SLE Flashcards
Define
DEFINITION: multi-system inflammatory autoimmune disorder
4/11 of the diagnostic criteria of the American College of Rheumatology provides high sensitivity and specificity for the diagnosis of SLE: SOAP BRAIN MD
- Serositis
- Oral ulcers
- Arthritis (non-erosive)
- Photosensitivity
- Bloods (haemolytic anaemia/leukopaenia/thrombocytopaenia)
- Renal disease (urine casts/proteinuria)
- ANA
- Immunological disorder (anti-dsDNA/anti-Sm/anti-phospholipid)
- Neurological disease (psychosis/seizures)
- Malar rash
- Discoid rash
Causes
UNKNOWN
Tissue damage may be caused by vascular immune complex deposition
Could be due to a combination of hormonal, genetic and exogenous factors
Epidemiology
COMMON
1-2/1000
More common in the YOUNG
More common in AFRO-CARIBBEAN and CHINESE
9 x more common in FEMALES
Symptoms and Signs
General Symptoms
- Fever
- Fatigue
- Weight loss
- Lymphadenopathy
- Splenomegaly
Raynaud’s phenomenon
Oral ulcers
Skin Rash
- Malar rash
- Discoid lupus (red scaly patches)
- Atypical rashes (e.g. photosensitivity, vasculitis, urticaria, purpura)
Systemic Involvement
- Musculoskeletal - arthritis, tendonitis, myopathy
- Heart - pericarditis, myocarditis, arrhythmias, Libman-Sacks endocarditis
- Lung - pleurisy, pleural effusion, basal atelectasis, restrictive lung defects
- Neurological - headache, stroke, cranial nerve palsies, confusion, chorea
- Psychiatric - depression, psychosis
- Renal - glomerulonephritis
Investigations
Bloods
- FBC
- U&E
- LFT
- Raised ESR
- Normal CRP
- Clotting
- Complement
Autoantibodies
- Anti-dsDNA (60%)
- Rheumatoid factor (30-50%)
- Anti-ENA
- Anti-RNP
- Anti-SM
- Anti-Ro
- Anti-La
- Anti-histone
- Anti-cardiolipin
Urine - haematuria, proteinuria, red cell casts
Joints - plain radiographs
Heart and Lungs - CXR, ECG, echocardiogram, CT
Kidneys - renal biopsy (if glomerulonephritis suspected)
CNS - MRI scan, lumbar puncture
