红斑狼疮 SLEEnglishpre 中山大学 内科学课件.ppt

Systemic Lupus Erythematosus Dr. Ye yujin Rheumatology department The 1st Affiliated Hospital of Sun Yat-Sen University 2009-12-30 Background: Systemic lupus erythematosus (SLE) 1) A chronic, multifaceted inflammatory autoimmune disease 2) Affect every organ system of the body 3) SLE is protean in its manifestations and follows a relapsing and remitting course Epidemiology and Etiology Pathophysiology Clinical features Treatment Epidemiology and Etiology Frequency Worldwide , the prevalence of SLE varies with ethnicity and geographical locations: 70-100 cases per 100,000 population in China. 50 cases per 100,000 population in the US, while 200 cases in the African-American women. 12 cases per 100,000 population in Britain 39 cases per 100,000 population in Sweden Sex Hormonal factors are important in the pathogenesis of the disease: In women of reproductive age , incidence of SLE is 6- to 10- fold higher than men. Additionally, pregnancy and administration of exogenous estrogen often precipitate exacerbations of SLE. Men at all ages have a risk of disease similar to that of women who are prepubertal or postmenopausal. Age Disease incidence is highest among women aged 14-64 years, because of female sex hormone production. Males do not have an age-related peak in incidence.  Causes Although the specific cause of SLE is unknown, multiple factors are associated with the development of the disease. These include genetic, racial, hormonal, and environmental factors. Genetic factors At least 10 different gene loci are known to increase the risk for SLE. A genetic predisposition is supported by the 10-fold increase in concordance among monozygotic twins versus dizygotic twins. Studies of the human leukocyte antigens (HLA) reveal that HLA-DR2 and HLA-DR3 occur more often in people with SLE than in the general population. The presence of the null complement alleles and congenital deficiencies of complement (especially C4, C2, and other earl