SLE

defintion
• Systemic Lupus Erythematosus (SLE) is an
autoimmune disease in connective tissue.
• multisystem autoimmune disease in which
organs, tissues, and cells suffer damage
mediated by tissue-binding autoantibodies
and immune complexes
 epidemiologi
• LES can be found at all ages, but most at the
age of 15-40 years (reproductive period). The
frequency in women compared to men is in
the range (5.5-9): 1.
 etiolgy
• The etiopathology of LES is not known with
certainty but is thought to involve complex
and multifactorial interactions between
genetic variations and environmental factors.
• Genetic factors (increased in siblings and
monozygotic twins)
• Attached to HLA class II  HLA-DR2 & 3  3X
fold
• Environmental factors (ultraviolet radiation,
tobacco, drugs, viruses).
• Hormonal  Imbalance of estrogen &
progesterone
 Berbagai jenis otoantibodi pada SLE
Jenis oto antibodi
(%) Kaitan klinis
1. ANA > 90 Tidak khas
2. ds-DNA 30-70 Nefritis
3. ss-DNA 70 Tidak diketahui
4. Histon 70 Lupus karena obat
5. Sm 20-40 Jarang didapatkan diluar SLE
6. U1RNP 30-40 Raynaud , muskuloskletal
7. Ro/SSA 30-45 Sekresi airmata dan ludah berkurang,
fotosensitifitas, neonatus lupus
8. La/SSB 10-15 Sekresi airmata dan ludah berkurang,
fotosensitifitas, neonatus lupus
9. Ribosomal P 10-20 Kelainan neuropsikiatrik
10. Antifosfolipid 30 Abortus berulang, trombosis
11. antibodi thd
eritrosit Anemia hemolitik
12. Antibodi thd
trombosit Trombositopenia
 Manifestasi klinis
• Common symptoms:
• Fever without cause
• Fatigue
• Weight loss
• Musculoskletal: arthralgia / arthritis
• Mukokutan:
• Skin: butterfly rash, discoid rash, subacute LE
photosensitivity, vasculitis
• Pulmonary manifestations (pneumonitis, pulmonary
embolism, pulmonary hypertension)
• Cardiovascular manifestations (pericardial, can be mild
pericarditis, pericardial effusion)
• Kidney manifestations
• Gastrointestinal manifestations
• Hemopoetic Manifestations
• Neuropsychiatric Manifestations
Erythematous rash Subacute cutaneous lupus Jaccoud arthropathy

Discoid lupus
 diagnosis
• LES diagnosis can be made based on clinical
and laboratory features.
• The American College of Rheumatology (ACR),
in 1997, proposed 11 criteria for LES
classification, where if 4 criteria were
obtained, a diagnosis of LES could be
established.
American College of Rheumatology Classification Criteria for SLE 1997
 Supporting investigation
• Hemoglobin, leukocytes, cell type count, blood
sedimentation rate (LED)
• Routine and microscopic urine, 24-hour
quantitative protein, and urine creatinine if
needed
• Blood chemistry (ureum, creatinine, liver
function, lipid profile)
• ANA, anti-dsDNA, complement (C3, C4) serology
• Plain thorax photo
 tatalaksana
Non farmakologis
• - Sunblok
• - Hindari terpapar dengan sinar matahari
Farmakologis
• - NSAIDs
• - Steroid
• - Hindroksi kloroquin/ kloroquin
• - Azatioprin
• - Siklofosfamid
• Mycophenylate mofetyl (MMF)