Case 3 - SLE

• What type of hypersensitivity is SLE?

  Type III
• What are the risk factors for SLE?

  Genetics (chromosome 6, C1q deficiency)

  Women

  Non-white populations

  Pregnancy (RF for flare)
• SLE is one of the most common autoimmune diseases.
• Mechanism of SLE

  Type 3 hypersensitivity to self antigens - autoimmunity

  Failre of central and/or peripheral self tolerance mechanisms -> antibody response to mounted to self antigens normally found in the cell nucleus -> plasma cells secrete IgG -> IgG bind to dsDNA from dying/dead cells -> formation of immune complexes that can deposit in vasculature

  Several different organs can be damaged
• What is the diagnosis of SLE?

  Based on clinical picture (symptoms)

  Presence of anti-nucleus antibodies
• What is the treatment of SLE?

  Corticosteroids -> suppress immune response -> reduce inflammation & tissue injury (due to immune complex deposition)

  Belimumab -> blocks B cell survival & stimulatory factor BAFF/BLvS -> B cells apoptosis -> reduces autoantibody levels
• What are the signs & symptoms of SLE?

  Wide range of symptoms

  Rash on face & arthritis = classic presentations