Autoimmune connective tissue disease Flashcards
Name some common symptoms of SLE
Malar rash Joint pains Photosensitivity Reynaud’s Mouth ulcers Alopecia Dry/gritty eyes Dry mouth Vagnial dryness Dry skin
How should a severe flare of SLE be treated?
IV cyclophosphamide + high-dose prednisolone
What are the 3 best tests for monitoring activity of SLE?
Anti-dsDNA antibodies Complement C3 and C4 consumption ESR
How do we treat the cutaneous symptoms of SLE?
Topical steroid. Use sunblock to prevent rashes. Sun exposure can also trigger acute systemic flares
What are the signs of lupus nephritis?
High blood pressure, foamy urine, and oedema (usually legs, feet and ankles)
What is polymyositis?
Progressive symmetrical proximal weakness and auto-immune mediated myositis. (Chronic inflammation of the muscles).
What is dermatomyositis?
Progressive symmetrical proximal weakness and auto-immune mediated myositis. Also involves the skin- may see macular rash, helitrope rash, nailfold erthema, Gottron’s papules.
What kind of rash is this and what condition is it associated with?
Discoid rash.
SLE.
What kind of rash is this and what condition is it associated with?
Heliotrope rash.
Dermatomyositis.
What kind of rash is this and what condition is it associated with?
Malar rash.
SLE.
What are the causes of erythema nodosum?
Sarcoidosis, drugs (sulphonamides, the Pill, Dapsone), streptococcal infection.
Rarer= Crohn’s/UC, BGC vaccination, Mycobacteria
What are the main symptoms of fibromyalgia?
Pain in at least 11 trigger points in the body,
Sleep deprivation,
Menorrhagia,
Low mood,
Fatigue,
Poor concentration
How do we treat fibromyalgia?
Physiotherapy
CBT
Patient education
Painkillers- tricyclic antidepressants (e.g. amitryptiline), neuropathic painkillers (e.g. pregabalin, gabapentin).
If these fail may use SNRIs.
What are the symptoms of limited cutaneous sclerosis (CREST syndrome)?
Calcinosis
Raynaud’s
Esophageal and gut dysmotility
Sclerodactyly
Telangiectasia
What are the symptoms of antiphospholipid syndrome (CLOT)?
Coagulation defects
Livedo reticularis
Obstretric (recurrent miscarriages)
Thrombocytopenia
How do we treat large-vessel vasculitis (e.g. giant cell arteritis)?
Steroids (prednisolone)
With adjuncts of aspirin and bone protection.
How do we treat medium/small vessel arteritis?
Steroids and IV cyclophosphamide (15mg/kg)
In what condition might you see cherry red spots in the retina?
Giant cell arteritis (due to central retinal artery occlusion)
What is Kawasaki’s disease?
An autoimmune acute systemic vasculitis affecting children under 5.
Key symptoms of Kawasaki’s disease?
1) Bilateral conjunctivitis
2) Dry lips, stawberry tongue
3) Acute cervical lympahdenopath
4) skin rash
5) swelling of hands and feet
What is a classical symptom of churg-strauss syndrome (could mention in an SBA?)
Asthma
