lupus

Question 1

what is systemic lupus erythematosus

Answer 1

inflammatory autoimmune connective tissue disease
affects multiple organs

Question 2

SLE epidemiology

Answer 2

more common in women and asians
15-50 years old
afro-caribbean- asian- caucasian

Question 3

aetiology

Answer 3

genetic
HLA DR2, HLADR3
hormonal
UV light
drugs
infections- EBV

Question 4

symptoms

Answer 4

fatigue
butterfly malar rash photosensitive
weight loss
joint pain
myalgia
fever
mouth ulcers
lymphadenopathy
hair loss
raynauds
pleuritic chest pain
splenomegaly
peripheral neuropathy

Question 5

classifcation criteria any 4 of

Answer 5

malar rash
discoid rash
photosensitivity
oral ulcers
arthritis
serositis (pleuritis or pericarditis)
renal (proteinuria or cellular casts)
neurological (seizures or psychosis)
Haematological (low WCC, platelets, lymphocytes, haemolytic anaemia)
Immunological (anti ds-DNA, Sm, cardiolipin, lupus anticoagulant, low complement)
ANA

Question 6

autoantibody in lupus

Answer 6

ANA seen in 95% of SLE patients. NOT specific
negative ANA excludes SLE
not diagnostic

anti-ds DNA- seen in 60% of patients with SLE
highly specific

anti-smith -seen in 10-30% highly specific for SLE
highly specific

anti - ro - neonatal lupus

antiphospholipid antibodies

Question 7

investigations

Answer 7

autoantibodies
full blood count
C3 and C4 levels decreased
CRP and ESR
immunoglobulins raised
urinalysis and urine protein creatinine for lupus nephritis
renal biopsy for lupus nephritis

Question 8

management

Answer 8

anti inflammatory meds and immunosuppression

NSAIDs
steroids
hydroxychloroquine
methotrexate
leflunomide
ciclosporin
biologics