology and Demographics]]== |
| Line 34: |
Line 32: |
| ==[[Systemic lupus erythematosus risk factors|Risk Factors]]== | | ==[[Systemic lupus erythematosus risk factors|Risk Factors]]== |
|
| |
|
| ==[[Systemic lupus erythematosus natural history|Natural History, Complications and Prognosis]]== | | ==[[Systemic lupus erythematosus screening|Screening]]== |
| | |
| | ==[[Systemic lupus erythematosus natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
|
| |
|
| ==Diagnosis== | | ==Diagnostic criteria== |
|
| |
|
| [[Systemic lupus erythematosus history and symptoms|History and Symptoms ]] | [[ Systemic lupus erythematosus physical examination|Physical Examination]] |[[Systemic lupus erythematosus laboratory tests|Laboratory Findings]] | [[Systemic lupus erythematosus CT|CT Scan]] | [[Systemic lupus erythematosus MRI|MRI]] | [[Systemic lupus erythematosus other diagnostic studies|Other Diagnostic Studies]] | | [[Diagnostic criteria|Diagnostic Criteria]] | [[Systemic lupus erythematosus history and symptoms|History and Symptoms]] | [[Systemic lupus erythematosus physical examination|Physical Examination]] | [[Systemic lupus erythematosus laboratory tests|Laboratory Findings]] | [[Systemic lupus erythematosus electrocardiogram|Electrocardiogram]] | [[Systemic lupus erythematosus x ray|X Ray]] | [[Systemic lupus erythematosus CT|CT]] | [[Systemic lupus erythematosus MRI|MRI]] | [[Systemic lupus erythematosus ultrasound or echocardiography|Echocardiography or Ultrasound]] | [[Systemic lupus erythematosus other imaging findings|Other Imaging Findings]] | [[Systemic lupus erythematosus other diagnostic studies|Other Diagnostic Studies]] |
|
| |
|
| ==Treatment== | | ==Treatment== |
| [[Systemic lupus erythematosus medical therapy|Medical Therapy]] | [[Systemic lupus erythematosus surgery |Surgery]] | | [[Systemic lupus erythematosus medical therapy|Medical Therapy]] | [[Systemic lupus erythematosus surgery |Surgery]] | [[Systemic lupus erythematosus primary prevention|Primary Prevention]] | [[Systemic lupus erythematosus secondary prevention|Secondary Prevention]] | [[Systemic lupus erythematosus cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Systemic lupus erythematosus future or investigational therapies|Future or Investigational Therapies]] |
| | |
| | |
| | |
|
| |
|
| | ==Case Studies== |
| | [[Systemic lupus erythematosus case study one|Case #1]] |
|
| |
|
| | | ==Related Chapters== |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| ==Diagnostic Findings== | |
| | |
| ===Physical Examination===
| |
| | |
| [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
| |
| | |
| | |
| <gallery perRow="3">
| |
| Image:Systemic lupus erythematosus 052.jpg|Skin: Lupus, systemic erythematosus; Discoid skin lesion in patient with SLE
| |
| Image:Systemic lupus erythematosus 053.jpg|Skin: ulcer, necrotic; lupus anticoagulant in thigh
| |
| Image:Systemic lupus erythematosus 054.jpg|Skin: lupus, erythematosus, subacute; Papulosquamous diseases
| |
| Image:Systemic lupus erythematosus 055.jpg|Skin: lupus, erythematosus; Papulosquamous diseases
| |
| Image:Systemic lupus erythematosus 056.jpg|Skin: lupus, erythematosus; papulosquamous diseases
| |
| Image:Systemic lupus erythematosus 057.jpg|Skin: alopecia, secondary lupus erythematosus; hair loss
| |
| Image:Systemic lupus erythematosus 058.jpg|Skin: discoid lupus, face
| |
| </gallery>
| |
| | |
| ===Gross Images===
| |
| | |
| [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
| |
| | |
| | |
| <gallery perRow="3">
| |
| Image:Systemic lupus erythematosus 001.jpg|Kidney: Lupus erythematosus: Gross, enlarged very pale kidneys with flea bite or ectasia. A good example of kidneys from a patient with nephrotic syndrome (subacute glomerulonephritis)
| |
| Image:Systemic lupus erythematosus 002.jpg|Kidney: Lupus erythematosus: Gross cut surface pale kidneys typical of nephrotic syndrome (subacute glomerulonephritis)
| |
| Image:Systemic lupus erythematosus 004.jpg|Lupus Erythematosus Hepatitis: Gross natural color. A 19yo female with lupus erythematosus and hepatitis characterized by periportal cell necrosis and sinus thrombosis cause uncertain photo shows focal grid-like hyperemia
| |
