Rav Immunol Sle Mkas

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* Systemic lupus erythematosus is characterized by

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* Systemic lupus erythematosus is characterized by the presence of autoantibodies, hypocomplementemia, increased production of interferon-α and interferon-β, and evidence of organ dysfunction.

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are contraindicated in patients with severe or unstable systemic lupus erythematosus, antiphospholipid antibody positivity, or a history of thrombosis.
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* Estrogen-progestin oral contraceptives are contraindicated in patients with severe or unstable systemic lupus erythematosus, antiphospholipid antibody positivity, or a history of thrombosis.
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Lupus nephritis may manifest

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Lupus nephritis may manifest as new-onset hypertension or edema associated with high titers of anti–double-stranded DNA antibodies, hypocomplementemia, proteinuria, hematuria, and erythrocyte and granular casts in the urine.
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Patients with a strong clinical suspicion for lupus nephritis should begin

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Patients with a strong clinical suspicion for lupus nephritis should begin high-dose corticosteroid therapy before renal biopsy is performed.
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Neurologic manifestations of systemic lupus erythematosus include

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Neurologic manifestations of systemic lupus erythematosus include peripheral neuropathy, mononeuritis multiplex, cranial neuritis, transverse myelitis, aseptic meningitis, stroke, seizure, encephalitis, and psychosis.
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Cardiopulmonary manifestations of systemic lupus erythematosus include

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Cardiopulmonary manifestations of systemic lupus erythematosus include pleurisy, pericarditis, endocarditis, myocarditis, interstitial lung disease, pneumonitis, and pulmonary hemorrhage.
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The antiphospholipid syndrome manifests as

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The antiphospholipid syndrome manifests as venous and arterial thrombosis and recurrent fetal loss and may be associated with thrombocytopenia, hemolytic anemia, livedo reticularis, and cardiac valvular disease.
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Patients with symptoms suggestive of systemic lupus erythematosus should undergo

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Patients with symptoms suggestive of systemic lupus erythematosus should undergo an antinuclear antibody assay, complete blood count, erythrocyte sedimentation rate measurement, and urinalysis.
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Patients with a high pretest probability of systemic lupus erythematosus and the presence of antinuclear antibodies should undergo measurement of

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Patients with a high pretest probability of systemic lupus erythematosus and the presence of antinuclear antibodies should undergo measurement of C3, C4, and CH50 and assays for antibodies to anti–double-stranded DNA, anti-Smith, antiribonucleoprotein, and anti-Ro/SSA, and anti-La/SSB.

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* Patients with drug-induced lupus typically have

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* Patients with drug-induced lupus typically have antinuclear and antihistone antibodies but do not have renal or neurologic involvement or antibodies to anti–double-stranded DNA, anti-Smith, antiribonucleoprotein, or anti-Ro/SSA or anti-La/SSB.
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In patients with drug-induced lupus, symptoms resolve

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In patients with drug-induced lupus, symptoms resolve 4 to 6 weeks after withdrawal of the offending drug.

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can be used to relieve pain in patients with systemic lupus erythematosus who have arthralgia or serositis.

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* NSAIDs can be used to relieve pain in patients with systemic lupus erythematosus who have arthralgia or serositis.
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is safe and effective for skin and joint manifestations of systemic lupus erythematosus.

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Hydroxychloroquine is safe and effective for skin and joint manifestations of systemic lupus erythematosus.
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should be continued indefinitely when appropriate to help prevent flares of systemic lupus erythematosus even in patients with quiescent disease.

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Hydroxychloroquine should be continued indefinitely when appropriate to help prevent flares of systemic lupus erythematosus even in patients with quiescent disease.
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is superior to corticosteroids alone....In patients with lupus nephritis, combination

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In patients with lupus nephritis, combination therapy with monthly intravenous cyclophosphamide and high-dose corticosteroids is superior to corticosteroids alone.

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Once remission of renal disease associated with systemic lupus erythematosus has been achieved, switching from

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* Once remission of renal disease associated with systemic lupus erythematosus has been achieved, switching from cyclophosphamide to mycophenolate mofetil or azathioprine should be considered to maintain remission.
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Systemic lupus erythematosus is a risk factor for

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Systemic lupus erythematosus is a risk factor for premature atherosclerosis, death from coronary artery dise-ase, and hematologic malignancy.