By: Rian Asmeida Farha binti Ahmad Rejab Wan Fadhilah binti Wan Ibrahim S YSTEMIC L UPUS E RYTHEMATOSUS (SLE)

INTRODUCTION  Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can be fatal; however, with recent medical advances, fatalities are becoming increasingly rare. autoimmune disease  The immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage.immune system  SLE can affect any part of the body, but most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system.heartjointsskinlungsblood vesselsliverkidneysnervous system  Lupus can occur at any age, and is most common in women, particularly of non-European descent.

EPIDEMIC  About 90% of SLE sufferers are women while about 10% are men and children.  About 90% of women with SLE are in their childbearing years, within the range of 15 to 50 years old. Ratio of SLE sufferers : In the West, among Afro-Carribeans 1 in people USA - 1 in 2,000 people China - 1 in 1,000 people  In Malaysia, it is estimated that more than 10,000 people have been diagnosed with SLE over the past 30 years. However, this number may be only the tip of the iceberg. The Malaysian SLE Association believes that there are many more SLE sufferers in Malaysia who have not been diagnosed.

S TATISTICS BY C OUNTRY FOR L UPUS Country/Region Extrapolated Prevalence Population Estimated Used USA1,511,461293,655,405 1 Czech Republic6,4141,0246,178 2 United Kingdom310,21660,270,708 2 Malaysia121,07123,522,482 2 China6,685,2451,298,847,624 2 About prevalence and incidence statistics in general for Lupus: The word 'prevalence' of Lupus usually means the estimated population of people who are managing Lupus at any given time

ETIOLOGY  The cause(s) of lupus is currently unknown, but there are environmental and genetic factors involved.  Some environmental factors which may trigger the disease include :  Infections  antibiotics (especially those in the sulfa and penicillin groups)  ultraviolet light  extreme stress  certain drugs  hormones.

SYMPTOMS PERCENTAGE (%) Achy joints / arthralgia95 Fever of more than 100 degrees F / 38 degrees C90 Arthritis / swollen joints90 Prolonged or extreme fatigue81 Skin Rashes74 Anemia71 Kidney Involvement50 Pain in the chest on deep breathing / pleurisy45 Butterfly-shaped rash across the cheeks and nose42 Sun or light sensitivity / photosensitivity30 Hair loss27 Abnormal blood clotting problems20 Fingers turning white and/or blue in the cold17 Mouth or nose ulcers12

S YSTEMIC L UPUS E RYTHEMATOSUS butterfly rash Finger turns blue Skin rashes

DIAGNOSIS CriterionDefinition Malar Rash Rash over the cheeks Discoid Rash Red raised patches Photosensitivity Reaction to sunlight, resulting in the development of or increase in skin rash Oral Ulcers Ulcers in the nose or mouth, usually painless Arthritis Nonerosive arthritis involving two or more peripheral joints (arthritis in which the bones around the joints do not become destroyed) Serositis Pleuritis or pericarditis (inflammation of the lining of the lung or heart) Renal Disorder Excessive protein in the urine (greater than 0.5 gm/day or 3+ on test sticks) and/or cellular casts (abnormal elements the urine, derived from red and/or white cells and/or kidney tubule cells)

DIAGNOSIS CriterionDefinition Neurologic Disorder Seizures (convulsions) and/or psychosis in the absence of drugs or metabolic disturbances which are known to cause such effects Hematologic Disorder Hemolytic anemia, leukopenia, lymphopenia or thrombocytopenia. The leukopenia and lymphopenia must be detected on two or more occasions. The thrombocytopenia must be detected in the absence of drugs known to induce it. Antinuclear Antibody Positive test for antinuclear antibodies (ANA) in the absence of drugs known to induce it. Immunologic Disorder Positive anti-double stranded anti-DNA test, positive anti-Sm test, positive antiphospholipid antibody such as anticardiolipin, or false positive syphilis test (VDRL). Adapted from: Tan, E.M., et. al. The 1982 Revised Criteria for the Classification of SLE. Arth Rheum 25:

BLOOD TESTS IN THE DIAGNOSIS OF SLE  The anti-nuclear antibody test (ANA) to determine if autoantibodies to cell nuclei are present in the blood.  The anti-DNA antibody test to determine if there are antibodies to the genetic material in the cell.  The anti-Sm antibody test to determine if there are antibodies to Sm, which is a ribonucleoprotein found in the cell nucleus.  Tests to examine the total level of serum (blood) complement (a group of proteins which can be consumed in immune reactions), and specific levels of complement proteins C3 and C4.

TREATMENTS  Drug therapy  nonsteroidal anti-inflammatory drugs and antimalarials nonsteroidal anti-inflammatory drugsantimalarials  Disease-modifying antirheumatic drugs (DMARDs) Disease-modifying antirheumatic drugs  Immunomodulating Drugs  Anticoagulants  Lifestyle changes  avoiding direct sunlight, covering up with sun-protective clothing, and using strong UVA/UVB sunblock lotion can also be effective in preventing photosensitivity problems.  Weight loss is also recommended in overweight and obese patients to alleviate some of the effects of the disease, especially where joint involvement is significant.

REFERENCES  et/templates/new_aboutintroduction.aspx?articl eid=75&zoneid=9 et/templates/new_aboutintroduction.aspx?articl eid=75&zoneid=9  thematosus thematosus   country.htm country.htm