| Image:Systemic lupus erythematosus 027.jpg|Brain: Lupus Erythematosus Libman Sacks Embolism: Gross fixed tissue one large and two small hemorrhages 19yo female with history of TIAs
| |
| Image:Systemic lupus erythematosus 028.jpg|Brain: Lupus Erythematosus Libman Sacks Embolism: Gross fixed tissue large hemorrhagic infarcts due to embolism 19yo female with known lupus and history of TIAs
| |
| Image:Systemic lupus erythematosus 029.jpg|Brain: Lupus Erythematosus Libman Sacks Embolism: Gross large hemorrhagic infarcts 19 yo female with history of TIAs proved case lupus with renal failure
| |
| Image:Systemic lupus erythematosus 030.jpg|Brain: Lupus Erythematosus Libman Sacks Embolism: Gross fixed tissue cerebellar hemorrhagic infarcts 19yo female with history of TIAs known lupus case with renal failure
| |
| Image:Systemic lupus erythematosus 031.jpg|Brain: Purulent Meningitis: Gross fixed tissue excellent example Pneumococcus case of young girl with lupus
| |
| Image:Systemic lupus erythematosus 032.jpg|Skeletal muscle: Hematoma: Gross natural color flank muscle hematoma old showing typical chocolate appearance of blood coagulum young female with lupus and thrombocytopenia
| |
| Image:Systemic lupus erythematosus 047.jpg|Brain: Lupus Erythematosus, Systemic; Microinfarct in Cerebral Cortex
| |
| Image:Systemic lupus erythematosus 040.jpg|Kidney: Lupus Nephritis: Gross natural color external view of flea bitten kidneys quite good advanced proliferative type glomerulonephritis of lupus in a 16yo female
| |
| Image:Systemic lupus erythematosus 041.jpg|Brain: Hemorrhage Massive With Lupus Erythematosus: Gross apparently fresh tissue large left frontoparietal hemorrhagic infarct in a 16yo female with advanced lupus nephritis and sepsis
| |
| Image:Systemic lupus erythematosus 042.jpg|Brain: Hemorrhage Massive With Lupus Erythematosus: Gross natural color not the best exposure but OK large left frontoparietal hemorrhage in 16yo female with advanced lupus nephritis and sepsis
| |
| Image:Systemic lupus erythematosus 043.jpg|Brain: Hemorrhage Massive With Lupus Erythematosus: Gross natural color but not best exposure large left frontoparietal hemorrhage in 16yo female with advanced lupus nephritis and sepsis
| |
| Image:Systemic lupus erythematosus 044.jpg|Lung: Tuberculosis Reactivation: Gross fixed tissue close-up of lung hilum with node and parenchyma lesions case of lupus erythematosus treated with prednisone for many years
| |
| Image:Systemic lupus erythematosus 045.jpg|Lung: Tuberculosis Reactivation: Gross fixed tissue close-up of lung showing lesions in nodes and parenchyma case of lupus erythematosus treated for long period with prednisone
| |
| Image:Systemic lupus erythematosus 046.jpg|Kidney: Lupus Erythematosus: Gross natural color nice external and cut surface view of uniformly scarred and moderately shrunken kidneys
| |
| Image:Systemic lupus erythematosus 021.jpg|Lupus Erythematosus Libman Sacks Endocarditis: Gross natural color mitral valve small lesions but cause much trouble in form of TIAs and terminally multiple hemorrhagic brain infarcts
| |
| Image:Systemic lupus erythematosus 019.jpg|Kidney: Lupus Erythematosus: Micro high mag H&E increased mesangial tissue and wire loops 10yo female with renal failure and TIAs due to Libman Sacks endocarditis
| |
| </gallery>
| |
| | |
| ===Microscopic Images===
| |
| | |
| [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
| |
| | |
| | |
| <gallery perRow="3">
| |
| Image:Systemic lupus erythematosus 003.jpg|Lupus erythematosus hepatitis: Micro high mag H&E, periportal sinus thrombosis with liver cell necrosis and noninflammatory infiltrate (possibly viral). A 19yo female with lupus erythematosus
| |
| Image:Systemic lupus erythematosus 005.jpg|Spleen: Lupus erythematosus Periarterial Fibrosis: Micro high may H&E. An excellent example of periarterial fibrosis
| |
| Image:Systemic lupus erythematosus 006.jpg|Spleen: Lupus erythematosus, periarterial fibrosis: Micro high may H&E. An excellent example of periarterial fibrosis
| |
| Image:Systemic lupus erythematosus 007.jpg|Spleen: Lupus erythematosus. Basophilic bodies and periarterial fibrosis: Micro high mag, H&E. Two basophilic bodies and periarterial fibrosis. An excellent example of this rarely seen lupus lesion.
