SLE Pathophysiology

PATHOPHYSIOLOGY  Modifiable - Environmental Factors a. Medications (antidepressants/ antibiotics)  b. Extreme stress c. Exposure to sunlight/UV radiation d. Infections e. Horm Hormon onal al cha chang nges es

Non – Modifiable - Genetics - Gender   - Age - R ace

Production of abnormal antibodies by B cells c ells (hallmark sign), (antidouble stranded DNA & anti smith)

Few tingible body macrophage ( engulf B cells that have undergone apoptosis after somatic hypomutation)

Dec./ missing/ deficient CRP & glycoproteins (complement factors for efficiently operating phagocytes)

Abnormal reaction of body against its own cells and serum protein

Increased level of anti ds DNA antiobodies Results to engulfed LE bodies in the LE cells Increased disease activity in client w/ SLE

ANA and nuclear antigen found in serum, small blood vessels, skin & glomelular basement membrane

immune complexes initiate the complement reaction & serum complement level are decreased during attacks of SLE

Degeneration of connective tissues, glomeruli, blood vessels

Increases in self & non self antigen

Hyperactivity of B cells

Immune complex deposition, Antineurral, antibody activity

Specific antigen in joints (T lymphocytes) Release lymphokines

RH factor (IgM, IgG) on antigen in synovial Cavity stimulated by self antigen (an antigen in the synovial cavity or an infectious antigen)

RF IgG complexes are present in rheumatoid lesions and apparently activate complement to  promote the inflammatory response

acute attacks of rheumatoid arthritis occur as the RF-IgG complexes precipitate in synovial fluid

Complement is activated that attacks  polymorphonuclear leukocytes, whose main function appears to be phagocytes of the complexes

liposomal enzymes released by this cells intensify inflammation

granulation tissue and inflammatory cells form a mass of tissue called PANNUS that erodes the articular cartilage

the joint space is destroyed, and the resultant scarring may completely immobilize the joints or cause bleeding and thrombus in the area

swelling & pain, warm skin, during RA attacks