Lupus and Gout

Question 1

Etiology of Lupus

Answer 1

Genetics, Hormonal, Evironmental

Question 2

Key Labs for Lupus Dx

Answer 2

• Anti-nuclear antibody (ANA)
• Anti-dsDNA
• Anti-SM
• Antiphospholipid Antibody
  (all +)

Question 3

Hydroxychloroquine

Answer 3

200-400 mg QD
AE: retinal toxicity, Neuroeffects, QT prolong

Question 4

Low Potency GC (Face)

Answer 4

Fluocinolone and Hydrocortisone

Question 5

Moderate Potency GC (trunk and extremities)

Answer 5

Triamcinolone and Betamethasone

Question 6

High-Potency (scalps sores and palms)

Answer 6

Clobetasol

Question 7

Immunosuppressants (Lupus)

Answer 7

adjunct to Steroid Tx
- MTX
- Mycophenolate Mofetil
- Cyclophosphamide
- AZA

Question 8

Biologics (Lupus)

Answer 8

Last Line
- Belimumab
- Anifrolumab
- Rituximab

Question 9

Calcineurin-i (CNI)

Answer 9

• TacroLIMUS (topical)
• PimecroLIMUS (topical)
• Voclosporin (PO) (Nephritis)
  eGFR needs to be >45

Question 10

Cutaneous Lupus Tx

Answer 10

• 1st Line: Topical Agents (CG or Tacro/PimecroLIMUS), HCQ, or Systemic GC
• 2nd Line: High dose GC, MTX, MMF

Question 11

Lupus Nephritis Tx:

Answer 11

• Mild/Mod (1 or 2): GC +/- AZA, MMF, or CNI
• Severe (3 or 4): MMF (preferred) or CYC +/- GC… OR 3xTx: Belimumab + MMF or CYC +/- GC… OR CNI +MMF +/- GC

Question 12

Pregnancy and LUPUS

Answer 12

• Safe: HCQ (DOC), NSAIDs, or GC
• CI: MMF, CYC, MTX, AZA, Biologics