Rheum - Lupus/SLE Flashcards
Antihistamine antibodies suggest?
Drug-induced lupus
Hydralazine, procainamide, isoniazid
Manifestations of SLE?
I’M DAMN SHARP
#Immunoglobulins (anti-dsDNA, anti-Sm, antiphospholipid) #malar rash #Discoid rash #ANA #mucositis (oral ulcers) #Neurologic (psychosis, seizures, stroke) #serositis (pleuritis, pericarditis, Libman-saks) #Hematologic (anemia, leukopenia, thrombocytopenia) #Arthritis #Renal – diffuse, proliferative, or membranous GN #Photosensitivity
X-ray of SLE arthritis?
Normal – joint pain without deformation or erosion
Other ocular RA findings?
#Photophobia #Cotton wool spots #blindness
How to tell if an acute lupus flare?
Low complement and high anti-dsDNA
Treatment of acute SLE flare?
Chronic infection?
Lupus nephritis?
Steroids
Hydroxychloroquine and belimumab
Steroids and cyclophosphamide/Mycophenolate
How to determine the severity of lupus nephritis?
Biopsy
Most common cause of death in young lupus patients? Older patients?
Infection
MI
APLS syndrome - pathophysiology?
IgG or IgM antibodies (Lupus anticoagulant, anti-Cardiolipin) against negatively charged phospholipids
Lab tests that suggest ALPS?
Clotting + elevated PTT and normal PT
APLS may give a false positive on which other test?
RPR and VDRL
Suspect APLS – best initial test? Most specific test for lupus anticoagulant?
Mixing study (if elevated PTT remains elevated, ALPS)
Russell viper venom test
Treatment for ALPS?
#If asymptomatic, no treatment #if thromboses, treat like DVT
Who should be investigated for anti-cardiolipin antibody as a cause of spontaneous abortions? Management to prevent recurrence?
2+ first trimester events or a 1+ second trimester event
Heparin and aspirin (not warfarin)
