SLE Flashcards
Specific for lupus in high titer may correlate with lupus nephritis
DsDNA
Specific for SLE
Anti dsDNA antibody
Abx Associated with decreased risk for nephritis
Anti ro
Anti la
The most common chronic dermatitis in lupus
Discoid lupus erythematosus
The most common pulmonary manifestation of SLE
pleuritic with or without pleural effusion
Mainstay of treatment for life threatening manifestations
Systemic glucocorticoids
MC pattern of vasculitis not specific for SLE but may indicate active disease
leukocytoclastic vasculitis
Antibody assoc with sick syndrome
subacute cutaneous lupus
anti Ro
SSA
Antibodies specific for SLE
Anti Sm
Anti dsDNA - in high titers
% positivity of ANA in SLE
> 98%
SLICC criteria for SLE
Presence of 4 criteria (at least one in each category (clinical and immunologic)
clinical part SLICC criteria for SLE
Skin
Oral ulcers
Alopecia
Renal
Synovitis
Neuro
< Hemolytic anemia,
Leukopenia,
Thrombocytopenia >
SLICC criteria
immunologic
ANA > reference negative value Anti dsDNA Anti Sm APAS Low C3 Positive direct coombs test
The most common chronic dermatitis in lupus
Discoid lupus erythematosus
Treatment discoid lupus
GC
systemic antimalarials
Rx SLE
not life or organ threatening
Low dose GC and conservative treatment
if life/ organ threatening: high dose GC, with addition of: MMF or Cyclophosphamide
what antibodies do they most likely have? scaly red patches similar to psoriasis or circular flat red rimmed lesions
Subacute cutaneous lupus erythemasus
anti Ro antibodies SS-A
the most serious manifestation of SLE
nephritis
Leading causes of mortality in SLE
nephritis
infection
Most common manifestation of diffuse CNS lupus
cognitive dysfunction
SLE patients with antibodies to phospholipids risk for _____
- hypercoagulability
2. acute thrombotic events
most common manifestation of SLE
pleuritis with or with out pleural effusion
Rx SLE pleuritis with or with out pleural effusion
NSAIDs
and if severe, GC.
MC cardiac manifestation of SLE
pericarditis
Antibodies in ANA negative lupus
anti Ro
anti DNA
Used to identify the lupus anticoagulany
russel viper venom test
Risk for NSAID use in SLE patients
NSAID induced aseptic meningitis
anti BLys
Belimumab
Mainstay of treatment for any inflammatory life threatening manifestation
systemic GC
induction therapy of choice in patients with crescentic lupus nephritis
Cyclophosphamide
Glucocorticoids that should be used in pregnancy because a placental enzyme, 11 B dehydrogenase 2 inactivates others
Dexamethasone
Betamethasone
Rx to control SLE in pregnant women
Hydroxychloroquine (category D but benefits outweigh the risk) and if necessary prednisone/prednisolone at the lowest effective doses
Antibodies to Ro potential problem
neonatal heart lo
rash
Rx SLE patients with APAS
arterial clotting with repeated metal loses and at least 2 positive tests for APAS
Long term anticoagulation
INR 2-2.5 for 1 episode of venous clotting
INR 3-3.5 patients with recurring clots
Hemolytic uremic syndrome
Hemolysis
Thrombocytopenia
Microvascular thrombosis
Rx lupus dermatitis
minimise sun exposure
SPF 30
Topical GC and antimalarials
if fail: retinoid acid
MC cause of drug induced lupus
anti arrhythmics procainamide, disopyramide, propafenone, hydralazine
