SLE features Flashcards
What is SLE?
Multisystem autoimmune disorder characterised by type 3 hypersensitivity reactions against nuclear contents of cells
This leads to immune complex deposition just about fucking anywhere in the body - which leads to local inflammation in these areas
What organ systems/tissues can be affected by SLE?
It can be useful to think about these when trying to remeber the millions of features
Skin
Mucosa & serosa
MSK
Renal
CVS
Respiratory
Neuro
What are the features of SLE - affecting the Skin?
Briefly explain what each is…
Malar rash - butterfly rash of face
Discoid rash - scaly, erythematous rash in sun exposed areas
Photosensitivity rash - rashes from sunlight
Reynauds
Alopecia
What MSK problems happen in SLE?
Arthritis
Arthralgia
What problems involving the mucosa & serosa can be present in SLE?
Ulcers - mouth & nose
Serositis - pleuritis, pericarditis
What features of SLE involve the CVS?
Pericarditis (common complication)
Myocarditis
Libmann-Sacks Endocarditis & aortic valve disease
What are the potential respiratory manifestations of SLE?
Pleuritis (aka pleurisy)
Fibrosing alveolitis
What are the renal manifestations of SLE?
Proteinuria
Glomerulonephritis
(esp Diffuse proliferative glomerulonephritis)
What effects can SLE have on le brain
Seizures
Psychosis
Depression
What are the haematological manifestations of SLE?
Leukopenia (low WCC)
Thrombocytopenia (low platelets)
Lymphocytopenia (low lymphocytes)
Haemolytic anaemia
ESR is raised
What are the general manifestations of SLE?
Fatigue
Fever
Lymphadenopathy
Describe the diagnostic criteria for SLE
Just think system by system, note that only some of the previously mentioned manifestations are diagnostic though
4 or more of:
- Malar rash
- Discoid rash
- Photosensitivity rash
- Ulcers (oral)
- Serositis - pleuritis or pericarditis
- Arthritis
- Renal manifestations (proteinuria, glomerulonephritis)
- Neuro manifestations (psychosis, seizures)
- Haematological manifestations
- +ve Immunology
- +ve ANA
What immunology stuff is looked for in SLE?
ANA
Anti dsDNA
Anti Smith (Sm)
Anti phospholipid
Anti-ro & anti-la (pregnancy)
Lupus anticoagulant
Low compliment
Note - ANA is seperate from immunology in the criteria
Mnemonic for criteria - DOPAMINE RASH
- Discoid rash
- Oral ulcers
- Photosensitivity rash
- Arthritis
- Malar rash
- Immunology (anti smith, dsDNA, phosphoL, ro, la)
- Neuro (psychosis & seizures)
- ESR raised
- Renal (proteinuria, glomerulonephritis)
- ANA
- Serositis (pleuritis, pericarditis)
- Haematology (leuko,thrombo,lymphocytopenia & heamolytic anaemia)
