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complications of lupus erythematosus

Complications: Life threatening complications: 1) glomerulonephritis 2) central nervous system disease a) seizures b) psychosis associated with 1] increased generalized SLE disease activity 2] high antiphospholipid antibody titers c) organic brain syndrome 3) hematologic disease a) hemolytic anemia b) thrombocytopenia 4) infectious complications of treatment 5) pulmonary a) lupus pneumonitis b) pulmonary alveolar hemorrhage 6) myocarditis 7) vasculitis of the gastrointestinal tract Other complications 1) avascular osteonecrosis 2) accelerated coronary artery disease [4] 3) hypertension 4) osteoporosis [2] 5) hyperlipidemia 6) higher prevalence of cervical intraepithelial neoplasia [3] 7) leukocytoclastic vasculitis (image) [5] Management: - Life-threatening complications 1) prednisone 1 mg/kg/day for non-infectious complications 2) the combination of cyclophosphamide plus prednisone is superior to prednisone alone in preventing renal failure 3) psychosis treated with a) glucocorticoids alone or in combination with immunosuppressive agent [2] b) antiplatelet &/or anticoagulation therapy if high high antiphospholipid antibody titers [2]

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systemic lupus erythematosus

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complication

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
  2. Bertsias GK, Boumpas DT. Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations. Nat Rev Rheumatol. 2010 Jun;6(6):358-67 PMID: 20458332
  3. Klumb EM, Araujo ML Jr, Jesus GR et al Is higher prevalence of cervical intraepithelial neoplasia in women with lupus due to immunosuppression? J Clin Rheumatol. 2010 Jun;16(4):153-7 PMID: 20407390
  4. Pons-Estel GJ, Gonzalez LA, Zhang J Predictors of cardiovascular damage in patients with systemic lupus erythematosus: data from LUMINA (LXVIII), a multiethnic US cohort. Rheumatology (Oxford). 2009 Jul;48(7):817-22 PMID: 19454606
  5. Yang L, Zeng YP Images in Dermatology. Cutaneous Vasculitis in Systemic Lupus Erythematosus. JAMA Dermatol. 2021;157(8):991 PMID: 34160552 https://jamanetwork.com/journals/jamadermatology/fullarticle/2781365
  6. What People with Lupus Need to Know About Osteoporosis http://www.osteo.org/newfile.asp?doc=r801i&doctitle=What+People+with+Lupus+Need+to+Know+About+Osteoporosis&doctype=HTML+Fact+Sheet