SLE is a chronic autoimmune disease that affects multiple organs due to the formation of autoantibodies and immune complex deposition, leading to inflammation and tissue damage.
Mnemonic: "S.L.E. =
Systemic Lupus Everywhere"
CAUSES & RISK FACTORS
- Genetic Factors (HLA-DR2, HLA-DR3).
- Environmental Triggers (Sunlight, Viral Infections, Drugs).
- Hormonal Influence (Common in Women, Estrogen-Linked).
- Autoimmune Dysfunction (Hyperactive B-Cells, Antibody Production).
Mnemonic: "G.E.H.A. = Genetics,
Environment, Hormones, Autoimmunity"
SYMPTOMS OF SLE
- General Symptoms: Fever, Fatigue, Weight Loss.
- Skin & Mucosal:
- Butterfly Rash (Malar Rash) – Red Rash Over Cheeks, Spares Nasolabial Folds.
- Discoid Rash – Scaly, Hyperpigmented Skin Lesions.
- Photosensitivity – Skin Worsens After Sun Exposure.
- Oral & Nasal Ulcers – Painless, Recurrent.
- Musculoskeletal:
- Arthritis (RA-like, Non-Erosive, Migratory).
- Jaccoud’s Arthropathy (Joint Deformity Without Bone Damage).
- Renal:
- Lupus Nephritis – Proteinuria, Hematuria, Hypertension.
- Cardiopulmonary:
- Pleuritis & Pericarditis (Most Common Heart & Lung Manifestations).
- Libman-Sacks Endocarditis (Sterile Valve Vegetations).
- Neurological:
- Seizures, Psychosis, Headache, Depression.
- Hematological:
- Anemia, Leukopenia, Thrombocytopenia.
- Raynaud’s Phenomenon:
- Fingers Turn White → Blue → Red in Cold (Due to Vasospasm).
Mnemonic: "S.L.E.P.A.I.N.
= Skin, Lupus Nephritis, Effusion (Pleuritis/Pericarditis), Psychosis, Anemia,
Infections, Neuropathy"
DIAGNOSIS OF SLE (SLICC CRITERIA)
Clinical Features (Need 4 of
11 for Diagnosis):
- Malar Rash
- Discoid Rash
- Photosensitivity
- Oral Ulcers
- Arthritis
- Serositis (Pleuritis/Pericarditis)
- Renal Disease (Proteinuria, Cellular Casts)
- Neurological (Seizures, Psychosis)
- Hematological (Anemia, Leukopenia, Thrombocytopenia)
Immunological Tests:
- ANA (Anti-Nuclear Antibody) – Screening Test, Highly Sensitive.
- Anti-dsDNA (Specific for SLE, Associated with Lupus Nephritis).
- Anti-Smith (Most Specific for SLE, Poor Prognosis).
- Anti-Phospholipid Antibodies (Increased Risk of Clotting & Miscarriages).
Mnemonic: "M.D.P.O.A.R.S.
= Malar Rash, Discoid Rash, Photosensitivity, Oral Ulcers, Arthritis, Renal,
Serositis"
TREATMENT OF SLE
1. LIFESTYLE & SUPPORTIVE
CARE
- Avoid Sun Exposure (Use Sunscreen SPF 25-50).
- Regular Exercise & Physiotherapy.
- Balanced Diet & Vitamin D Supplements.
Mnemonic: "S.E.D. = Sun
Avoidance, Exercise, Diet"
2. MEDICAL MANAGEMENT
- NSAIDs (For Joint Pain & Mild Symptoms).
- Hydroxychloroquine (For Skin & Joint Involvement).
- Corticosteroids (For Moderate to Severe Flares).
- Immunosuppressants (Azathioprine, Methotrexate, Mycophenolate for Severe Disease).
- Biologics (Rituximab, Belimumab for Resistant Cases).
Mnemonic: "N.H.C.I.B. =
NSAIDs, Hydroxychloroquine, Corticosteroids, Immunosuppressants,
Biologics"
3. MANAGEMENT OF LUPUS NEPHRITIS
- High-Dose Steroids + Cyclophosphamide/Mycophenolate Mofetil.
- ACE Inhibitors for Proteinuria.
- Regular Renal Function Monitoring.
Mnemonic: "S.C.A.R. =
Steroids, Cyclophosphamide, ACE Inhibitors, Renal Monitoring"
4. ANTIPHOSPHOLIPID SYNDROME
MANAGEMENT
- Lifelong Warfarin If History of Thrombosis.
- Low-Dose Aspirin for Prevention.
Mnemonic: "W.A. =
Warfarin, Aspirin"
5. PREGNANCY MANAGEMENT
- Plan Pregnancy in Remission.
- Safe Drugs: Hydroxychloroquine, Azathioprine, Low-Dose Steroids.
- Avoid: Methotrexate, Mycophenolate, Cyclophosphamide.
Mnemonic: "H.A.L. =
Hydroxychloroquine, Azathioprine, Low-Dose Steroids"
HOMOEOPATHIC MANAGEMENT OF SLE
- For Joint Pain & Stiffness:
- Rhus Tox, Bryonia, Arnica, Calc Fluor.
- For Skin Rash & Ulcers:
- Apis, Cistus, Graphites, Sepia.
- For Autoimmune & Chronic Cases:
- Syphilinum, Medorrhinum, Kali Carb.
Mnemonic: "R.B.A.C. =
Rhus Tox, Bryonia, Arnica, Calc Fluor for Joint Pain"
FINAL REVISION WITH MNEMONICS
- Definition = "S.L.E. = Systemic Lupus Everywhere"
- Causes = "G.E.H.A." (Genetics, Environment, Hormones, Autoimmunity)
- Symptoms = "S.L.E.P.A.I.N." (Skin, Lupus Nephritis, Effusion, Psychosis, Anemia, Infections, Neuropathy)
- Diagnosis = "M.D.P.O.A.R.S." (Malar Rash, Discoid Rash, Photosensitivity, Oral Ulcers, Rrthritis, Renal, Serositis)
- Lifestyle = "S.E.D." (Sun Avoidance, Exercise, Diet)
- Medical = "N.H.C.I.B." (NSAIDs, Hydroxychloroquine, Corticosteroids, Immunosuppressants, Biologics)
- Lupus Nephritis = "S.C.A.R." (Steroids, Cyclophosphamide, ACE Inhibitors, Renal Monitoring)
- Antiphospholipid = "W.A." (Warfarin, Aspirin)
- Pregnancy = "H.A.L." (Hydroxychloroquine, Azathioprine, Low-Dose Steroids)
- Homeopathy = "R.B.A.C." (Rhus Tox, Bryonia, Arnica, Calc Fluor for Joint Pain)
