Lupus

Question 1

Serologies of lupus

Answer 1

• ANA is sensitive but not specific
• anti-dsDNA and anti-Sm ab are highly specific
• anti-dsDNA correlates with disease activity
• low C3 and C4 correlate to acute flare

Question 2

Drug-induced lupus

Answer 2

• common causes: hydralazine, procainamide, isoniazid, minocycline, TNF-alpha inhibitors
• symptoms: fever, serositis, arthritis
• serologies: ANA positive, antihistone ab positive

Question 3

Treatment of lupus

Answer 3

• arthritis: NSAIDs and hydroxychloroquine
• proliferative glomerulonephritis: IV cyclophosphamide or mycophenolate and high dose steroids
• life threatening disease such as lupus pneumonitis, inflammatory cns disease, severe cytopenia with high dose steroids, cyclophosphamide, azothioprine, or mycophenolate

Question 4

Diagnosis of lupus

Answer 4

Must have any 4 of the following:

• positive ANA
• malar rash
• discoid rash with erythematous, raised patches with keratotic scaling and follicular plugging
• photosensitivity
• oral ulcers
• arthritis
• serositis(pleural, pericardial, abdominal)
• kidney disorder(new onset HTN, proteinuria w/ or wo hematuria)
• neurological disorder: peripheral neuropathy, mononeuritis multiplex, cranial neuritis, transverse myelitis, aseptic meningitis, stroke, encephalitis, psychosis, seizures)
• hematologic disorder: autoimmune hemolytic anemia, leukopenia, lymphopenia, thrombocytopenia
• immunologic disorder: anti phospholipid syndrome,