Systemic Lupus

Erythematous

Aqmarina Thalia Azdhani

DEFINISI

adalah penyakit autoimun yang

ditandai dengan adanya inflamasi
tersebar luas, mempengaruhi
setiap organ atau sistem dalam
tubuh. Penyakit ini berhubungan
dengan deposisi autoantibodi dan
kompleks imun, sehingga
mengakibatan kerusakan jaringan.
PATHOGENESIS
 DIAGNOSIS
Suspicion of SLE need to be considered if there is 2 (two) or more criteria as
listed : 1. Young woman with 2 or more organs included
DIAGNOSIS
 MANAGEMENT
Mild Moderate Severe
• Skin • Mild – moderate Nefritis • Severe Nefritis (Class IV, III+V,
Manifestation • Thrombocytopenia (trombosit IV+V or III-V with impaired
• Arthritis 20-50x103/mm3) renal function
• Major serositis • Refractory Thrombocytopenia
(<20 x 103 /mm3)
• Refractory Hemolytic Anemia
Therapy
Induction Therapy • Associated with lung
Choloroquine or
MP iv (0,5-1gr/day for 3 days (haemorrhagic)
MTX
followed by: • Abdominal vasculitis
and/Or
AZA (2mg/kg/day) or MMF TR
CS (low dose)
(2-3gr/day) Induction Therapy
NSAID
+ MP iv (0,5-1gr/day for 3 days)
CS (0,5-0,6 mg/kg/day for 4-6 CYC iv (0,5-0,75 gr/m2/month x 7
weeks then lowered slowly dose)
RP

Maintenance Therapy RS TR
AZA (1-2mg/kg/day) or MMF (1-2
gr/day) Maintenance Therapy Needed Rituximab
+ CYC iv (0,5-0,75 gr/m2/3 Calcineurin Inhibitor
KS (lowered until 0,125 mg/kg/2 days months for one year) IVIg
dose)
 MANAGEMENT
General practitioner
PRIMARY HEALTHCARE CENTRE SUSPECTED SLE

Reconcile

MILD SLE RHEUMATOLOGIST / INTERNIST

• Diagnose
• Activity review and disease stage
SLE with complication / • Medication planning
increase activity • Monitoring disease’s activity regularly

Moderate and Severe SLE

Refractere SLE/life threatening
 MONITORING
1. Hemoglobin, leucocyte, cells count, erythrocyte
sedimentation rate (ESR)

2. Blood chemistry (ureum, creatinin, liver function,

lipid profile)

3. ANA serology

4. Anti-dsDNA

5. Complement (C3,C4)
 PROGNOSIS
• Over the past decade in US, the five-year survival rate
of patients with SLE has improved to more than 95%
because of more effective recognition and treatment of
infectious and renal complication.

• Poor prognosis mostly associated with high serum

creatinine levels (>1.4 mg/dL), hypertension, NS (prot
>2,6 g/24 hr), anemia (Hb <12,4 g/dL),
hypoalbuminemia, hypocomplementemia, aPL, and
male sex.

• Complication : Hemolytic anemia, thrombosis, cerebral

lupus, nephritic lupus, secondary infection.
THANK YOU