Difference between revisions of "Systemic Lupus Erythematosus"

Revision as of 16:56, 22 February 2011

Also known as: SLE — Multi-Systemic Immune Mediated Disease

Introduction

Systemic Lupus Erythematous is an immune-mediated disease which can affect many different organ systems. The immune system is directed against various tissues of the body and immune complexes cause a type III hypersensitivity reaction. The condition is documented in cats and dogs but the etiology is not known. The disease has been reported in colonies of dogs suggesting that there may be a genetic or infectious component to the cause.

Diagnosis

Clinical Signs

Clinical signs depend on the tissues and organ systems affected by the condition. A combination of the following signs may be seen:

Immune-mediated haemolytic anaemia
Immune-mediated thrombocytopenia
Polyarthritis
Glomerulonephritis
Vasculitis
Dermatitis
Seizures

Diagnosis of SLE is made on a combination of clinical findings, haemotologic, serum biochemistry and immunological testing results. Diagnosis can be challenging as the condition can mimic a number of other diseases. Ruling out differential diagnoses will help in securing a definitive diagnosis.

Laboratory Tests

A positive antinuclear antibody (ANA) test is supportive of a diagnosis of SLE.

Treatment

Treatment is with immunosuppressive drugs. Corticosteroids are the most widely used immunosuppresive drugs, prednisolone or dexamethasone is used alone or in combination with azathioprine or cyclophosphamide in more severe cases. Typically the dose can be tapered once the condition is under control.

Prognosis

Prognosis is good with appropriate treatment.

Literature Search

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Systemic Lupus Erythematosus publications

References

Blood, D.C. and Studdert, V. P. (1999) Saunders Comprehensive Veterinary Dictionary (2nd Edition) Elsevier Science
Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier

From Pathology

Systemic (SLE)
- Multiple organs involved
- Cats, dogs, horses
- Immune dysregulation:
  - Damaged T-cell suppressor function, either primary deficiency or antibody mediated
  - Cytokine dysregulation
  - Resulting B-cell hyperactivity -> antibodies to self antigens -> antigen-antibody complexes deposited in various tissues -> Type III hypersensitivity
- Lesions localised or generalised
- Erythema, alopecia, depigmentation, crusting and scaling, ulceration
- Microscopically: lymphohistiocytic interface dermatitis, thickened basement membrane, vasculitis, subepidermal vesicles, basal cell degeneration

Also see Discoid Lupus Erythematosus

@@ Line 53: / Line 53: @@
 **Erythema, alopecia, depigmentation, crusting and scaling, ulceration
 **Microscopically: lymphohistiocytic interface dermatitis, thickened basement membrane, vasculitis, subepidermal vesicles, basal cell degeneration
-*'''Discoid'''
-**Milder variant of systemic
-**Depigmentation, erythema, scaling, erosions, ulceration, crusting
+*Also see [[Discoid Lupus Erythematosus]]
-**Usually involves nasal planum, dorsum of muzzle, occasionally pinnae, lips, oral mucosa or periocular area
-**Microscopically: lichenoid interface dermatitis, often with lymphocytes, plasma cells, basal cell degeneration, loss of pigment
 [[Category:Integumentary System - Autoimmune Reactions]]
 [[Category:Antibody Mediated Autoimmune Diseases]]
 [[Category:Immunological Diseases - Cat]][[Category:Immunological Diseases - Dog]]