Systemic lupus erythematosus

Question 1

What is SLE?

Answer 1

Systemic lupus erythematosus (SLE) is a chronic multi-system autoimmune disorder.

Question 2

What are risk factors for SLE?

Answer 2

Female, child-bearing age
African, Asian
HLADR8, DR2, DR3
Family history

Drug induced

Question 3

What are some clinical features of SLE?

Answer 3

Lots.
fatigue, weight loss, fever,

Cutaneous: non-scarring alopecia, malar or discoid rash

Arthralgia
Serositis e.g. lungs, heart

Renal

Question 4

How is SLE diagnosed?

Answer 4

SLICC criteria. Need >4 features, with 1 clinical and 1 immunological criteria

Question 5

What are differentials for SLE?

Answer 5

• RA
  
  • Antiphospholipid syndrome
  • Systemic sclerosis
  • Mixed CRD
  • Lyme disease
  • Glomerulonephritis

Question 6

What are Ix for SLE?

Answer 6

immunology: ANA, ENA, complement, lupus anticoagulant

Bloods: FBC (leucopenia) Haemolytic anaemia , U+E for renal

Urinalysis and PCR, maybe renal biopsy

Will depend on Sx

Question 7

What is treatment of SLE?

Answer 7

Steroids, HCQ, belimumab are licensed in UK.

Will depend on Sx. Topical suncream for rash, topical steroids, NSAIDs if no renal impairment, other DMARDs, IVIG or plasmapheresis…

Question 8

What are complications of SLE?

Answer 8

Related to disease and related to treatments…