SLE

Question 1

Systemic lupus erythematous defin

Answer 1

Multisys AI dis. Ab produc against various Ag. Polyclonal B cell sec.
tiss dam by eg imm complex format and deposit, complem activat etc.

Question 2

Feats

Answer 2

Remitting and relapsing.
Non specif eg malaise, fatigue, myalgia, fever.
Malar rash, discoid rash, photosensitiv, oral ulcer, non erosive arthritis, serositis, renal disord eg proteinuria, CNS disord eg seiz, blood disord eg haemolytic anaem/leukopenia/lymphopenia/thrombocytopenia, imm disord eg anti dsDNA/anti Sm/anti Plip.
Lymphadenopathy, wl, alopecia, nail fold infarct, non infec endocarditis, raynauds.
Antinuclear Ab (ANA) in 95%

Question 3

Immunology and investig

Answer 3

95% ANA pos
Anti dsDNA in 60%
ENA up to 30%
40% RhF pos
Anti Plip
AI thyr dis in up to 10%
Other investig-
Low C3 and 4 
Somet high ESR
CRP NORMAL

Question 4

Drug induced

Answer 4

Isoniazid
Procainamide
Chlorpromazine
Phenytoin
Quinidine

Question 5

Mx

Answer 5

-severe flares-
Cyclophosphamide and high prednisolone
-cutaneous-
Topical steroids, sun cream preven
-maint-
NSAIDs, hydroxychloroquine, low steroids, azathioprine, methotrexate, mycophenolate. 
-nephritis-
Cycophsphamide, mycophenolate. 
-B cell deplet-
Rituximab

Question 6

Prog

Answer 6

80% surv at 15yr