Rheum Flashcards
IgA nephropathy (Berger’s diseae) with systemic vasculitic involvement =
IgA vasculitis (Henoch-Schonlein Purpura)
Features of IgA Vasculitis (Henoch-Schonlein Purpura)
Purpura on extensors/buttocks
Abdo pain (GI bleeding)
Nephritis
(Polyarthritis)
IgA vasculitis (HSP) usually presents in
Children following an infection
anti-scl-70 (anti-topoisomerase) is highly specific for:
Diffuse cutaneous systemic sclerosis (+ increased risk pulmonary fibrosis)
anti-centromere is highly specific for:
Limited cutaneous systemic sclerosis
anti-dsDNA is highly specific for:
SLE
anti-Smith is highly specific for:
SLE
anti-Mi-2 is highly specific for:
Dermatomyositis
but only present in 25%
anti-Jo-1 is seen in
Polymyositis (in disease with lung involvement, Raynauds & fever)
Indications for plasma exchange (plasmapharesis)
Guillain-Barre
Myasthenia gravis
Goodpastures
ANCA vasculitis with rapidly progressive GN
ANCA vasculitis with pulmonary haemorrhage
TTP/HUS
Cryoglobulinaemia
Hyperviscosity (eg in MM)
Anti-Ro are seen in
Sjogrens
Also SLE
SLE and pregnant - Which antibody signifies risk of neonatal heart block
Anti-Ro
Initial management of RA
DMARD monotherapy (usually methotrexate)
+/- bridging steroids
Other DMARD options in RA
Sulfasalazine
Leflunomide
Hydroxychloroquine
Management of RA - inadequate response to DMARDs
at least 2 DMARDs, including MTX
TNF-inhibitors:
Etanercept
Infliximab
Adalimumab
Before starting TNF-inhibitor
Screen for TB, Hep B
(+/-Hep C if risk) due to risk of re-activation