SLE

Question 1

Presentation

Answer 1

Erythematous, maculopapular rash in a butterfly distribution - scaling and follicular plugging - scarring rash, exacerbated by sun
Symmetrical arthropathy of the small joints affecting the PIP and MCP joints
Raynaud’s

Question 2

Multisystem

Answer 2

Skin - butterfly rash, photosensitivity, palmar erythema, vasculitic lesions, purpura, urticaria, livedo reticularis, telangectasia, alopecia, Raynaud’s
MSK - non-erosive polyarthritis, JAccoud’s arthropathy,
Resp - ILD, pleural effusions
CV - pericarditis, myocarditis, heart failure
Neuro - seizures,
Haem - splemomegaly
Renal - lupus nephritis

Question 3

Causes of drug induced lupus

Answer 3

Procainamide, hydralazine, isoniazid, quinine

Question 4

Drug induced lupus Ab

Answer 4

Anti-histone

Question 5

SLE Ab

Answer 5

Anti-dsDNA

Question 6

Jaccoud’s arthropathy

Answer 6

Non-erosive deforming arthritis - affecting ligaments and peri-articular soft tissues

Question 7

Management - non pharmacological

Answer 7

Avoid sunlight
Avoid OCP
Stop smoking

Question 8

Management - pharmacological

Answer 8

NSAIDs
Hydroxychloroquine
Corticosteroids
Cytotoxic drugs - azathioprine, cyclophosphamide, mycophenolate, ciclosporin

Question 9

WHO classification lupus nephritis

Answer 9

I - normal
II - mesangial glomerulonephritis
III - focal proliferative GN
IV - diffuse proliferative GN
V - membranous GN
VI - sclerosing GN