SLE

Question 1

who is most affected?

Answer 1

asian
women
young to middle aged

Question 2

leading cause of death

Answer 2

CVD and infection

Question 3

antibodies

Answer 3

ANA +ve

dsDNA, anti Ro, anti Smith

Question 4

rash

Answer 4

photosensitive malar rash

butterfly shape - spare nasolabial folds

Question 5

list some non-specific symptoms

Answer 5

depression, seizures 
alopecia 
photosensitive rash 
uveitis/iritis 
serositis
arthralgia 
lupus nephritis 
mouth ulcers 
splenomegaly 
fever
weight loss

Question 6

investigations

Answer 6

autoantibodies 
FBC, CRP, ESR
C3 and C4
immunoglobulins 
urinalysis - ACR
renal biopsy

Question 7

why do ACR and renal biopsy?

Answer 7

lupus nephritis

Question 8

diagnostic criteria

Answer 8

SLICC or ACR

ANA antibodies and clinical features

Question 9

complications

Answer 9

CVD
infection 
anaemia of chronic disease
pancytopenia 
pleuritis, ILD - fibrosis
neuropsychiatric
lupus nephritis 
recurrent miscarriage 
VTE

Question 10

treatment - 1st line

Answer 10

NSAIDs
steroids
hydroxychloroquine
suncream and avoidance

Question 11

other immunosuppressants

Answer 11

methotrexate
MMF
azathioprine, leflunomide, ciclosporin

Question 12

biologics

Answer 12

rituximab - CD20

belimumab

Question 13

What other antibodies may be +ve?

Answer 13

antiphospholipid - anticardiolipin and lupus anticoagulant

Question 14

What happens to complement?

Answer 14

C3 and C4 low in active disease

Question 15

how many clinical and lab needed for diagnosis?

Answer 15

atleast 4 in total

atleast 1 of each

Question 16

Can you list any of the 11 clinical criteria?

Answer 16

malar rash 
discoid rash 
non scarring alopecia 
oral/nasal ulcers
synovitis 
serositis 
urinalysis - proteinuria or red cast cells 
neurological features 
haemolytic anaemia 
leucopenia 
thrombocytopenia

Question 17

Can you list any of the 6 lab criteria?

Answer 17

\+ve ANA
anti dsDNA
Anti smith antibodies
antiphospholipid ab
\+ve coombs test
low complement