The Clinical Presentation of Systemic Lupus Erythematosus
2011; Elsevier BV; Linguagem: Inglês
10.1016/b978-0-12-374994-9.10030-0
Autores Tópico(s)T-cell and B-cell Immunology
ResumoSystemic lupus erythematosus (SLE) is an autoimmune disease that affects many organ systems, is more prevalent in females, and has no known etiology. Moreover, the presentation of patients with the disease can be as diverse as the many systems in the body that it can affect. The systems commonly involved include muscle and joints, brain and peripheral nervous system, lungs, heart, kidneys, skin, serous membranes, and components of the blood. This disease is complex and often affects one organ system to the exclusion of others. Moreover, the clinical manifestations are protean, overlap with other illnesses, and are often subtle. The complex nature of lupus could explain the convergence of seemingly unrelated abnormalities and the varied nature of pathology observed from patient to patient in this illness. Although lupus is largely associated with specific immune response genes in the MHC class II or class III regions, there are new and exciting genetic associations that include other loci. Suspected pathogenetic factors, such as sex steroid hormones or gonadotrophins such as prolactin, may play a role in the severity of the disease and the different clinical presentations. Environmental factors such as drugs, diet, and toxins have also been implicated in the pathogenesis of SLE. Immunological tests, which are specific to most autoimmune diseases such as lupus, include the presence of specific cytotoxic lymphocytes and a variety of autoantibodies, including a persistently positive antinuclear antibody. Although there are a few nonimmunologic laboratory characteristics of SLE, these are not specific.
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