内科学精品教学课件（时国朝）32 SLE-8Y.pptxVIP

Systemic Lupus Erythematosus; Systemic Lupus erythematosus ( SLE ) is a syndrome of unknown aetiology most commonly affecting young women. Virtually any organ of the body may be involved . Typically the course of the disease is a series of remissions and exacerbations. With good management, the ten years survival may be over 90%. ;Etiology and Pathogenesis of SLE;1. Genetic factor;;2. Environmental factors;Allergy. Does it induce lupus flare? No direct evidence. Infection. There has been continuing interest in the possibility that infectious agents might initiate or flare SLE. Mechanism might include molecular mimicry between external Ag and a self-Ag, epitope spreading, nonspecific activation of T or B cells. There has been recent interest in EB, CMV and other virus. ;3. Sex hormones;The metabolish of sex hormone is abnormal in some lupus patients. Men and women with lupus metabolized testosterone more rapidly than normal, and estrogenic metabolites of estradial persist longer in women. Neuroendocrine system. Hyperprolactinemia, abnormalities in hypothalamic and/or pituitary function. ;4. Abnormal immune system;Autoantibodies to DNA, RNA, and a host of other cell nucleus antigens. Circulating immune complexes are frequently observed and these may deposit in the kidney, skin, brain, lung, and other tissues. It causes inflammation and tissue damage by a number of mechanism, notably fixation and activation of the complement system. ;Overview of the pathogenesis of SLE;Clinical manifestations of SLE;The clinical spectrum of SLE is very broad It make SLE both fascinating but potentially difficult to diagnose and manage.;General symptoms;Fatigue is common in patients with SLE, especially during periods of disease activity. It is also often the only symptom that remains after treatment of acute flares. Low grade fever, anemia, or any source of inflammation can result in fatigue. ;Raynaud’s phenomenon is commonly found in lupus. It lack