Systemic Lupus Eryhtematosis

(SLE)

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Dx (4+ of)

-  Malar rash

-  Nose & cheeks, photosensitive

-  Discoid rash

-  Photosensitivity

-  Oral ulcers

-  Arthritis

-  Serositis

-  Renal, neuro, haem or immune disorder

-  Antinuclear antibodies (ANA)

-  Anti-dsDNA, anti-sm

 

Features

-  Female 3:1 male

-  Onset 16-55

 

Asssociated S/S

-  Fever, malaise, anorexia, weight loss

-  Anaemia

-  Thrombocytopaenia

-  Thrombosis (lupus anticoagulant): PE, stroke

-  Vasculitis

-  Pericardial effusion

-  Raynauds phenomenon

 

DDx

-  Drug induced

-  Hydralazine, Isoniazid, Methyldopa, Procanimide, Quinidine..

 

Investigations

-  Autoimmune Screen

-  ANA: anti-dsDNA, anti-sm, anti-histone

-  Antiphospholipid Ab: pro-coag

-  Anti-C1q: renal disease in SLE

-  RF may be + in SLE

-  FBE: pancytopaenia

-  Co-ags: Antiphospholipid Ab

-  U&E: renal function

-  Urinalysis: protein, blood

-  CXR

-  Echo

 

Management

-  NSAIDS, anti-malarials

-  Steroids

-  Immunosupressants: cyclophosphamide, azithioprine

-  Warfarin: if thrombotic risk