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Renal Involvement in Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#Renal #diseases #SLE #Systemic #Lupus #Erythematosus #venn #nephrology
Erythematosus ... #Erythematosus ... #venn #nephrology ... #nephritis #classification ... #types #rheumatology
I’M DAMN SHARP - Lupus Diagnosis Mnemonic
I  	 Immunoglobulins (Anti-dsDNA, Anti-Sm, Anti-phospholipid)
M 	 Malar Rash
D
Antinuclear Antibody (ANA ... Pleuritis) H Hematologic ... Renal Disease (Nephritis ... #erythematosus ... #rheumatology #diagnosis
SLE (Systemic Lupus Erythematosus)

Suspect:
Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
findings (ANA, ... Non-autoimmune rheumatologic ... Malignancy (e.g. hematologic ... antibodies • (-) ANA ... #Diagnosis #Rheumatology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
Erythematosus ... pericarditis • Hematologic ... nephritis, Class ... low C4, Low C3 and ... #diagnosis #rheumatology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
Systemic Lupus Erythematosus ... Management Summary ... nephritis, NPSLE ... #Systemic #Erythematosus ... #Summary #rheumatology
Pancytopenia - Differential Diagnosis

Congenital Diseases:
• GATA2 deficiency
• Fanconi’s anemia
• Wiskott-Aldrich syndrome
• Ribosomopathy or telomeropathy

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Inflammatory and ... Diseases: • Systemic lupus ... erythematosus ... • Epstein-Barr virus ... Differential #Diagnosis #Hematology
Management of Lupus Nephritis
Lupus nephritis (LN) in 10 to 40% of SLE
Hallmark = proteinuria 20.5 g/g
Management of Lupus ... Nephritis Lupus ... #Nephritis #Management ... #rheumatology # ... nephrology
Rapidly Progressive Glomerulonephritis (RPGN)
RPGN has three primary pathophysiologic causes differentiated by immunofluorescence

Immune Complex Mediated (granular staining):
Complement: Post-strep GN ... , Lupus Nephritis ... (C-ANCA): GPA > ... (P-ANCA): eGPA, ... diagnosis #algorithm #rheumatology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Erythematosus ( ... #Erythematosus ... #SLE #CNS #neurology ... #rheumatology # ... cerebritis #diagnosis #management
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... Antinuclear (ANA ... #Erythematosus ... Summary #diagnosis #rheumatology ... #management