Multisystem Autoimmune Diseases

Question 1

What is Systemic Lupus Erythematous?

Answer 1

A chronic multi-system disorder that most commonly affects women during their reproductive years. It is characterised by the presence of antinuclear antibodies. In addition to constitutional symptoms, it most frequently involves the skin and joints, although serositis, nephritis, haematological cytopenias and neurological manifestations may occur during the course of the disease.

Question 2

What are the risks factors for SLE?

Answer 2

Smoking
Female
Onset is 15-50 years old
Ethnicity- Afro-Caribbean and Asians more likely to be affected
FH

Question 3

What are the cutaneous symptoms of SLE?

Answer 3

Butterfly rash on face that spares the nasal folds and is photosensitive
Discoid Rash
Urticaria
Vasculitis
Purpura
Oral Ulcers

Question 4

What is seen on a blood test in SLE?

Answer 4

Thrombocytopenia
Anaemia
Leukopenia

Question 5

What are the cardiac and respiratory symptoms involved in SLE?

Answer 5

Pericarditis
Endocarditis
Aortic Valve Lesions
Pleurisy
Fibrosis of the lungs
Pleural Effusion

Question 6

What are the Neuro symptoms involved in SLE?

Answer 6

Seizures
Peripheral Neuropathy
Ataxia
Hemiplegia
Cranial Nerve Lesions

Question 7

What other systems are affected by SLE?

Answer 7

Myopathy
Reynaud's phenomenon
Malaise
Depression
Abdominal Pain
Alopecia
Arthritis
Kidneys can shut down so need urine dipstick-symptoms of nephrosis
Dysphagia

Question 8

What investigations should be done in SLE?

Answer 8

Do investigations specific to the symptoms of the system affected ie chest X rays for lungs etc
FBC
PTT
Us and Es
ESR
CRP
ECG
Complement Consumption in a complement test

Question 9

What antibodies are found and should be tested for in SLE?

Answer 9

Smith Antigen
Anti Nuclear Antibodies
Double stranded antibodies

Question 10

What is the management for SLE?

Answer 10

Manage the systemic symptoms appropriately

Question 11

What is Scleroderma?

Answer 11

Systemic sclerosis (SSc), also known as scleroderma, is a multi-system, autoimmune disease, characterised by functional and structural abnormalities of small blood vessels, fibrosis of skin and internal organs, and production of auto-antibodies.

Question 12

What are the risk factors for scleroderma?

Answer 12

FH
Exposure to toxins such as silica dust
Male
Onset is age 30-50 years old

Question 13

What does CREST mean in scleroderma?

Answer 13

Calcified lesions on fingers
Reynaud's phenomenon
Oesophageal dysmotility
Sclerodactyly
Telangiectasia

Question 14

What are the two types of scleroderma?

Answer 14

Limited

Diffuse

Question 15

What are some complications of scleroderma?

Answer 15

Limited- Pulmonary hypertension
Diffuse-Pulmonary fibrosis
Renal crisis
Small bowel bacterial overgrowth

Question 16

What antibodies are positive in scleroderma?

Answer 16

Auto antibodies- ANA antibodies

Question 17

What is Sjogren’s syndrome?

Answer 17

Sjogren syndrome is a systemic auto-immune disorder characterised by the presence of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) as a consequence of lymphocytic infiltration into the lacrimal and salivary glands.

Question 18

What are the risk factors for Sjogren’s syndrome?

Answer 18

Female
Peak ages at 20s to 30s and after the menopause
Genetic factors
Other autoimmune diseases (then called secondary Sjogren’s)
HLA markers

Question 19

What are the symptoms of Sjogren’s syndrome?

Answer 19

Dry eyes
Dry mouth
Fatigue
Vasculitis
Dental Caries
Increased oral infections due to less saliva
Arthralgia
Myalgia
Enlarged parotid glands
Facial pain
Kidney Disease
GI and CNS symptoms
Reynaud's phenomenon
Systemic Symptoms

Question 20

What investigations should be done for Sjogren’s syndrome?

Answer 20

Schirmer's test-quantitively measure tears
Anti-60KD and anti-LA antibodies
Parotid gland studies
Skin biopsy
Sialometry

Question 21

What are the symptoms of autoimmune myositis?

Answer 21

Proximal and symmetrical muscle weakness