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Flashcards in Systemic Lupus Erythematosus Deck (7):

What are the risk factors of SLE?

- Female
- age 15 - 45
- African/Asian decent


Pathophysiology of SLE

IgG antibodies to dsDNA and nuclear (ANA = anti nuclear antibodies)


What are the three main rashes that occur in SLE?

- Malar rash: erythema over the cheeks and bridge of nose, sparing the nasolabial folds
- Photosensitive rash: Rash occurs after sun exposure. It can be painful and pruritic and usually lasts a few days, healing without scarring
- Discoid rash: Erythematous raised patches with adherent keratotic scaling and follicular plugging. This is the chronic rash


Outline the articular features of SLE

Non - destructive, non-deforming polyarthritis i.e. REVERSIBLE (with fist, prayer and reverse prayer)


What are the common extra-articular features of SLE?

- The 3 rashes: malar, photosensitive and discoid
- Fatigue
- Weight loss
- Fever
- Oral ulcers
- Pleuritis and pericarditis (serositis)
- Renal impairment (proteinuria)
- Alopecia
- Fibromyalgia
- Raynaud's Phenomenon
- abdo pain, n/v


How do we diagnose SLE?

Clinical picture
FBE: anaemia, leukopaenia, thrombocytopaenia
Serology: ANA, anti-dsDNA
ESR and CRP elevated
Urinalysis: protein, red casts


What is the 1st line treatment of SLE, its adjuncts and other options in progressing disease?

1st line: NSAIDs + lifestyle changes
- Naproxen (main)
- Stop smoking, sun protection, exercise

Adjunct: Hydroxychloroquine

Adjunct: Corticosteroids
Predinisolone orally 5-40mg od

Adjunct: Methotrexate and folic acid