Systemic lupus erythematosus

Question 1

What are the common symptoms of SLE?

Answer 1

80% have skin involvement: Malar rash sparing nasolabial folds, photosensitivity, discoid rash in sun exposed areas, telangiectasia, nail capillary dilation
Arthritis and arthralgia
Systemic: Fever, fatigue, weight loss

Question 2

What are less common symptoms of SLE?

Answer 2

Non-scarring alopecia, lymphadenopathy, mouth ulcers
Vascular: Raynauds, vasculitis
Heart: Pericarditis, endocarditis
Lungs: Pleuritis, pneumonitis, pulmonary HTN, interstitial lung disease
Kidneys: Glomerulonephritis
Neuro: Seizures, psychosis
Haem: Anaemia

Question 3

What do investigations show in SLE?

Answer 3

ANA, Anti-dsDNA, Anti-Sm
HLA-DR2 and HLA-DR3
Raised ESR, normal CRP
Low C3 and C4
Bloods: Haemolytic anaemia, thrombocytopaenia, leukopenia

Question 4

What is the management of SLE?

Answer 4

General: Avoid sun, stop smoking
Pharma: Hydroxychloroquinine, steroids
If severe: Immunosuppression e.g. azathioprine