SLE ☺️ Flashcards

1
Q

Epidemiology
Etiology
Pathophysiology

A

Female, 20-40s
Afro Caribbean, Asian

AI T3 hypersensitivity
-HLA B8, DR2-3
immune system dysregulation => immune complex formation, deposits in any organ

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2
Q

Presentation

  • general features
  • skin
  • MSK
  • CV, resp
  • renal
  • psych
A

General
-fatigue, fever, mouth ulcers, lymphadenopathy

Skin

  • photosensitivity
  • malar/discoid in sun exposed areas/non scarring alopecia
  • Raynaud’s, nailfold capillaries

MSK
-non erosive arthritis

CV

  • pericarditis
  • pulmonary fibrosis

Renal
-glomerulonephritis

Psych
-A+D

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3
Q

Investigations

A

AB - ANA, dsDNA, Smith
-Ro, La

High ESR
Low C3,4 (formation of complex => depletion)

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4
Q

Management

  • lifestyle
  • mild
A

CV risk factors
-exercise, alcohol, smoking, diet
Sun protection

Mild - HCQ + NSAIDS/CS
-can add methotrexate
Moderate - HCQ + immunosuppressive steroid sparing
Severe - lupus nephritis, neuropsychiatric lupus
-intensive immunosuppression + prolonged maintenance to prevent relapse

Belimumab, rituximab can only be used if criteria for use met

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5
Q

What is renal nephritis

  • assessment
  • management
A

Severe complication => ESRF

  • regular urinalysis for proteinuria
  • renal biopsy - diffuse proliferative GN due to immune complex deposits (most severe and common)

Management

  • HTN treatment
  • CS and immunosuppresants (azathiopurine)
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6
Q

What is the diagnostic criteria for SLE

A
Minimum of 4 criteria
-at least 1 clinical criterion
-at least 1 immunological criterion
OR
lupus nephritis as the sole criterion in the presence of ANA or anti dsDNA
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