内科学 系统性红斑狼疮-於强 培训资料.pptVIP

Systemic Lupus  Erythematosus; What is Lupus a chronic, relapsing, inflammatory,  and often febrile multisystemic disease  of connective tissue, characterized  principally by involvement of the skin.  Joints, kidneys and serosal membranes. an autoimmune disease ; 一. Types of lupus; 二. Characteristic of disease:;三. Pathogenic factor;五. Pathology 1. vasculitis 2. lupus nephritis a. minimal change b. mesangial proliferative c. focal segmental lesions d. diffuse e. membranous f. sclerosing ; 六.Clinical menifestations  of SLE -----Multiple system  involvement ; 1. Nonspecific symptom ● fever ● loss of weight ● debilitity;  2.Skin and mucosa  ● skin symptoms in 80% of patients  ● specific features: 40%  malar rash discoid rash ● nonspecific features 60%  ● photosensitivity 40%  ● baldness 40%  ● oral ulcer 60% ● Raynaud’s phenomenon;;;; 3. Joint and muscle 80% ● arthritis---non erosion ● large and small joints ● myosalgia 40% ● myositis 5%; 4. Kidney ▲ renal biopsy can be found  renal involvement is all ▲ present in about 70% of  patients ▲ 25% patients are dead in  cause of renal  involvement ; 5. Heart ● pericarditis  pericardial effusions ● myocarditis ● endocarditis  cardiac valves