systemic lupus erythematous

Question 1

what is SLE

Answer 1

complex autoimmune disease with multi-system involvement
can affect virtually all tissues

Question 2

what autoantibody is strongly associated with SLE

Answer 2

anti-nuclear antibody

Question 3

epidemiology of SLE

Answer 3

significant geographical variation for prevalence
most common in women of child bearing age

Question 4

pathogenesis of SLE

Answer 4

complex interaction between exposome (environmental factors ) and genome resulting in epigenetic change which alters expression of certain genes

Question 5

name 2 environmental and 2 genetic factors influencing SLE

Answer 5

environment - UVB radiation, infections
genetic - macrophage failure, deficiency of complement proteins

Question 6

Extra oral manifestations of SLE

Answer 6

• butterfly rash due to photosensitivity
• vascular dermatitis (raised red dry lesions)
• raynauds

Question 7

intra oral manifestations of SLE

Answer 7

• xerostomia (sjogrens or drug induces)
• active lesions - apthous ulcers
• non active lesions - pigmentation due to hydroxychloroquine

Question 8

diagnosis of SLE

Answer 8

ACR-EULAR criteria
1. must have ANA titre of >=1.80 on HPe-2 cells
2. must score at least 10 on weighted criteria

Question 9

weighted criteria in ACR - EULAR diagnosis of SLE

Answer 9

7 clinical categories e.g musculoskeletal, renal
3 immunological categories e.g complement proteins

Question 10

discoid lupus

Answer 10

primarily affects mucocutaneously, no systemic involvement

Question 11

main drug used in treatment of SLE

Answer 11

hydroxychloroquine

Question 12

phases of drug treatment for SLE

Answer 12

1. hydroxychloroquine = 1st line drug
2. glucocorticoids e.g prednisolone for flare ups
3. immunosuppresive agents if max dose 1 and 2 e.g azathioprine
4. monoclonal antibody therapy if max 3 e.g rituximab