Rheumatology 6 - SLE Flashcards
define systemic lupus erythematosus, SLE
autoimmune systemic connective tissue disease, characterised by ANA, dsDNA antibodies
presenting features of SLE
fatigue weight loss arthralgia myalgia fever photosensitive malar rash splenomegaly SOB pleuritic chest pain mouth ulcers hair loss Raynaud's
investigating SLE
FBC autoantibodies C3, C4 levels (low in active disease) CRP + ESR immunoglobulins
lupus nephritis:
- urine protein :creat ratio
- renal biospy
anti centromere antibodies
limited cutaneous systemic sclerosis
anti Ro, anti La antibodies
Sjogren’s syndrome
anti scl70 / topoisomerase antibodies
systemic sclerosis
anti Jo 1
dermatomyositis
diagnosing SLE
SLICC criteria
ANA Abs + clinical features
complications of SLE (many)
hypertension + CVD
infection
anaemia of chronic disease, low WBCs, low platelets
pericarditis (sharp chest pain worse on lying down)
pleuritis (sharp pain on inspiration)
pulmonary fibrosis
lupus nephritis (can go to ESRF)
neuropsych lupus (optic neuritis, transverse myelitis, psychosis)
recurrent miscarriage
which other autoimmune syndrome occurs in 40% of SLE patients?
antiphospholipid syndrome
treating SLE
NSAIDs
steroids
hydroxychloroquine if mild
avoid the sun
more extreme ISupp or biologics if resistant to treatment
define discoid lupus erythematosus
usually 20-40 yrs old
increased risk of SLE
lesions on face, ears, scalp
photosensitive
scarring alopoecia
skin biopsy confirms
topical, injected steroids
