Systemic Lupus Erythematosus (SLE)

Question 1

What is SLE.

Answer 1

A multisystemic disease in which antibodies and immune complexes may can cellular and tissue damage.
Autoantibodies are made against a variety of autoantigens (eg ANA).

Question 2

What ethnic group is most affected by SLE.

Answer 2

African-Caribbean women aged 25-35 years.

Question 3

What is the most common age of onset of SLE.

Answer 3

25-35 years.

Question 4

What factors contribute to the development of SLE (besides age, sex and ethnic group). (2)

Answer 4

Concordance in twins.

Familial tendency.

Question 5

What are the symptoms of SLE. (6)

Answer 5

Fever.
Malaise. 
Fatigue. 
Arthralgia. 
Weight loss. 
Alopecia.

Question 6

What are the physical signs of SLE. (15)

Answer 6

Malar 'butterfly' rash. 
Discoid lupus. 
Mucosal ulcers. 
Vasculitic rash. 
Lymphadenopathy. 
Nail fold infarcts.
Non-infective endocarditis. 
Symmetrical arthritis. 
Raynaud's (30%).
Migraine (40%). 
Stroke. 
Sjogren's.
Episcleritis. 
Retinal infarcts. 
Optic neuritis.

Question 7

What is seen on the blood results of a patient with SLE. (6)

Answer 7

Coombs' positive haemolytioc anaemia. 
Neutropenia. 
Lymphocytopenia. 
Thrombocytopenia. 
Raised ESR. 
Normal CRP.

Question 8

What should you always check in a patient with SLE in the bloods.

Answer 8

Renal profile.

Question 9

What antibodies are present in SLE. (6)

Answer 9

ANA (>95%). 
Anti-dsDNA (60%). 
Anti-smRNA. 
Antiphospholipid antibodies. 
Anti-Ro/La (20-30%). 
Decreased C3 and C4.

Question 10

What is the mnemonic to remember the diagnositic criteria for SLE.

Answer 10

ORDER HIS ANA.

Question 11

What does ORDER HIS ANA stand for in the diagnostic criteria of SLE. (11)

Answer 11

Oral ulcers. 
Rash (malar).
Discoid rash. 
Exaggerated photosensitivity. 
Renal disease.
Haematological abnormality. 
Immunological abnormality.
Serositis. 
Arthritis (non-erosive). 
Neurological disease. 
ANA.

Question 12

How many criteria are needed to make a positive diagnosis of SLE.

Answer 12

4 out of 11.

Question 13

What are the mechanisms by which SLE causes tissue damage. (2)

Answer 13

Immune complex formation and deposition.
Complement activation.
Other direct effects.

Question 14

What is the prevalence of SLE.

Answer 14

0.2%.

Question 15

What is the genetic association with SLE. (4)

Answer 15

HLA B8, DR2 or DR3.

Question 16

What is the familial associated with SLE.

Answer 16

10% of relatives might be affected.

Question 17

What is a potential trigger of SLE.

Answer 17

EBV.

Question 18

What other conditions might SLE be associated with. (2)

Answer 18

Sjogren’s (15-20%).

Autoimmune thyroid disease (5-10%).