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SLE
Adenopathy and splenic manifestations: Generalized adenopathy is common, particularly among children, young adults, and blacks. Splenomegaly occurs in 10% of patients. The spleen may develop periarterial fibrosis.
Neurologic manifestations: Neurologic symptoms can result from involvement of any part of the central or peripheral nervous system or meninges. Mild cognitive impairment is common. There may also be headaches, personality changes, ischemic stroke, subarachnoid hemorrhage, seizures, psychoses, organic brain syndrome, aseptic meningitis, peripheral neuropathies, transverse myelitis, or cerebellar dysfunction.
Renal manifestations: Renal involvement can develop at any time and may be the only manifestation of SLE. It may be benign and asymptomatic or progressive and fatal. Renal lesions can range in severity from a focal, usually benign, glomerulitis to a diffuse, potentially fatal, membranoproliferative glomerulonephritis. Common manifestations include proteinuria (most often), an abnormal urinary sediment manifested by RBC casts and leukocytes, hypertension, and edema.
Obstetric manifestations: Obstetric manifestations include early and late fetal loss. In patients with antiphospholipid antibodies, the risk of recurrent miscarriages is increased. Pregnancy can be successful (, particularly after 6 to 12 mo of remission, but SLE flares are common during pregnancy. Pregnancy should be timed when disease is in remission. During pregnancy, the patient should be monitored closely for any disease flare or thrombotic events by a multidisciplinary team that includes a rheumatologist, an obstetrician who specializes in high-risk pregnancies, and a hematologist.
Hematologic manifestations: Hematologic manifestations include anemia (often autoimmune hemolytic), leukopenia (usually lymphopenia, with < 1500 cells/μL,), and thrombocytopenia (sometimes life-threatening autoimmune thrombocytopenia). Recurrent arterial or venous thrombosis, thrombocytopenia, and a high probability of obstetric complications occur in patients with antiphospholipid antibodies. Thromboses probably account for many of the complications of SLE, including obstetric complications.
GI manifestations: GI manifestations can result from bowel vasculitis or impaired bowel motility. In addition, pancreatitis can result from SLE or from its treatment with corticosteroids or azathioprine . Manifestations may include abdominal pain from serositis, nausea, vomiting, manifestations of bowel perforation, and pseudo-obstruction. SLE rarely causes parenchymal liver disease.
Management will be
discussed later but must read the diet
section first and take omega-3 at least 3
grams daily and use Sun-D or vitamin -D3
3000 units daily and also read the
electronic section of the cidpusa.org. You
can fully reverse SLE.
Diagnosis of SLE next page
