Systemic Lupus Erythematosus

Question 1

Three risk factors for SLE

Answer 1

1. Female
2. Age 15-35
3. Non-European

Question 2

Which type of hypersensitivity response?

Answer 2

III

Question 3

Two main features of childhood SLE

Answer 3

1. Butterfly rash

2. Photosensitivity

Question 4

Diagnostic criteria for SLE

Answer 4

SOAPP BRRAIN MD

• Serositis
• Oral ulcers
• Arthritis
• Photosensitivity
• Pulmonary fibrosis
• Blood disorders
• Renal involvement
• Raynaud’s phenomenon
• Anti-nuclear antibodies
• Immunologic phenomena (dsDNA, anti-Sm, anticardiolipin)
• Neurologic disorder
• Malar rash
• Discoid rash

4 or more!

Question 5

Histological appearance of SLE-affected kidney

Answer 5

Membranous glomerulonephritis with “wire loop” abnormalities - immune complex deposition along GBM leading to granular appearance in immunofluorescence testing

Question 6

Pharmacological management of SLE (5)

Answer 6

• Immunosuppression (steroids, NSAIDs, cyclophosphamide)
• DMARDs (hydroxychloroquine, methotrexate, azathioprine)
• Analgesia (opioids)
• IV immunoglobulins
• Blood thinners (for antiphospholipid syndrome)

Question 7

Leading cause of death in SLE

Answer 7

Cardiovascular disease due to accelerated atherosclerosis

Other causes - infections, osteoporosis, cancer

Question 8

Poor prognostic factors (5)

Answer 8

1. High serum creatinine
2. Hypertension
3. Nephrotic syndrome
4. Anaemia
5. Hypoalbuminaemia