Systemic Lupus Erythematosus

Question 1

What is Systemic Lupus Erythematosus (SLE)?

Answer 1

A multi-system autoimmune disease.

Question 2

What is the pathology of What is Systemic Lupus Erythematosus (SLE)?

Answer 2

1) Auto-antibodies are made up against a variety of auto-antigens.
2) Therefore the immune system of the body mistakenly attacks healthy tissue/
3) Affects skin, joints, kidneys, brain and reproductive systems.

Question 3

What is the aetiology of Systemic Lupus Erythematosus (SLE)?

Answer 3

• Referred to as the disease of the young (15-50 years old)
• Female>Male (9:1 Ratio)
• Child bearing age women are more likely to be affected.
• Ethnicity: Afro-Caribbeans > Asians > Caucasians

Question 4

How many of the classification criterion should be present to be an acceptable diagnosis of Systemic Lupus Erythematosus (SLE)?

Answer 4

Any 4 of 11

Question 5

What are the classification criterion used to diagnose Systemic Lupus Erythematosus (SLE)? (11)

Answer 5

1) Malar Rash (butterfly rash) - 50% of cases.
2) Arthritis (in 2+ joints) - 90% of cases.
3) Anti Nuclear Body (ANA) - positive in over 95% of cases
4) Renal (proteinuria or cell cast)
5) Serositis (pleurisy or pericarditis)
6) Haematological (on another flashy)
7) Immunological (on another flashy)
8) Neurological (seizures or psychosis)
9) Discoid Rash (Alopecia, raised scarring, permanent marks)
10) Oral Ulcers
11) Photo-sensitivity

Question 6

What haematological symptoms / signs are associated with Systemic Lupus Erythematosus (SLE)? (4)

Answer 6

• Haemolytic Anaemia
• Thrombocytopenia
• Leukopenia
• Lymphopenia

Question 7

What immunological signs / antibodies are present in Systemic Lupus Erythematosus (SLE)? (6)

Answer 7

• Anti-dsDNA Antibody
• Anti-SM Antibody
• Anti-phospholipid Antibody
• Antinuclear Antibody (ANA)
• Lupus Anticoagulant
• Cardiolipin

Question 8

What investigations do we conduct for Systemic Lupus Erythematosus (SLE)? (4)

Answer 8

• Complement (decreased C3 and C4)
• Anti-dsDNA Antibody Titres
• Bloods (CRP normal and ESR raised)
• Blood Pressure

Question 9

What treatments are available for Systemic Lupus Erythematosus (SLE)? (3)

[think mild, moderate and severe]

Answer 9

Mild: Hydroxychloroquine

Moderate: Azathioprine, Methotrexate, Mycophenolate

Severe: Cyclophosphamide, Rituximab