| |
| Image:Systemic lupus erythematosus 008.jpg|Lupus Erythematosus, Libman Sacks Endocarditis: Micro low mag trichrome stain thickened valve leaflet with small mural fibrin deposit. A 19yo female with cerebral lupus in form of TIAs due to this lesion.
| |
| Image:Systemic lupus erythematosus 009.jpg|Lupus Erythematosus, Libman Sacks Endocarditis: Micro low mag, elastic van Gieson stain, mitral valve thickened, leaflet with small mural fibrin deposit that caused TIAs in 19yo female
| |
| Image:Systemic lupus erythematosus 010.jpg|Adrenal: Autoimmune Adrenalitis: Micro high mag H&E focal area of lymphocytic infiltration in zona reticularis in a 19yo female with lupus erythematosus
| |
| Image:Systemic lupus erythematosus 039.jpg|Kidney: Lupus Erythematosus: Micro high mag H&E. A nice example of a lesion of chronic glomerulonephritis with lobular scarring. A fibrous type crescent.
| |
| Image:Systemic lupus erythematosus 011.jpg|Kidney: Lupus Erythematosus: Micro high mag H&E two glomeruli showing mesangial thickening and focal wire loop type lesions 19yo female with renal failure and embolic brain disease from Libman Sacks lesion on mitral valve
| |
| Image:Systemic lupus erythematosus 012.jpg|Lupus Erythematosus Myocardial Necrosis Due To Libman Sacks: Micro low mag H&E focal myocardial necrosis due to embolism from Libman Sacks lesion on mitral valve 19yo female with TIAs due to mitral lesion
| |
| Image:Systemic lupus erythematosus 013.jpg|Lupus Erythematosus Focal Myocardial Scar Due To Libman Sacks Embolism: Micro low mag H&E focal scar in myocardium due to embolism
| |
| Image:Systemic lupus erythematosus 014.jpg|Lupus Erythematosus Myocardial Scar Due To Libman Sacks Embolism: Micro low mag H&E scar with portion of embolus in small artery
| |
| Image:Systemic lupus erythematosus 015.jpg|Lupus Erythematosus Myocardial Necrosis Due To Libman Sacks: Micro low mag H&E well shown focal myocardial necrosis due to embolism from mitral Libman Sacks lesion
| |
| Image:Systemic lupus erythematosus 016.jpg|Lupus Erythematosus Embolus From Libman Sacks Lesion: Micro med mag H&E well shown embolus in small artery
| |
| Image:Systemic lupus erythematosus 017.jpg|Lupus Erythematosus Hepatitis: Micro low mag trichrome stain periportal liver cell necrosis and sinus thrombosis with no inflammatory reaction cause unknown 19yo female with lupus erythematosus
| |
| Image:Systemic lupus erythematosus 018.jpg|Lung: Diffuse Alveolar Damage: Gross natural color section of both lungs with frank meaty appearance case of lupus erythematosus in 19yo female
| |
| Image:Systemic lupus erythematosus 020.jpg|Lung: Necrotizing Bronchiolitis: Micro low mag H&E well shown lesion in lung that grossly looked like diffuse alveolar damage which indeed has lesions of this type additionally 19yo female with lupus erythematosus
| |
| Image:Systemic lupus erythematosus 023.jpg|Lupus Erythematosus Libman Sacks Endocarditis: Micro low mag H&E mitral valve lesion with easily seen mural thrombi and focal necrobiosis of collagen in thickened valve leaflet 19yo female
| |
| Image:Systemic lupus erythematosus 024.jpg|Lung: Necrotizing Bronchiolitis: Micro low mag H&E well shown necrotizing bronchiolitis and surrounding lesions of diffuse alveolar damage 19yo female with lupus erythematosus
| |
| Image:Systemic lupus erythematosus 025.jpg|Myocarditis: Micro high mag H&E focal myofiber necrosis typical for this diagnosis but this is case of lupus erythematosus with Libman Sacks lesion and brain emboli and heart emboli did she also have viral myocarditis? This lesion is typical for the diagnosis
