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Pathology
Chronic inflammatory multisystem disease that follows a relapsing and remitting course, and characterized by autoantibody response to nuclear and cytoplasmic antigens
Aetiology
Unknown aetiology.
Peak in Afro-Caribbean women 25-35 years
Associated with epilepsy, digital infarcts, alopecia and pleurisy
Signs
Malar ‘butterfly’ rash, discoid rash, episcleritis, optic neuritis, Raynaud’s phenomenon, Sjögren’s syndrome, mucosal ulceration, symmetrical arthritis
Symptoms
Arthralgia, fever, malaise
Investigations
Bloods: FBC shows pancytopenia, Raised ESR & CRP, Decreased C3/C4 Levels
Auto-Antibodies: ANA, Anti-dsDNA, Anti-Sm (Most specific antibody for SLE),
anti-cardiolipin, anti-Ro/La, anti-histone.
Renal Biopsy: Lupus nephritis.Treatment
Medical: NSAIDs for arthritis, corticosteroids, immunosuppression
Prognosis
80% survival at 15 years.
Increased long term risk of cardiovascular disease and osteoporosis
Cardiovascular: Pericarditis, myocarditis, endocarditis (Libman-Sacks)
Neurological: Stroke, fits, psychosis
Renal: 50% develop lupus nephritis
Respiratory: ARDS, pleural effusion
Key Facts
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Key References
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