Systemic Lupus Erythematosus WHAT IS SLE? SLE is a result of disturbed immune regulation that causes an exaggerated production of autoantibodies.

. Risk factors Genetic factors Hormonal factors Environmental factors(e.g. sunlight and thermal burns) Certain medications (Hydralazine, procainaide, isoniazid, chlorpromazine and some antiseizure medications) HOW SLE HAPPENS In an autoimmune disorder like SLE, a person's antibodies begin to recognize the body's own tissues as foreign. Cells and chemicals of the immune system damage the tissues of the body. The reaction that occurs in tissue is called inflammation. Inflammation includes swelling, redness, increased blood flow, and tissue destruction. In SLE, some of the common antibodies that normally fight diseases are thought to be out of control. These include antinuclear antibodies and antiDNA antibodies. Antinuclear antibodies are directed against the cell's central structure that contains genetic material (the nucleus). Anti-DNA antibodies are directed against the cell's genetic material. OCCURRENCE: SLE can occur in both males and females of all ages, but 90% of patients are women. The majority of these women are in their childbearing years. African Americans are more likely than Caucasians to develop SLE. ASSESSMENT Malar (butterfly) rash Discoid rash photosensitivity Mouth ulcers Arthritis Serositis (pleurisy, pericarditis) Joint swelling, tenderness and pain on movement Pericarditis subtle changes in behavior patterns and cognitive ability DIAGNOSTIC TEST No single laboratory test confirms SLE. antibody tests Blood testing - reveals moderate to severe anemia, thrombocytopenia, leukocytosis or leukopenia and positive ANAs. Serum electrolyte levels, renal function, cardiac and liver enzymes, clotting factors MEDICAL MANAGEMENT GOALS: Preventing progressive loss of organ function Reducing the likelihood of acute disease Minimizing disease related disabilities Preventing complications from therapy

 Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen (Aleve) and ibuprofen (Advil, Motrin, others), may be used to treat pain, swelling and fever associated with lupus. Stronger NSAIDs are available by prescription. Side effects : stomach bleeding, kidney problems and an increased risk of heart problems. Antimalarial drugs. Medications commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), also can help control lupus. Side effects: stomach upset and, very rarely, damage to the retina of the eye. Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus. Side effects: weight gain, easy bruising, thinning bones (osteoporosis), high blood pressure, diabetes and increased risk of infection. *The risk of side effects increases with higher doses and longer term therapy. Immune suppressants. Examples include cyclophosphamide (Cytoxan), azathioprine (Imuran, Azasan), mycophenolate (Cellcept), leflunomide (Arava) and methotrexate (Trexall). Side effects: Potential side effects may include an increased risk of infection, liver damage, decreased fertility and an increased risk of cancer. A newer medication, belimumab (Benlysta) also reduces lupus symptoms in some people. Side effects include nausea, diarrhea and fever. Plasmapheresis - is sometimes used to remove antibodies and other immune substances from the blood to suppress immunity. It is for SLE patients with serious brain (lupus cerebritis) or kidney disease (lupus nephritis). NURSING MANAGEMENT Protect joints, ease pain with splints, thermal modalities and relaxation techniques such as deep breathing and imagery. Implement exercise programs for joint motion and muscle strengthening and overall health. Make use of adaptive devices and techniques. Avoid direct exposure to sunlight and encourage use of sunscreen and wear protective clothing. Advise to avoid pregnancy at the time of the disease. Encourage good nutrition, sleep habits, exercise, rest and relaxation techniques. Encourage good oral hygiene.

Prepared by: Group 1 Pancho, Ferlyn Almencion, April Grace Candidato, Dominic Dayanan, Ma. Mae Guda, Mary Christine Rosaupan, Gelson