SLE Flashcards
ARA criteria for SLE
- Malar rash (sparing the nasolabial folds)
- Discoid rash
- Photosensitivity rash
- Oral ulcers
- Arthritis - non erosive and affecting two or more peripheral joints
- Serositis - pleurisy or pericarditis, with audible rub, effusion or ECF changes
- Renal disorder - persistent proteinuria >0.5g/day or cellular casts
- Neurological disorder - seizure or psychosis not related to drugs or metabolic abnormalities
- Haematological disorder (haemoytic anaemia,leukopenia lymphopenia, thrombocytopenia
- Immunological disorder - antiDNA antibodies in abnormal titre, or anti-smith antibody or positive anti-phospholipid antibodies
- ANA >1:160
four or more manifestations
Systems review for SLE
- Apthous ulcers
- Serositis
- Raynaud’s
- Alopecia
- Photosensitivity rashes
- Dry eyes and mouth
- Thrombosis
- Miscarriages
- Nephritis
Drugs inducing SLE
Procainamide
Hydralazine
Isoniazid
Methyldopa
Penicillamine
Chlorpromazine
Anticonvulsnats (particularly phenytoin)
What autoantibodies do you expect with minocycline/hydralazine induced lupus-like syndrome
ANA and ANCA
What are the two autoantibodies specific in SLE?
ds-DNA and anti-Sm (Smith)
What antibody is associated with mixed connective tissue disease?
Anti-nuclear ribonucleoprotein (anti-nRNP)
What autoantibody is associated with congenital heart block
anti-Ro-SS-A (also assocaited with primary Sjogren’s syndrome
What is the most common cause of death in mixed connective tissue disease?
Pulnonary arterial hypertension
What is the treatment for pulmonary hypertension in mixed connective tissue disease?
Cyclophosphamide
What is the monitoring for hydroxychloroquine?
annual retinal and visual field examination
When is steroids indicated in SLE?
CNS involvement, pericarditis, myocarditis, pleurisy, severe haemolytic anaemia, thrombocytopenis
What biopsy abnormality has the best prognosis for lupus nephritis?
Mesangial proliferative
Treatment to reduce the risk of abortion in women with antiphospholipid antibodies
Heparin + low dose aspirin
What steroid cross the placenta?
Dexamethasone?
