SLE Flashcards
Systemic Lupus Erythematosus
Multisystemic autoimmune inflammatory disease resulting in the formation and deposition of immune complexes
Epidemiology of SLE
F»M=9:1
Child-bearing age
↑ in Afro-Caribs and Asians
Features of SLE
Relapsing, remitting history Constitutional symptoms: fatigue, wt. loss, fever, myalgia Malar rash Livedo reticularis Alopecia
A RASH POINts an MD
Arthritis - non erosive
Renal - proteinuria + HTN ANA +ve Serositis - pleuritis and pericarditis Haematological - AI haemolytic anaemia Photosensitivity Oral ulcers Immune - anti dsDNA, Sm, phosopholipid Neurological - seizures
Malar rash
Discoid rash
SLE antibodies
95% ANA +ve
dsDNA is very specific
ENA +ve: Ro, La, Smmoth muscle antibody
Ix and monitoring disease activity in SLE
Monitoring:
- Anti-dsDNA
- Complement: ↓C3, ↓C4
- ↑ESR
- Urine dipstick: PCR
Other Ix:
Bloods: FBC, U+E, CRP, clotting (usually normal)
Drug induced lupus
Causes:
- procainamide
- phenytoin
- hydralazine
- isoniazid
Anti-histone Abs in 100%
Mostly skin and lung signs
Disease remits if drug stopped
Mx of SLE
- Patient education - lifestyle modification, use of sunscreen
Start DMARDs:
- Hydroxychloroquine
- Azathioprine
- Mycophenolate
Use of steroids:
- Oral Prednisolone
- IV Methylprednislone
In Severe cases: IV Cyclophosphamide or Rituximab
CRP
Often normal