Sunday, February 13, 2011

Manifestations of SLE.


Vasculitis:

acute necrotizing vasculitis due to type III HS is found in many tissues and forms the pathological basis of involvement of any organs

fibrinoid deposits within vessel walls containing antibody, DNA, complement fragments, and fibrinogen: aka fibrinoid necrosis

In chronic stages, vessels show fibrous thickening with luminal narrowing

Kidney:

Renal failure is the most common cause of death

DNA/anti-DNA complexes within the glomeruli

Mesangial lupus glomerulonephritis

Focal proliferative glomerulonephritis

Diffuse proliferative glomerulonephritis

Membranous glomerulonephritis

Skin:

erythematous or maculopapular eruption over the malar eminences and bridge of the nose ("butterfly pattern“)

Photosensitivity

Immunofluorescence microscopy reveals deposition of Ig and complement at the dermoepidermal junction

Joint involvement:

Erosion of the membranes and destruction of articular cartilage like in RA is very uncommon

Central nervous system:

focal neurologic deficits and/or neuropsychiatric symptoms

multifocal cerebral microinfarcts

thrombosis caused by antiphospholipid antibodies

Spleen:

follicular hyperplasia with numerous plasma cells in the red pulp

Central penicilliary arteries characteristically show thickening and perivascular fibrosis, producing onion-skin lesions

Serositis:

serous effusions to fibrinous exudates and progressing to fibrous opacification in the chronic stage

Heart:

Pericarditis, myocarditis and endocarditis all may be seen

Libman-Sacks endocarditis / nonbacterial verrucous( thrombotic) endocarditis

coronary artery disease

Accelerated atherosclerosis

Lungs:

lungs may reveal interstitial fibrosis.



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