系统性红斑狼疮(SLE)概述和特性
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pathology-vasculitis cerebrospinal fluid-no special (intracranial pressure↑protein↑cell population↑ glucose↓) Identify with other central nervous system disease
Etiology
genetic factors environmental factors Sex hormonal factors
Pathogenesis
Excessive, abnormal production of “self” antibodies and formation of IC. Autoantibodies against nuclear, cytoplasmic and membrane components of multiple cell types in multiple organs
抗磷脂抗体综合征 (antiphospholipid antibody syndrome)
clinical manifestation: -arterous and/or venous thrombosis -spontaneous abortion -thrombocytopenቤተ መጻሕፍቲ ባይዱa
laboratory examination: -positive anti-phospholipid antibody
Digestive system
Clinical features -anepithymia -nausea and vomiting -abdominal pain、diarrhea -peritoneal effusion -acute abdomen
pathology -mesenterium vasculitis
.
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
Pathology
光镜:1.结缔组织的纤维蛋白样变性 2.基质黏液性水肿 3.坏死性血管炎
Hematology system
leukopenia thrombocytopenia anemias: hemolytic anemias
anemias of chronic disease lymphadenectasis splenectasis
Respiratory system
pleurisy Pleural effusion Pulmonary interstitial fibrosis Lupus pneumonia Pulmonary hypertension Respiratory failure
特征性:疣状心内膜炎 苏木紫小体 “洋葱皮样”病变
临床应用：皮肤狼疮带试验 肾活检
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
Systemic features
lung
Circulatory system
heart -pericarditis -myocarditis -endocarditis Libman-Sack endocarditis -cardiac arrhythmias -cardiac failure
vessel -vasculitis
skin and mucosa
skin and mucosa
skin and mucosa
skin and mucosa
Muscle and Joint
arthritis --Jaccoud’s arthropathy Muscle pain、myositis femoral head necrosis
Fever Weak Weight loss
skin and mucosa
光敏感 photosensitivity 脱发 alopecia 雷诺现象Raynaud’s phenomenon 口腔溃疡oral ulcer 皮疹 rash
skin and mucosa
skin and mucosa
系统性红斑狼疮(SLE)
概述和特性
Systemic Lupus Erythematosus
Many Different
Autoantibodies
Multiple System Involvement
SLE onset by sex and age
Number of patients
90
80
70
Muscle and Joint
Renal lesion
Proteinuria hematuria cylindruria Nephritic syndrome Renal insufficiency
lupus nephritis
Class I Class II Class III Class IV Class V Class VI
60
Male
50
Female
40
30
20
10
0 10 20 30 40 50 60 70 80
Age
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
正常
系膜增殖性 mesangial
局灶增殖性 focal proliferative
弥漫增殖性 diffuse proliferative
膜性
membranous
肾小球硬化性glomerulosclerosis
Nervous system
clinical manifestation: -headache、vomiting -psychogenia -epilepsy -convulsion 、 conscious disturbance -coma
Etiology
genetic factors environmental factors Sex hormonal factors
Pathogenesis
Excessive, abnormal production of “self” antibodies and formation of IC. Autoantibodies against nuclear, cytoplasmic and membrane components of multiple cell types in multiple organs
抗磷脂抗体综合征 (antiphospholipid antibody syndrome)
clinical manifestation: -arterous and/or venous thrombosis -spontaneous abortion -thrombocytopenቤተ መጻሕፍቲ ባይዱa
laboratory examination: -positive anti-phospholipid antibody
Digestive system
Clinical features -anepithymia -nausea and vomiting -abdominal pain、diarrhea -peritoneal effusion -acute abdomen
pathology -mesenterium vasculitis
.
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
Pathology
光镜:1.结缔组织的纤维蛋白样变性 2.基质黏液性水肿 3.坏死性血管炎
Hematology system
leukopenia thrombocytopenia anemias: hemolytic anemias
anemias of chronic disease lymphadenectasis splenectasis
Respiratory system
pleurisy Pleural effusion Pulmonary interstitial fibrosis Lupus pneumonia Pulmonary hypertension Respiratory failure
特征性:疣状心内膜炎 苏木紫小体 “洋葱皮样”病变
临床应用：皮肤狼疮带试验 肾活检
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
Systemic features
lung
Circulatory system
heart -pericarditis -myocarditis -endocarditis Libman-Sack endocarditis -cardiac arrhythmias -cardiac failure
vessel -vasculitis
skin and mucosa
skin and mucosa
skin and mucosa
skin and mucosa
Muscle and Joint
arthritis --Jaccoud’s arthropathy Muscle pain、myositis femoral head necrosis
Fever Weak Weight loss
skin and mucosa
光敏感 photosensitivity 脱发 alopecia 雷诺现象Raynaud’s phenomenon 口腔溃疡oral ulcer 皮疹 rash
skin and mucosa
skin and mucosa
系统性红斑狼疮(SLE)
概述和特性
Systemic Lupus Erythematosus
Many Different
Autoantibodies
Multiple System Involvement
SLE onset by sex and age
Number of patients
90
80
70
Muscle and Joint
Renal lesion
Proteinuria hematuria cylindruria Nephritic syndrome Renal insufficiency
lupus nephritis
Class I Class II Class III Class IV Class V Class VI
60
Male
50
Female
40
30
20
10
0 10 20 30 40 50 60 70 80
Age
Etiology and pathogenesis pathology Clinical findings Laboratory findings Diagnosis Treatment prognosis
正常
系膜增殖性 mesangial
局灶增殖性 focal proliferative
弥漫增殖性 diffuse proliferative
膜性
membranous
肾小球硬化性glomerulosclerosis
Nervous system
clinical manifestation: -headache、vomiting -psychogenia -epilepsy -convulsion 、 conscious disturbance -coma