Connective Tissue Disease 1 - SLE Flashcards
Dr S Silburn
where can SLE affect?
any part of the body
in whom is SLE more common?
females
9:1
asians, afro Americans and carribeans
uncommon in African blacks
what does the nuclear material released from necrotic cells act as?
auto-antibodies
outline some clinical criteria of SLE
cutaneous manifestations oral or nasal ulcers alopecia arthritis renal leukopenia
outline some immunologic criteria of SLE
ANA
Anti-DNA
Anti-Sm
name some mucocutaneous features seen in SLE
photosensitivity malar rash discoid lupus erythematosus subacute cutaneous lupus mouth ulcers alopecia
where is there sparing of in malar rash?
nasolabial folds
name some musculoskeletal features seen in SLE
Non-deforming polyarthritis/polyarthralgia
Deforming arthropathy - Jaccoud’s arthritis
Myopathy - weakness, myalgia & myositis
what is the difference on X-ray in someone with Jaccoud’s arthritis and someone with Rheumatoid arthritis
Jaccoud’s arthritis - x ray is normal
rheumatoid arthritis - x ray is not
to check kidneys in SLE, what test should you perform? what are you looking for?
urinalysis
protein and/or blood
whats the next step after urinalysis of kidney showing high protein or blood?
renal biopsy
name some neurological features seen in SLE
Depression/psychosis
Migrainous headache
Seizures
Cranial or peripheral neuropathy
Mononeuritis multiplex
name some haematological features seen in SLE
Lymphadenopathy
Leucopenia
Lymphopenia
Haemolytic anaemia
Thrombocytopenia
what does anti-phospholipid syndrome cause?
blood clots
miscarriage
are people with SLE more susceptible to infection?
yes
what are the 2 reasons you should look at autoantibodies for?
To confirm/establish diagnosis
To determine degree of organ involvement
name the important antibodies in SLE
ANA Anti-dsDNA Anti-Sm Anti-Ro Anti-RNP
which antibody is associated with neonatal SLE?
Anti-Ro
which autoantibody is most specific to SLE?
anti-double-stranded-DNA
name the anti-phospholipid antibodies
Anti-cardiolipin antibody
Lupus anticoagulant
Anti-beta 2 glycoprotein
Must be positive on 2 occasions 12 weeks apart
does CRP increase in SLE?
no
what is the drug treatment in SLE?
NSAIDs and simple analgesia
anti-malarials - hydroxychloroquine
steroids
immunosuppressives
biologics
as complement levels decrease in SLE, anti-DNA levels _______
increase
name some immunosuppressives
azathioprine
Cyclophosphamide
Methotrexate
Mycophenolate mofetil
name the treatments for the spectrum of SLE:
mild -
moderate -
severe -
mild - HCQ, NSAIDs
moderate - steroids, AZ, MTX
severe - IV steroids, Cyclophosphamide and biologics
