Lupus eritematoso sistémico (I). Etiopatogenia. Manifestaciones clínicas. Historia natural. Pruebas diagnósticas. Diagnóstico diferencial

  1. Galindo, M.
  2. Molina, R.A.
  3. Álvarez, J.L. Pablos
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2017

Issue Title: Enfermedades del sistema inmune y reumatológicas (II) Lupus eritematoso. Esclerodermia. Enfermedad mixta del tejido correctivo

Series: 12

Issue: 25

Pages: 1429-1439

Type: Article

DOI: 10.1016/J.MED.2017.01.001 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Concept and epidemiology Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder of unknown unknown aetiology affecting predominantly women between their second and fifth decades of life. Etiopathogenesis Its aetiology involves genetic as well as hormonal and environmental factors, notable amongst those are some infections, particularly viral ones, and the exposure to ultraviolet light or certain drugs. Clinical manifestations The clinical spectrum is very broad, with skin and mucous, hematological and joint manifestations as well as lupus nephritis being the most common. Comorbidities The risk of developing comorbidities like infections, arteriosclerosis, osteoporosis and certain neoplasms is increased as a consequence of the disease itself and of the treatments used for controlling it. Diagnosis Diagnosis of SLE is conducted by gathering clinical data and lab tests, after ruling out possible differential diagnoses of the disease.

