Systemic Lupus Erythematous

Question 1

What is SLE?

Answer 1

An autoimmune disease where there’s inadequate T cell suppressor activity and increased B cell activity

Complex multi system disease with variable presentations

Characterised by remissions and flares

Can be familial

Question 2

What are the common symptoms and signs? (SOAP BRAIN)

Answer 2

Serositis 
Oral ulcers
Arthritis (small joints)
Photosensitivity (malar/discoid rash)
Blood Disorders (low WCC, lymphopenia, thrombocytopenia, haemolytic anaemia 
Renal involvement (glomerulonephritis)
Autoantibodies (ANA positive) 
Immunologic tests (low complements)
Neurologic disorder (seizures psychosis)

Question 3

What investigations are done for SLE?

Answer 3

ESR
Plasma viscosity
Autoantibodies - ANA, anti-Ro, anti-La, anti-dsDNA (rises with disease activity), antiphospholipid 
C3/C4
Urinalysis for renal disease
Skin biopsy
renal biopsy

Question 4

What is the treatment for SLE?

Answer 4

• Sun protection
• Healthy lifestyle advice, related to CV risk
• Hydroxychloroquine - rash and arthralgia
• Mycophenolate mofetil, azathioprine and rituximab
• short courses of prednisolone for flare ups