SLE

Question 1

ix of sle

Answer 1

99% ana + (but low specificity)
anti-dsDNA
anti-smith

OTHERS
anti-U1 RNP, anti-Ro, anti-LA

Question 2

specificity and sensitivity of anti-dsDNA for sle

Answer 2

> 99% specificity
70% sensitivity

Question 3

specificity and sensitivity of anti-smith for sle

Answer 3

> 99% specificity
30% sensitivity

Question 4

monitoring of sle

Answer 4

inflammatory markers: ESR better
CRP may be normal during active disease (if raised suggests underlying infection or serositis) - but non-specific

complement (C3, C4) low during active disease (as forming complexes consumes it)

anti-dsDNA can be used and would be high, but not present in all pt

Question 5

epidemiology of sle?

Answer 5

9:1 f:m
more common in Afro-caribbeans and Asian communities
20-40y onset

Question 6

what genes is sle a/w?

Answer 6

hla b8
hla dr2
hla dr3

Question 7

immune complexes in sle can affect?

Answer 7

any organ - incl skin, joints, kidneys, brain

Question 8

immune complexes in sle can affect?

Answer 8

any organ - incl skin, joints, kidneys, brain

Question 9

low levels of what complement levels are a/w increased risk of sle?

Answer 9

c4a
c4b
(c3?)

Question 10

mx of SLE?

Answer 10

hydroxychloroquine
lifestyle: dietary advice, smoking cessation, sun protection, exercise, and psychological therapy

Question 11

typical dose of hydroxychloroquine?

Answer 11

200-400 mg/day orally given in 1-2 divided doses

Question 12

what is monitored for in pt taking hydroxychloroquine?

Answer 12

ophthalmological screening (by visual field examination and/or spectral domain-OCT)

recommended at baseline, after 5 years, and yearly thereafter in the absence of risk factors for retinal toxicity