Bibliographic References

  • Lockshin MD. Sex differences in autoimmune disease. Lupus. 2006;15: 753-6.
  • Lu LJ, Wallace DJ, Ishimori ML, Scofield RH, Weisman MH. Review: Male systemic lupus erythematosus: a review of sex disparities in this di-sease. Lupus. 2010; 19:119-29.
  • Lahita RG. The role of sex hormones in systemic lupus erythematosus. Curr Opin Rheumatol. 1999;11:352-6.
  • Tarr T, Dérfalvi B, Györi N, Szántó A, Siminszky Z, Malik A. Similarities and differences between pediatric and adult patients with systemic lupus erythematosus. Lupus. 2015; 24:796-803.
  • Ballou SP, Khan MA, Kushner. Clinical features of systemic lupus erythematosus: differences related to race and age of onset. Arthri-tis Rheum. 1982; 25:55-60.
  • Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum. 2010; 39:257-68.
  • Laffon A, Carmona L, Ballina FJ, Gabriel R. Prevalencia de enfermedades reumáticas en la población española. EPISER. 2016.
  • Deapen D, Escalante A, Weinrib L, Horwitz D, Bachman B, Roy-Burman P, et al. A revised estimate of twin concordance in systemic lupus erythe-matosus. Arthritis Rheum. 1992;35:311-8.
  • Kariuki SN, Ghodke-Puranik Y, Dorschner JM, Chrabot BS, Kelly JA, Tsao BP. Genetic analysis of the pathogenic molecular sub-pheno-type interferon-alpha identifies multiple novel loci involved in systemic lupus erythematosus. Genes Immun. 2015; 16:15-23.
  • Patel DR, Richardson BC. Dissecting complex epigenetic alterations in human lupus. Arthritis Res Ther. 2013;29:15:201.
  • Yung R, Richardson B. Drug-induced rheumatic syndromes. Bull Rheum Dis. 2002;51:1.
  • Margolis DJ, Hoffstad O, Bilker W. Association or lack of association between tetracycline class antibiotics used for acne vulgaris and lupus erythematosus. Br J Dermatol. 2007;157:540-6.
  • Costenbader KH, Feskanich D, Stampfer MJ, Karlson EW. Reproductive and menopausal factors and risk of systemic lupus erythematosus in wo-men. Arthritis Rheum. 2007;56:1251-62.
  • Hahn BH, Ebling F, Singh RR, Singh RP, Karpouzas G, La Cava A. Cellular and molecular mechanisms of regulation of autoantibody produc-tion in lupus. Ann N Y Acad Sci. 2005;1051:433-41.
  • Mountz JD, Wu J, Cheng J, Zhou T. Autoimmune disease. A problem of defective apoptosis. Arthritis Rheum. 1994;37:1415-20.
  • D’Andrea DM, Coupaye-Gerard B, Kleyman TR, Foster MH, Madaio MP. Lupus autoantibodies interact directly with distinct glomerular and vascular cell surface antigens. Kidney Int. 1996;49:1214-21.
  • Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365:2110-21.
  • Rönnblom L, Eloranta ML, Alm GV. The type I interferon system in systemic lupus erythematosus. Arthritis Rheum. 2006; 54:408-20.
  • Gatto M, Zen M, Ghirardello A, Bettio S, Bassi N, Iaccarino L. Emerging and critical issues in the pathogenesis of lupus. Autoimmun Rev. 2013;12:523-36.
  • Walling HW, Sontheimer RD. Cutaneous lupus erythematosus: issues in diagnosis and treatment. Am J Clin Dermatol. 2009;10:365-81.
  • Patel P, Werth V. Cutaneous lupus erythematosus: a review. Dermatol Clin. 2002;20:373-85.
  • Grossman JM. Lupus arthritis. Best Pract Res Clin Rheumatol. 2009;23: 495-506.
  • Santiago MB, Galvão V. Jaccoud arthropathy in systemic lupus erythematosus: analysis of clinical characteristics and review of the literature. Medicine (Baltimore). 2008;87:37-44.
  • Danila MI, Pons-Estel GJ, Zhang J, Vilá LM, Reveille JD, Alarcón GS. Renal damage is the most important predictor of mortality within the damage index: data from LUMINA LXIV, a multiethnic US cohort. Rheumatology (Oxford). 2009;48:542-5.
  • Weening JJ, D’Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB. International Society of Nephrology Working Group on the Classification of Lupus Nephritis, Renal Pathology Society Working Group on the Classification of Lupus Nephritis. The classification of glo-merulonephritis in systemic lupus erythematosus revisited. Kidney Int. 2004;65:521.
  • Newman K, Owlia MB, El-Hemaidi I, Akhtari M. Management of immune cytopenias in patients with systemic lupus erythematosus - Old and new. Autoimmun Rev. 2013;12:784-91.
  • Giannouli S, Voulgarelis M, Ziakas PD, Tzioufas AG. Anaemia in systemic lupus erythematosus: from pathophysiology to clinical assessment. Ann Rheum Dis. 2006;65:144-8.
  • Keeling DM, Isenberg DA. Haematological manifestations of systemic lupus erythematosus. Blood Rev 1993;7:199-207.
  • Keane MP, Lynch JP 3rd. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax. 2000;55:159-66.
  • Vincze K, Odler B, Müller V. Pulmonary manifestations in systemic lupus erythematosus. Orv Hetil. 2016;157:1154-60.
  • Miner JJ, Kim AH. Cardiac manifestations of systemic lupus erythematosus. Rheum Dis Clin North Am. 2014; 40:51-60.
  • Wong KL, Woo EK, Yu YL, Wong RW. Neurological manifestations of systemic lupus erythematosus: a prospective study. Q J Med. 1991;81:857-70.
  • Colasanti T, Delunardo F, Margutti P, Vacirca D, Piro E, Siracusano A. Autoantibodies involved in neuropsychiatric manifestations associated with systemic lupus erythematosus. J Neuroimmunol. 2009;25:212:213.
  • Tian XP, Zhang X. Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment. World J Gastroenterol. 2010;16:2971-7.
  • Silpa-archa S, Lee JJ, Foster CS. Ocular manifestations in systemic lupus erythematosus. Br J Ophthalmol. 2016;100:135-41.
  • Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore). 2003; 82:299-308.
  • Panopalis P, Yazdany J. Bone health in systemic lupus erythematosus. Curr Rheumatol Rep. 2009;11:177.
  • Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64:2677-86.
  • Agmon-Levin N, Damoiseaux J, Kallenberg C, Sack U, Witte T, Herold M. International recommendations for the assessment of autoantibodies to cellular antigens referred to as antinuclear antibodies. Ann Rheum Dis. 2014;73:17-23.
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