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12 Cards in this Set

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What is SLE?
• a multi-system autoimmune disorder of unknown cause

• characterized by periods of active disease and remission

• manifestations ranging from mild dermatologic and joint symptoms to life-threatening internal organ failure and cytopenias
What are theoretical causes of some of the clinical manifestations of SLE?
• trapping of antigen-antibody complexes in capillaries of visceral strucutres
• autoantibody-mediated destruction of host cells
True/False: SLE is more common in women
The correct answer is: True
What are manifestations of SLE that result in critical illness?
• lupus nephritis
• lupus cerebritis
• pulmonary hemorrhage
• small vessel vasculitis
What are common cutaneous features of SLE?
• alopecia
• discoid lesions
• malar "butterfly" rash
• nail fold infarcts
• periungual erythema
• photosensitivity
• splinter hemorrhages
• urticaria
Which autoantibodies are most specific for SLE?
• Smith (Sm) antigen: 99% specific
• double-stranded DNA (dsDNA): 95% specific
• Proliferating cell antigen (PCNA):95% specific
• Ribonuclear protein (RNP): 87-94% specific
Which autoantibody is most sensitive to SLE?
antinuclear antibodies (ANA)
In SLE, which autoantibodies are associated with lupus nephritis?
• anti-DNA
• anti-Smith
What are the criteria for diagnosing SLE?
Pneumonic: DOPAMINE RASH
• D: Discoid rash
• O: Oral aphthous ulcers
• P: Photosensitivity
• A: Arthritis
• M: Malar rash
• I: Immunologic criteria
• N: Neurologic changes
• E: ESR increased
• R: Renal disease
• A: ANA +
• S: Serositis (pleurisy, pericarditis)
• H: hematologic disease
What are the most common drugs that can cause drug-induced lupus erythematosus (DILE)?
• Procadinamide*
• Hydralazine*
• Chlorpromazine
• INH
• Methyldopa
• Quinidine
• Others (ex. anticonvulsants, beta-blockers, antimicrobials)

* most studied drugs to cause SLE
What are 4 features of DILE that differentiate it from SLE?
• sex ratio is nearly equal
• nephritis and CNS features are not usually present
• hypocomplementemia & antibodies to native DNA are absent
• clinical features & most lab abnormalities revert to normal when the offending drug is withdrawn
What are medical treatment options for SLE?
• NSAIDS
• glucocorticoids
• Hydroxychloroquine
• Immunosuppressives (ex. Azathioprine, Mycophenolate mofetil, Cyclophosphamide)
• IVIG
• Methotrexate