Environmental Factors:

Risk Factors:
Systemic Lupus Erythematusos  Susceptibility to certain
 Genetic
viruses
Predisposition
 Hormonal Abnormality
 Ultraviolet radiation
 Medications
Pathophysiology  Hydralazine
The immune system starts to develop  Procainamide hydrochloride
antibodies to the nuclear antigen. B cells begin  Penicillin
Clinical Manifestations: to overproduce antibodies and antigens with  Isonicotonic acid hyrazide
the help of multiple cytokines such as B-  Quinidine
 Fever
lymphocyte stimulator, which is overexpressed
 Malaise
in SLE. The antibodies and antigen antibody
 Weight loss and anorexia
complexes and have the propensity to get
 Subacute cutaneous
trapped in the capillaries of visceral structures.
erythematosus
 Acute cutaneous lesion The antibodies also act to destroy host cells. It Diagnostic Findings:
consisting of a butterfly is thought that those two mechanisms are
shaped erythematusos responsible for majority of the clinical o Complete history and
rash across the bridge of manifestations of this disease process. It is physical examination
the nose and cheeks hypothesized that the immunoregulatory and blood tests.
 Papulosquamous or disturbances is brought about by some o Anti-DNA – antibody that
annular lupus combination of four distinct factors: genetic, develops against DNA
erythematusos immunologic, hormonal, and environment. patient’s oeweqwn DNA
 Arthralgia o Anti-ds DNA- antibody
 Arthritis against DNA that is
 Joint swelling, tenderness highly specific to SLE,
and pain on movement. which helps differentiate
 Myocarditis it from drug induced
 Hypertension lupus.
o Anti- Sm – antibody against
Sm, which is a specific
protein fround in the
nucleus.
o CBC may reveal anemia

Nursing Management:
 Educate the patient about the
importance of continuing
prescribed medication.
 Nurse should also screen the
patient for osteoporosis,
because long term use of
corticosteroids increase the
incidence of osteoporosis.
 Educating the patient regarding
calcium and Vitamin D
supplementation daily is
encourage.
 The patient is reminded of the
importance of monitoring
because of increased risk of
systemic involvement
including renal and
cardiovascular effects.

Medical Management:
 Regular monitoring to assess disease activity and
therapeutic effectiveness.
 Monoclonal antibodies, cortcicosteroids, antimalarial
agents.
 Belimumab- treatment for SLE.
 IV administration of corticosteroids is an alternative to
traditional high doses administration.
 Anti malarial medications- Hydroxychloroquine, is an
effective for managing cutaneous musculoskeletal and
mild systemic features of SLE.
 NSAIDs- used for minor clinical manifestations are often
used in conjuction with corticosteroid.
 Immunosuppressive agents used because of their effect on
overall immune function.