| |
| Image:Systemic lupus erythematosus 026.jpg|Kidney: Lupus Erythematosus: Micro high mag PAS stain thickened mesangium and capillary basement membranes 19yo female with renal failure and proved lupus
| |
| Image:Systemic lupus erythematosus 033.jpg|Artery: Arteritis in Lupus Erythematosus: Micro med mag H&E. A good example of vasculitis
| |
| Image:Systemic lupus erythematosus 034.jpg|Kidney: Lupus Erythematosus: Micro high mag PASH typical glomerulonephritis lesion with crescent
| |
| Image:Systemic lupus erythematosus 035.jpg|Kidney: Lupus Erythematosus: Micro med mag PASH glomerulonephritis
| |
| Image:Systemic lupus erythematosus 036.jpg|Kidney: Lupus Erythematosus: Micro med mag H&E typical glomerulonephritis lesion
| |
| Image:Systemic lupus erythematosus 037.jpg|Kidney: Lupus Erythematosus: Micro med mag H&E two glomeruli showing lobular glomerulonephritis lesion
| |
| Image:Systemic lupus erythematosus 038.jpg|Kidney: Lupus Erythematosus: Micro med mag PASH typical chronic glomerulonephritis lesion with crescent
| |
| Image:Systemic lupus erythematosus 048.jpg|Vessel: lupus, systemic erythematosus; Thrombus in capillary
| |
| Image:Systemic lupus erythematosus 049.jpg|Vessel: lupus, systemic erythematosus; Thrombus in capillary
| |
| Image:Systemic lupus erythematosus 050.jpg|Vessel: lupus, systemic erythematosus; Thrombus in arteriole and vein
| |
| Image:Systemic lupus erythematosus 051.jpg|Vessel: lupus, systemic erythematosus; Thrombus in pial vessel
| |
| Image:Systemic lupus erythematosus 022.jpg|Lupus Erythematosus Libman Sacks Endocarditis: Micro high mag H&E atrial surface of mitral valve with small fibrin thrombus representing Libman Sacks lesion 10yo female
| |
| </gallery>
| |
| | |
| ==Videos==
| |
| {{#ev:youtube|Tw07BFaDEo0}}
| |
| | |
| ==See also==
| |
| * [[Abzyme]]
| |
| * [[Anti-nuclear antibody]] | | * [[Anti-nuclear antibody]] |
| * [[Discoid lupus erythematosus]] in dogs | | * [[Discoid lupus erythematosus]] |
| * Lupus Canada
| |
| * Lupus Foundation of America
| |
| | |
| ==References==
| |
| {{Reflist|2}}
| |
| | |
| ==External links==
| |
| *{{DMOZ|Health/Conditions_and_Diseases/Musculoskeletal_Disorders/Connective_Tissue/Lupus/}}
| |
| *[http://www.uklupus.co.uk The Lupus Site]
| |
| *[http://www.lupus.org/ The Lupus Foundation of America]
| |
| | |
|
| |
|
| {{Diseases of the skin and subcutaneous tissue}} | | {{Diseases of the skin and subcutaneous tissue}} |
| {{Diseases of the musculoskeletal system and connective tissue}} | | {{Diseases of the musculoskeletal system and connective tissue}} |
| {{Vesiculobullous disease}} | | {{Vesiculobullous disease}} |
| [[bg:Лупус]]
| |
| [[ca:Lupus eritematós sistèmic]]
| |
| [[da:Systemisk Lupus Erythematosus]]
| |
| [[de:Lupus erythematodes]]
| |
| [[es:Lupus eritematoso sistémico]]
| |
| [[fa:لوپوس منتشر]]
| |
| [[fr:Lupus érythémateux disséminé]]
| |
| [[id:Lupus eritematosus sistemik]]
| |
| [[it:Lupus eritematoso sistemico]]
| |
| [[he:זאבת]]
| |
| [[ms:Lupus eritematosus sistemik]]
| |
| [[nl:Lupus erythematodes]]
| |
| [[ja:全身性エリテマトーデス]]
| |
| [[pl:Toczeń rumieniowaty układowy]]
| |
| [[pt:Lupus eritematoso sistêmico]]
| |
| [[ru:Системная красная волчанка]]
| |
| [[simple:Lupus erythematosus]]
| |
| [[fi:Sle]]
| |
| [[sv:Systemisk lupus erythematosus]]
| |
| [[th:โรคลูปัส]]
| |
| [[tr:Sistemik lupus eritematozus]]
| |
| [[zh:紅斑性狼瘡]]
| |
|
| |
|
| [[Category:Arthritis]] | | [[Category:Arthritis]] |
