SLE Dx and Tx Flashcards
1
Q
Is SLE a polyarthralgia?
A
- YES (5 or more joints).
2
Q
What are the characteristic features of connective tissue diseases?
A
- polyarthritis
- systemic signs of disease
- multiple autoantibodies
3
Q
What are the criteria for SLE?
A
- malar rash (spares nasolabial folds).
- periungual erythema (redness around the nail beds).
- phosensitivity
- inflammation of PIP joints
- pericardial effusion
- verrucous endocarditis
- dementia and seizures
- ANA
- pleural effusion
- arthritis
- renal disorders
- leukopenia
- hemolytic anemia (reticulocyte elevation)
- thrombocytopenia (less than 100,000).
- anti-SMITH antibodies
- false-positive RPR syphilis screening tests
- antiphospholipid antibody syndrome
4
Q
What is the epidemiology of SLE?
A
- age of onset= 15-40
- black females mostly
5
Q
What complement deficiencies are seen in lupus?
A
- C1q, C4 and C2
6
Q
What environmental triggers are associated with SLE?
A
- UV light
- drugs
- smoking
- infections
- silica
- mercury
7
Q
What lab tests should you order for connective tissue diseases like SLE?
A
- CBC
- UA
- CMP
- ANA
- RA-latex
- ESR
8
Q
If ANA is positive, what else should you order?
A
- anti-dsDNA
- anti-ENA (RNP, SMITH, RO, LA).
- RPR
- complement
- anti-histone
9
Q
What is the most SPECIFIC test for SLE?
A
- anti-smith
10
Q
If a pt also has anti-RNP, what does that mean they likely have?
A
- Overlap disease; mixed connective tissue disease (MCTD)= SLE + Scleroderma + Polymyositis
11
Q
How do we manage SLE?
A
- NSAIDs
- Steroids (especially for pleural effusion).
- anti-malarials (work well for arthritis).
- cytotoxics (where steroids fail)= imuran or cytoxan
- methotrexate
- leflunomide
- DHEA
- mycophenolate mofetil
- belimumab (IV only)
12
Q
*** What does drug-induced lupus spare?
A
- renal and CNS
