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Nury collection

Systemic Lupus Erythematosus

( SLE )
DEF:

Kelainan inflamasi otoimun

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Mengenai sistem organ multipel

PATOGENESIS
Sekunder Krn. Antigen antibody Complex PD. Kapiler dr. Struktur viseral Destruksi sel host ok oto antibodi ( Mis ; trombositopenia )

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Nury collection

EPIDEMIOLOGI
Di pengaruhi ; seks, ras, Genetik

85 % wanita
Tampak peran hormon seks
- Peny. Timbul stlh menarche - Peny. Timbul sblm Menopause

Wanita kulit Putih 1 : 1000 Wanita kulit hitam 1 ; 250

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Nury collection

 Idetical twins 25 70 % Gen Spesifikk ; HLADR 2, HLADR 3 & Null Complements Alleles

ETIOLOGI

Bisa krn. Obat atau spontan

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Tabel 1: Drugs Implicated in drug-induced lupus like syndrome

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Nury collection

Beda SLE Ok obat & Spontan

1. Rasio Seks hampir sama

2. Gambaran nefritis & SSP tdk ada.

3. Komplemen serum & antibodi Thd DNA tidak ada

4. Gambaran klinik & LAB kembali normal jika obat di stop

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Nury collection

DIAGNOSIS
Perlu di pikirkan -Px. Peny. Multisistem

- Tes serologis positif ( ANA )

DIAGNOSA BANDING
-Artritis rematoid -Vasculitis - scleroderma -Poly artritis -Drug Induce Lupus
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Tabel 2 : Rivesed ARA criteria for the classification

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Nury collection

G/. Klinis
- Demam, Anoreksia, Malaise, BB - Kulit : Butter Fly rash , discoid Lupus, Peri ungual Erythema, nail Fold Infarct, Alopecia - Lesi Mukosa - Artritis - Mata : Conyunctivitis, photophobia, Ggn. Visi Cotton Wool Spot pada retina )cytoid bodies )
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- Efusi pleura, Bronkopneumonia, Pneumonitis - Jantung : Perikarditis, gagal jantung , Aritmia, carditis verukosa atipikal dl. Libman Sack Regurgitasi mitral ) - Abdominal pain, Ileus, Peritonitis - Neurologis : psikosis SOO, kejang neuropati perifer/cranial, meilitis transversa, stroke.
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- Ginjal : Glomerulo nefritis

( mis : Mesangial, Focal proliferative, Diffuse proliferative & membranous ) - Lain lain : trombosis arteri & vena limpadenopati,spleno megali Tiroiditis hashimato, anemia hemolitik

Thrombo Cytopenic purpura

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LABORATORIUM
Produksi Oto Antibodi
( Coomas positif )

Anemia Hemolitik ANA tes

+

Antibodi thd DNA Double Strand & Smoota Muscle +

Komplemen Serum
Antibodi Anti Fospolipid
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+
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TERAPI
1. OAINS Keluhan sendi 2. Anti Malaria ( Hydroxy Chloroquine ) keluhan kulit & sendi 3. Kortikosteroid Topical / Sistemik 4. Obat Imuno supresif Bila resisten kortikosteroid, Mis : cyclo phospihamid, Azathioprine.
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Nury collection

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