Systemic lupus erythematosus (SLE): Pathology review
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Systemic lupus erythematosus (SLE): Pathology review
Pathology
Bone disorders
Osteomyelitis
Bone tumors
Chondrosarcoma
Osteochondroma
Achondroplasia
Arthrogryposis
Cleidocranial dysplasia
Club foot
Craniosynostosis
Flat feet
Genu valgum
Genu varum
Osteogenesis imperfecta
Pectus excavatum
Pigeon toe
Lordosis, kyphosis, and scoliosis
Osteomalacia and rickets
Osteopetrosis
Osteoporosis
Osteosclerosis
Paget disease of bone
Musculoskeletal injuries and trauma
Degenerative disc disease
Sciatica
Spinal disc herniation
Spondylolisthesis
Spondylolysis
Achilles tendon rupture
Anterior cruciate ligament injury
Iliotibial band syndrome
Meniscus tear
Patellar tendon rupture
Patellofemoral pain syndrome
Sprained ankle
Unhappy triad
Compartment syndrome
Rhabdomyolysis
Carpal tunnel syndrome
Erb-Duchenne palsy
Klumpke paralysis
Sciatica
Thoracic outlet syndrome
Ulnar claw
Winged scapula
Carpal tunnel syndrome
Dislocated shoulder
Erb-Duchenne palsy
Klumpke paralysis
Radial head subluxation (Nursemaid elbow)
Rotator cuff tear
Thoracic outlet syndrome
Ulnar claw
Winged scapula
Musculoskeletal system pathology review
Back pain: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Gout and pseudogout: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Scleroderma: Pathology review
Seronegative and septic arthritis: Pathology review
Sjogren syndrome: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Assessments
Systemic lupus erythematosus (SLE): Pathology review
USMLE® Step 1 questions
0 / 10 complete
Questions
USMLE® Step 1 style questions USMLE
of complete
| Laboratory value | Result |
| Hemoglobin | 14.0 g/dL |
| Platelets | 100,000/mm3 |
| Leukocytes | 3,500/mm3 |
Which of the following is the most common cause of death in patients with this condition?
Transcript
At the internal medicine department, a 42 year old female named Mary shows up. She complains of multiple skin lesions on the arms, chest and back. She reports having these lesions for about 3 months. In the past, she had similar lesions. She reports morning stiffness involving her fingers and knees, as well as a history of multiple miscarriages. Blood tests revealed pancytopenia as well as a very high ESR and CRP. She was positive for ANA and antiphospholipid antibodies.
Meanwhile, at the emergency department, a 25 year old man named Kyle shows up with flank pain and hematuria. He has a history of migratory arthralgias and photosensitivity. He was positive for ANA and double-stranded DNA antibodies, and also had low complement levels. Blood tests revealed very high ESR and CRP, as well as high creatinine, so a urinalysis was performed, showing proteinuria and red blood cell casts.
Both individuals actually have very different presentations of the same disease, called Systemic Lupus Erythematosus. This is a systemic, relapsing, and remitting autoimmune disease, where systemic means that essentially any tissue or organ can undergo inflammation; while relapsing and remitting, stands for periods of illness, called relapses or flares; and periods of remission during which there are few or no symptoms.
Now, lupus develops when the person’s immune system starts recognizing nuclear antigens of the body’s own cells as foreign and tries to attack them. Essentially, B cells start producing antibodies which bind to nuclear antigens in our own cells. Normally, these B cells are destroyed before they fully mature in a process called self tolerance, but in people with lupus this process is impaired. The antibodies released by these B cells form antigen-antibody complexes and these complexes drift around in the blood until they deposit or stick to the vessel wall in all sorts of different organs and tissues like the kidneys, skin, joints, heart.
Summary
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden" Lupus (2006)
- "Research and therapeutics—traditional and emerging therapies in systemic lupus erythematosus" Rheumatology (2017)
- "A diverse array of genetic factors contribute to the pathogenesis of Systemic Lupus Erythematosus" Orphanet Journal of Rare Diseases (2013)
- "Epidemiology and socioeconomic impact of skin disease in lupus erythematosus" Lupus (1997)
- "Anti-cyclic citrullinated peptide antibody as a marker of erosive arthritis in patients with systemic lupus erythematosus: a systematic review and meta-analysis" Lupus (2014)
- "Renal damage is the most important predictor of mortality within the damage index: data from LUMINA LXIV, a multiethnic US cohort" Rheumatology (2008)
- "Dubois' Lupus Erythematosus and Related Syndromes - E-Book" Elsevier Health Sciences (2018)
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