[8] Systemic Lupus Erythematosus Flashcards
What is SLE?
A multi-systemic autoimmune inflammatory disease in which auto-antibodies to a variety of autoantigens result in the formation and deposition of immune complexes
What is the prevalence of SLE?
0.2%
What is the male:female ratio of SLE?
M:F = 1:9
What age does SLE present?
Child bearing age
Which ethnicity has a higher incidence of SLE?
Afro-caribbeans and Asians
What course does SLE take?
Relaxing and remitting
What constitutional symptoms are present in SLE?
Fatigue
Weight loss
Fever
Myalgia
What are the categories of clinical features of SLE?
Renal Serosal Haemotological Immune Neurological Other
What are the other symptoms of SLE?
Arthritis
Photosensitivity
Oral ulcers
Rash
Describe the arthritis in SLE
Non-erosive
Involving peripheral joints
What arthritic condition might develop in SLE?
Jaccourd’s arthritis
What is Jaccourd’s arthritis?
A reducible deforming arthropathy
What are the renal features of SLE?
Proteinuria
Increased BP
What are the serosal features of SLE?
Pleuritis
Pericarditis
What are the features of pleuritis in SLE?
Pleuritic pain
Dyspnoea
Effusions
What are the symptoms of pericarditis in SLE?
Chest pain relieved by sitting forwards
What are the haemotological features of SLE?
Autoimmune haemolytic anaemia
Decreased WCC
Decreased platelets
What are the immune features of SLE?
Anti-dsDNA antibodies
Anti-Sm antibodies
Anti-phospholipid antibodies
What are the neurological features of SLE?
Seizures
Psychosis
What rash might develop in SLE?
Malar rash
Discoid rash
What is a malar rash?
Facial erythema sparing the nasolabial folds
What happens in a discoid rash?
Erythema leads to pigmented hyperkeratotic papules, leading to atrophic depressed lesions
Where does the discoid rash affect in SLE?
Mainly the face and chest
What % of cases of SLE are ANA +ve?
95%
What immunology test is very specific for SLE?
dsDNA
What is the sensitivity of dsDNA test for SLE?
60%
What % of cases of SLE are ENA +ve?
30%
How is disease activity monitored in SLE?
Ant-dsDNA titres
Complement
ESR
What happens to complement in SLE?
Decreased C3 and C4
What happens to ESR in SLE?
Increases
What other investigations should be done in SLE?
Bloods
Urine
What blood tests should be done in SLE?
FBC
U&E
CRP
Clotting
What urine tests should be done in SLE?
Dipstick
PCR
Where should SLE be managed?
In specialist SLE and lupus nephritis clinics
