Lupus

Question 1

What are the 4 stages in the natural history of SLE

Answer 1

1. Healthy adult: no cellular or humoral auto-reactivity
2. Serological disease: autoantibodies and self reactive T cells but no Sx
3. Mild manifestations: expanding autoimmunity and few Sx (undefined but subtle like rash, brain fog, synovitis)
4. Disease: immune mediated pathology with resultant tissue and organ damage

Question 2

What is the definition of stage 2 SLE

Answer 2

Autoantibodies plus the following but not meeting the clinical criteria for SLE:
1. Leukopenia
2. Low platelet
3. Low complements
4. Isolated rash
5. Isolated joint

Question 3

What are the agents under study to prevent progression from incomplete to complete SLE

Answer 3

1. B cell: antiCD-20 and anti-Blyss
2. T cell: Abatacept
3. Type I IFN: HCQ and Anifrolumab