4.3 SLE clinical pathology Flashcards Preview

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Flashcards in 4.3 SLE clinical pathology Deck (12)
1

what is the gene thought to be involved in SLE?

HLADR3

2

What are the clinical criteria for SLE?

Acute cutaneous lupus
Chronic cutaneous lupus
Oral or nasal ulcers
Non scarring alopecia
Arthritis
Serositis
Renal
Neurologic
Haemolytic anaemia
Leukopenia
Thrombocytopenia

3

What are the immunologic criteria for SLE?

ANA
Anti-DNA
Anti-Sm
Antiphospholipid Ab
Low complement
Direct coombs test

4

What do you need for a diagnosis of SLE?

4 or more criteria with at least one each of clinical and immunological

5

What is the charateristic rash for acute cutaneous lupus?

Malar butterfly rash - erythema and malar distribution over cheeks and bridge of nose sparing nasolabial folds - occurs after UV exposure

6

What would you see on skin biopsy in acute cutaneous lupus?

basal layer vacuolation, follicular plugging, mucin-dermal deposition
Immunofluroscence may detect immunoglobulin and complement at the dermo-epidermal junction

7

What is the presentation of chronic discoid lupus

discrete, erythematous plaques covered by a scale that extends into hair follicles - will have scarring alopecia

8

What is the typical pattern of SLE arthritis?

Migratory, usually gone after 24h
Usually finger PIPs, wrists and knees
Degree of pain exceeds objective physical findings
Rarely erosive on x-ray

9

Where do patients experience avascular necrosis?

Bilateral head of femur

10

What are SLE patients at higher risk for?

Osteonecrosis
Osteoporosis
Muscle disease
Alopecia
Arthritis/arthrialgia

11

What are the treatments for MSK aspects of SLE?

Analgesics - paracetamol
NSAIDs
Anti-malarials
Tricyclic antidepressants
Calcium and Vitamin D

12

What is the treatment for SLE?

hydrochloroquin
Methotrexate in moderately active disease with arthritis, pleural or pericardial serositis
Cyclophosphamide in severe disease with renal involvement
Azathioprine for steroid sparing effect
Mycophenolate for some renal disease