SYSTEMIC LUPUS ERYTHEMATOSUS瑞金医院肾脏科 李晓.ppt

SYSTEMIC LUPUS  ERYTHEMATOSUS瑞金医院肾脏科 李晓 Introduction SLE is a chronic, usually life-long, potentially fatal autoimmune disease characterized by inflammation in many different organ systems commonly involved skin and kidney. Introduction SLE is associated with the production of autoantibodies reactive with nuclear, cytoplasma and cell membrane antigens. Introduction fatigue anemia fever rashes sun sensitivity alopecia arthritis pericarditis pleurisy vasculitis nephritis central nervous system disease Introduction F:M=7-10:1 Child-bearing age （ 13 ~ 40 years old） Prevalence in women China 113 per 100,000 USA 50 per 100,000 Etiology Genetics HLA-DRw2 and HLA-DRw3 Virus type C viruses isolated Hormone estrogens (androgens) Environment ultraviolet light Drugs procainamide, alpha-methyldopa, D-penicillamine, quinidine, ... Pathogenesis The deposition of DNA-anti-DNA immune complexes Antibodies to erythrocytes, granulocytes, lymphocytes, and macrophages Genetic Environmental 1.Lymphoreticular 1.Infections (viral,bacterial,parasite) 2.Hormonal 2.Drugs 3. Metabolic 3.UV light B cell proliferation (nucleic acids,IC, cellular debris) B cell differentiation Genetic Autoantibody production 1.Anti-lymphocyte 2.Anti-nuclear 3.Other +Antigen Tissue deposition Inflammation Pathology(1) Hematoxylin bodies These basophilic staining bodies are nuclear debris, often associated with antinuclear antibody, and represent a correlate of the LE cell in vivo. Pathology(2) The spleen has “unio