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DOI: 10.1055/s-0033-1363352
Systemischer Lupus erythematodes und Lupusnephritis – Symptome und Diagnostik
Systemic Lupus erythematosus and lupus nephritis – Symptoms and diagnosticsPublikationsverlauf
Publikationsdatum:
25. November 2013 (online)
Der systemische Lupus erythematodes (SLE) ist eine Autoimmunerkrankung, die alle Organe befallen kann. Am häufigsten sind junge Frauen von der Erkrankung betroffen, deren Symptome Abgeschlagenheit, Hautausschläge, Haarausfall und Sonnenempfindlichkeit sowie Gelenkschmerzen oft unspezifisch klingen können. Für die Diagnosestellung ist daher eine detaillierte Anamnese und umfassende klinische Untersuchung nötig. Diese wird durch verschiedene Laborparameter ergänzt, wobei der Testung auf antinukleäre Antikörper eine besondere Bedeutung zukommt. Die Nierenbeteiligung bei SLE kann sich klinisch unterschiedlich manifestieren – von isolierter Proteinurie bis hin zum rapiden Nierenversagen. Eine Nierenbiopsie sollte zur Klassifikation der Lupusnephritis und Therapiewahl angestrebt werden.
Systemic lupus erythematosus is an autoimmune disease which can affect all organs of the body. The disease most frequently affects young women who may complain of tiredness, skin alterations, hair loss and joint pain. The diagnosis of SLE requires a comprehensive clinical history and physical examination. Specific autoantibodies such as antinuclear antibodies help to make the diagnosis. Renal manifestations of SLE cause different symptoms such as isolated proteinuria or renal failure with microhematuria. A kidney biopsy is required in most cases to classify the nephritis and to choose from different treatment options.
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Literatur
- 1 Cervera R, Khamashta MA, Font J et al. Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore) 1993; 72: 113-124
- 2 Cervera R, Khamashta MA, Font J et al. European Working Party on Systemic Lupus Erythematosus. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore) 2003; 82: 299-308
- 3 Weening JJ, D'Agati VD, Schwartz MM et al. International Society of Nephrology Working Group on the Classification of Lupus Nephritis, Renal Pathology Society Working Group on the Classification of Lupus Nephritis. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int 2004; 65: 521-530
- 4 te Borg EJ, Horst G, Limburg PC et al. C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study. J Rheumatol 1990; 17: 1642-1648
- 5 Eberhardt OK, Haubitz M, Brunkhorst FM et al. Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum 1997; 40: 1250-1256
- 6 Solomon DH, Kavanaugh AJ, Schur PH. American College of Rheumatology Ad Hoc Committee on Immunologic Testing Guidelines. Evidence-based guidelines for the use of immunologic tests: antinuclear antibody testing. Arthritis Rheum 2002; 47: 434-444
- 7 Rahman A, Isenberg DA. Systemic lupus erythematosus. N Engl J Med 2008; 358: 929-939
- 8 Yang XW, Tan Y, Yu F, Zhao MH. Combination of anti-C1q and anti-dsDNA antibodies is associated with higher renal disease activity and predicts renal prognosis of patients with lupus nephritis. Nephrol Dial Transplant 2012; 27: 3552-3559
- 9 Tan EM, Cohen AS, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-1277
- 10 Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725-1725
- 11 Petri M, Orbai AM, Alarcón GS et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64: 2677-2686