SLE Flashcards
What drugs can induce SLE?
Sulfonamides Hydralazine Isoniazid Phenytoin Procainamide
SHIPP
What complement levels are low in SLE?
C3 and C4
What antibodies might you request if suspecting SLE?
ANA
Anti- dsDNA
Anti- SM
Anti- Phospholipids
What complement levels would you investigate if suspecting SLE?
C3 and C4
What are some clinical features of SLE?
Acute cutaneous lupus- Malar/Butterfly rash Chronic cutaneous lupus- Discoid lupus Non-scarring Alopecia Oral/Nasal Ulcers Synovitis- Arthralgia Serositis- Pericarditis/Pleuritis Renal Impairment- Always do urine dip Neurological involvement- seizures, psychosis, confusional states Haematology- Haemolytic anaemia
What are the skin signs seen in SLE?
Acute cutaneous lupus- malar/butterfly rash that spares the nasolabial folds (it’s photosensitive)
Chronic cutaneous lupus- Discoid lupus, erythematous keratotic, scaly patches seen which heal with scarring.
Non- scarring alopecia is also a greaures.
What level of ESR and CRP is usually seen in lupus?
ESR is typically elevated
CRP is often normal
Why are complement levels low in lupus?
Formation of immune complexes uses up complement
Low levels of C3 and C4 are seen in lupus
What needs to be done before starting someone on hydroxychloroquine?
Retinal photographs as hydroxychloroquine can cause bull’s eye maculopathy
Ask patients about visual symptoms and monitor visual acuity annually
Why do you need to check visual acuity in patients taking hydroxychloroquine?
As it can cause Bulls Eye Maculopathy- damaging central vision
Note- Hydroxychloroquine is also used to treat RA (its one of the DMARDs along with methotrexate, sulfasalazine and leflunomide)
What are some of the clinical features of SLE?
Acute cutaneous lupus- malar rash Chronic cutaneous lupus- discoid lesions Non-scarring alopecia Oral ulcers Serositis- Pericarditis/ Pleuritis Lupus Nephritis- Renal Injury, Nephritis Syndrome Neurological- acute confusion, psychosis, delirium Arthralgia- due to synovitis Haemolytic anaemia
What non-specific features might someone with lupus describe?
Low grade fever
Fatigue
Nausea
Weight loss
What is lupus anti-coagulant, what does it cause?
This causes antiphospholipid syndrome secondary to lupus- it results in:
Clotting/coagulation defects (APTT is prolonged)
Livedo reticularis
Obstetric complications- recurrent miscarriages
Thrombocytopenia
What immunology tests might be requested if suspecting lupus?
ANA Anti dsDNA Anti SM Lupus Anticoagulant/ Anti-cardiolipin C3 and C4 (goes down)
What inflammatory markers might be requested?
ESR - Goes up
CRP- Typically is normal
THINK OF LUPUS IF MULTISYSTEM DISEASE WITH RAISED ESR BUT NORMAL CRP
