课件：系统性红斑狼疮留学生上课.ppt

ANA ANA: positive in 95% of cases. Pretest probability affects interpretation. In PCP setting, 2% for SLE. In rheum: 30% Low Positive (1:160 or lower): SLE likelihood 2% (26% for rheumatologists) High Positive (1:320 or higher): SLE likelihood: 2-17% (32-81% for rheumatologists) SLE specific patterns: Rim and Homogenous Additional work-up Serum cr. and albumin CBC w/ diff U/A ESR Complement levels Renal bx if warranted Treatment Treatment plans are based on patient age, sex, health, symptoms, and lifestyle Goals of treatment are to: -prevent flares -treat flares when they occur -minimize organ damage and complications Conservative management For those w/out major organ involvement. NSAIDs: to control pain, swelling, and fever Caution w/ NSAIDS though. SLE pts are at increased risk for aseptic meningitis Antimalarials: Generally to treat fatigue joint pain, skin rashes, and inflammation of the lungs Commonly used: Hydroxycholorquine Used alone or in combination with other drugs Cont. Corticosteroids (Mainstay of SLE treatment) To rapidly suppress inflammation Usually start with high-dose IV pulse and convert to PO steroids with goal of tapering and converting to something else. Commonly used: prednisone, hydrocortisone, methylprednisolone, and dexamethasone Immunosuppressives Primarily for CNS/renal involvement Mycophenolate mofetil (cellcept) Azathioprine (imuran): requires several months to be effective, effective in smaller percentage of patients MTX: for treatment of dermatitis and arthritis, not life-threatening disease Cyclosporine: used in steroid-resistant SLE, risk of nephrotoxicity Cyclophosphamide (cytoxan) Almost all trials performed on patients with nephritis Thank you for your attetion! THANK YOU SUCCESS * * 可编辑 可编辑 Systemic Lupus Erythematosus Doctor NaLi Bin zhou medical college Yantai affiliated hospital SLE Autoimmune disease that affects multisystems 1.5 million cases of lupus Prevalence of 17 to 48 per 100,000