Updating on the pathogenesis of systemic lupus erythematosus

The severe renal manifestation, lupus nephritis, is classified based on histological findings in renal biopsies.Apoptotic debris, including chromatin, is present in the extracellular matrix and circulation of patients with SLE.Table 29-1 lists the American College of Rheumatology criteria for the classification of SLE. An abnormal serum level of Ig G or Ig M anticardiolipin antibodies 2.A positive test result for lupus anticoagulant using a standard method 3.Systemic lupus erythematosus (SLE) is the classic model of an autoimmune disease.SLE is a systemic rheumatic disorder and the term used most often for the group of disorders that includes SLE and other abnormalities involving multiple systems (e.g., joints, connective tissue, collagen vascular system) in the disease process.• Explain the epidemiology and signs and symptoms of SLE.

The disease has wide prevalence but tends to occur more commonly in non-white females during the second to fourth decades of life. Overall, SLE is much more common in women, with a 3–1 female-to-male ratio before puberty, rising to 9–1 in patients of reproductive age.• Discuss the laboratory evaluation of antinuclear antibodies. Correctly answer case study related multiple choice questions • Be prepared to participate in a discussion of critical thinking questions.• Describe the principle, sources of error, limitation, and clinical application of the antinuclear antibody visible method • Describe the principle and clinical applications of the rapid slide test for antinucleoprotein and autoimmune enzyme immunoassay ANA screening test • Correctly answer end of chapter review questions.It is imperative that pathologists reach a consensus concerning the definition of the different classes of SLE nephritis and the meaning of the pathologic terminology applied in order to standardize the way biopsies are interpreted and reported between different centers.With these objectives in mind, a group of renal pathologists, nephrologists, and rheumatologists convened to formulate a revised classification of lupus nephritis during a 3-day consensus conference held at Columbia University, New York, New York in May 2002.

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SLE is a multisystem autoimmune disease whose etiology and pathogenesis are incompletely understood.

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