SLE Flashcards
How is the diagnostic criteria scored for SLE diagnosis?
4 out of 11 of the diagnostic criterias to be diagnosed with SLE.
What are the 11 diagnostic criterias for SLE?
MD SOAP BRAIN(lab findings)
What does MD SOAP stand for?
M: mallory rash
D: discoid rash
S: serositis (pleurisy, pericarditis, chest pain)
O: oropharyngeal ulcers
A: polyarthritis (similar presentation to RA)
P: photosensitivity
What are the four lab critierias?
B: blood features (haemolytic anaemia picture)
R: renal problems like lupus nephritis leading to proteinuria, oedema, hypertension and haematuria and cast formation
A: ANA positive
I: Immunological findings (anti-dsDNA, anti-Smith antibodies)
What is the SLE triad?
Fatigue, arthritis and skin rash.
Which immunological tests would you do for Sjogren’s syndrome?
Anti-Ro, Anti-La
Anti-Ro tests for Sjogren-Syndrome related antigen A (SSA)
Anti-La tests for Sjogren-Syndrome related antigen B (SSB).
In which autoimmune diseases are ANA raised in particularly?
SLE, Sjogren’s syndrome, Raynaud’s phenomenon, scleroderma, thyroid diseases, TB, subacute bacterial endocarditis, drug-induced LE, primary biliary cirrhosis, viral (EBV, HIV, parovirus, HCV)
What types of lupus nephropathies are there?
- Minimal mesangial LN
- Mesangial proliferative LN
- Focal LN
- Diffused LN
- Lupus membranous nephropathy
- Advanced sclerosing LN
What is pathogenesis of mallory rash?
It is photosensitivity to UV light –> radiation causes apoptosis of cells with exposure of DNA to autoantibodies –> deposition of immune complexes in the UV exposed areas of the skin (type 3 hypersensitivity).
Nasolabial folds are spared as they are not as exposed to sunlight.
What antigen tests are specific for SLE?
Anti-Smith
Anti-dsDNA
Anti-histone antibody (drug induced lupus)
Antiphospholipid antibodies (lupus anticoagulant)
RF and anti-CCP
What is lupus anticoagulant?
It is an autoantibody/immunoglobulin against phospholipids and proteins of platelets and monocytes.
It leads to platelet adhesion and aggregation leading to thrombosis.
What are different classes and kidney damage associated with SLE?
1) Minimal mesangial LN (class I)
2) Mesangial proliferative LN (class 2)
3) Focal LN (class 3)
4) Diffused LN (class 4)
5) Lupus membranous nephropathy (class 5)
6) Diffused sclerosing LN (class 6)
7) Tubulointerstitial disease
8) Vascular disease
What different diagnosis can you make from immunofluorescence results?
- Centromere
- Homogenous
- Speckled
- Nucleolar
If the antinuclear bodies are staining:
- Centromere: limited systemic sclerosis
- Homogenous: SLE, drug-induced SLE, Sjogren’s
- Speckled: SLE, Sjogren’s, mixed CT disease, diffused systemic sclerosis
- Nucleolar: SLE or scleroderma
