Systemic lupus erythematosus: diagnosis and management

Published on November 30, 2017   52 min

Other Talks in the Category: Immunology

0:00
Hello. I'm Sara Tedeschi and I'm a Rheumatologist at Brigham and Women's Hospital and Harvard Medical School in Boston Massachusetts. Thank you for joining us in this lecture focused on the diagnosis and management of systemic lupus erythematosus. During this lecture, I will refer to systemic lupus erythematosus simply as lupus, for the sake of brevity. The information that we will discuss should be viewed as a general overview of the way that Rheumatologists consider whether a patient may have lupus and considerations for treating specific lupus manifestations. In clinical practice, lupus patients vary widely and the decision about diagnosis and especially treatment must be individualized for each patient.
0:43
This lecture will begin with distinguishing the difference between lupus classification criteria and a clinical diagnosis of lupus. We'll then focus on the clinical and laboratory evaluation that is commonly performed in rheumatology clinics to evaluate for suspected lupus. We'll cover a general approach to treatment, including preventive care, tailoring lupus therapy to specific manifestations, and considerations for women of reproductive potential who may desire a future pregnancy. Lupus is a relatively uncommon chronic autoimmune disease with a range of severity.
1:14
Recent estimates of the prevalence of lupus in the United States were conducted by evaluating hospital discharge diagnosis codes in California and Pennsylvania. And the estimates showed that between 100 and 150 individuals per 100,000 adults have lupus in the United States. Specifically among women, the prevalence is higher with two cases per 1,000 adult women. In general, lupus affects younger patients and is predominately female with ratios of approximately seven to nine women for one man who's affected. Lupus disproportionately occurs in non-Caucasian patients and in many cases, the manifestations may be more severe in those patients. Lupus is a very heterogeneous condition both in terms of the manifestations with a range of clinical abnormalities and immunologic abnormalities, as well as a range of severity. In some cases, patients may have only cutaneous manifestations that require very little treatment, whereas, on the other end of the spectrum, some patients have very severe multi-organ disease requiring hemodialysis or kidney transplant. Importantly when we're considering lupus as a diagnosis, we always need to make sure that we are ruling out conditions that may mimic lupus and we'll go into that further when we talk about the evaluation.
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Systemic lupus erythematosus: diagnosis and management

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