Systemic Lupus Erythematosus

Question 1

Typical Patient

Answer 1

Black Woman of Child baring age

Question 2

Symptoms

Answer 2

Relapsing and remitting: Constitutional symptoms, Joint Pain (2+), Rash

SEROSITIS (Pleuritis, Pericarditis)
ORAL ULCERS (Painless ulcers on palate)
ARTHRITIS (Small joints, non-erosive)
PHOTOSENSITIVITY (Malar rash, Discoid rash)

BLOOD DISORDERS (Haemolytic anaemia, Thrombocytopenia)
RENAL DISEASE (Glomerulonephritis)
AUTOANTIBODIES (ANA +Ve)
IMMUNOLGIC TESTS
NEURO (Seizures, Psychosis)

Increased CVS risk, Infertility, miss-carriage

Question 3

Investigations

Answer 3

Anti Nuclear Antibodies
Anti Ds DNA
Anti Smith Antibodies
Anti Ro/ La Antibodies
Anti Phospholipid Antibodies

Raised ESR, PV (Normal CRP)

Urinalysis
FBC, U&E

Skin Biopsy
Renal Biopsy

Question 4

Triggers

Answer 4

UV Light
Smoking
Oestrogen
Drugs: Isoniazid, Anti TNF

Question 5

Treatment

Answer 5

Avoid triggers
Reduce UV exposure
Reduce CVS Risk
Stop Smoking

Hydroxychloroquine
Etanercept/ Azathioprine
Prednisolone