lupus Flashcards
classic presntation
patient comes in with arthritis
systemic systems
epidemiology
way more common in women and in afro caribbean orgin and asian
triggers
Oestrogen-containing contraception hence why women on the pill
oestrogen in general - hence why women
Overexposure to sunlight.
Infections.
Stress
triggers
Oestrogen-containing contraception.
Overexposure to sunlight.
Infections.
Stres
dermatological manifestations
ulcers /mouth,genital, nose
vasculatis - petechia, purpura
disocoid plaques
hair loss /alopecia
malar rash (spares the nasolabial folds)
also associated with levido reticularis /
- note there is a a variant with just discloud lupus and no other systemic fidninds
type of arthriis
The usual presentation is a polyarthritis which may be symmetrical or asymmetrical.
CVS presentations
raynauds phenomenon
carditis - peri is the most common
lungs
pleural
effusions
pneumonitis which chronic can lead to fibrosis
most common cause of lupus death
kidney problems
neurological
Seizures.
Migraines.
Peripheral neuropathies.
Psychiatric symptoms including psychosis or depression or anxiety.
hematological
Anaemia of chronic disease (common).
Lymphopenia (common).
Autoimmune haemolytic anaemia.
Thrombocytopenia.
Leucopoenia.
GI
Peritonitis (aseptic).
Hepatosplenomegaly.
WHAT OTher diseases is lupus associated with >
Secondary Sjogren’s syndrome
Secondary anti-phospholipid syndrome
Mixed connective tissue disease (features of SLE, systemic sclerosis and poly/dermatomyositis)
dil?
DRUG induced happens when someone takes meds for a month or more. in order to claim it they must have had no symptoms before the medication and symptoms would stop after
most common is the joint pain, and the systemic and serositis
malar rash less common and kindey involvement
drugs known to cause DIL
sulfadiazine
Isoniazid
hlorpromazine
what antibodies do we look for
doublce stranders
antinuclear antibodies
anti - sm
anti histone anitbodies
what specif anitbody to look for in DIL
anti - histone anitbodies ( a type of anti nuclear anitbody )
if you suspect someone has lupus what investigations
ESR CRP-i n absence of infection
urinalanalysi -screen for kindey involvement
complement - low c3 and c4
specific antibodies
which antibody cannot tell you much
ANA cos + in other diseases
whats more speicif for lupus
dbss
anti phospholipid
treatment of lupus
cs
malaria drugs - hydroxychloroquine
immunosuppressants like cyclophosphamide
DMARD
when do we use immunosippresnants
for more severe disease like organ invlvement othwrise if mild we use nsaids and hydroxychloroquine
when do we use immunosippresnants
for more severe disease like organ invlvement othwrise if mild we use nsaids and hydroxychloroquine
what do we use for lupus nephritis
CS and usually a cytotoxic drug like cyclopohosphamide
